RQI stands for Resuscitation Quality Improvement, a CPR training program launched by the American Heart Association in 2015. Instead of the traditional approach where healthcare workers take a full CPR course every two years, RQI uses short, frequent practice sessions spread throughout the year to keep life-saving skills sharp.
How RQI Works
The core idea behind RQI is “low-dose, high-frequency” training. Rather than sitting through an intensive refresher course once every 24 months, healthcare workers complete brief skill-check sessions on a quarterly basis. Each session combines three elements: self-paced online learning, hands-on practice with a manikin that gives real-time feedback on compression depth and ventilation quality, and short knowledge assessments.
This structure is designed around a well-documented problem in healthcare: CPR skills decay quickly after traditional certification courses. Within months of completing a standard Basic Life Support (BLS) class, most providers have already lost measurable proficiency in chest compressions and rescue breathing. By the time their two-year certification expires, the skills they’re using on real patients may look very different from what they demonstrated on test day.
RQI addresses this by breaking training into small, repeated doses. The quarterly sessions are self-directed, meaning healthcare workers can complete them on their own schedule using an RQI station at their facility. This makes the program far less disruptive than pulling staff off the floor for a half-day classroom course.
What Makes It Different From Traditional BLS
In a conventional BLS course, you learn and test on the same day. You demonstrate competency once, receive your card, and don’t formally practice again for two years. RQI flips that model. It treats CPR competence as something that needs ongoing verification, not a one-time checkpoint.
The program uses what’s called mastery learning and deliberate practice. You don’t just go through the motions on a manikin. The system measures specific performance metrics (how deep your compressions are, whether your ventilations deliver the right volume) and requires you to meet a passing threshold before you move on. If your technique has drifted since your last session, the feedback helps you correct it in real time.
A study published in the Joint Commission Journal on Quality and Patient Safety tracked healthcare workers at a community hospital over one year of RQI use. Their compression scores and ventilation scores improved significantly between the first and fourth quarterly sessions. The number of attempts needed to pass the ventilation portion also dropped over time, suggesting the frequent practice was building lasting muscle memory. Staff surveys taken 30 months after implementation showed increased confidence in their CPR skills and overall satisfaction with the program compared to the old model.
Where RQI Is Used
RQI was designed primarily for hospitals and health systems, where large numbers of clinical staff need to maintain CPR certification. Nurses, physicians, respiratory therapists, and other providers who might respond to a cardiac arrest are the typical users. The program has been adopted by hospitals across the United States and has also been implemented internationally. One study documented its rollout in the emergency department of a teaching hospital in China, where researchers found it effective for improving CPR competence in that setting as well.
Hospitals typically install dedicated RQI stations, compact setups with a practice manikin and a tablet or screen, in accessible locations so staff can complete sessions during a shift or between duties. The self-directed design means there’s no need to coordinate schedules with an instructor, which is a major logistical advantage for facilities that operate around the clock.
Why Hospitals Are Adopting It
The shift toward RQI is driven by both quality improvement goals and practical realities. Organizing traditional BLS courses for hundreds or thousands of employees is expensive and time-consuming. Pulling clinical staff away from patient care for classroom sessions creates scheduling headaches. And despite all that effort, the evidence consistently shows that skills fade long before the next recertification date.
RQI offers a more sustainable model. The quarterly sessions are short enough that they don’t require backfilling staff positions, and the self-paced format eliminates the need for dedicated instructors for every session. For hospital administrators, it also provides a data trail. The system tracks each provider’s performance over time, making it easier to identify trends, flag individuals who may need extra support, and demonstrate to accreditation bodies that staff competency is being actively maintained rather than checked once and forgotten.
From a patient safety perspective, the reasoning is straightforward. Cardiac arrest survival depends heavily on the quality of CPR delivered in the first few minutes. Compressions that are too shallow, ventilations that miss the mark, or hesitation from providers who haven’t practiced recently all reduce the chances of a good outcome. A training model that keeps those skills consistently sharp has a direct line to better resuscitation performance when it matters most.