Abstract 254: Systems-Based Statewide Program for Cardiac Resuscitation Leads to Increased Survival Over Time: A Report of the 5 Initial States in the Heart Rescue Project
Introduction: The Heart Rescue Project aims to improve survival from out-of-hospital cardiac arrest by supporting implementation of community-based best practices for the management of cardiac arrest patients. The project is supported by the Medtronic Foundation and is currently in its 4th year. Five university-based consortia sought to improve survival for their respective states: Universities of Minnesota, Pennsylvania, Washington, Arizona and Duke University.
Methods: The statewide initiatives included multifaceted programs that spanned the chain of survival. The activities included improving bystander CPR rates by increasing public awareness and education, optimizing prompt delivery and quality of CPR, facilitating interdisciplinary medical specialty programs and improving in-hospital post-arrest care, primary percutaneous coronary intervention, and optimal intensive care. Importantly, the HRP mandated prospective collection of data through the Cardiac Arrest Registry to Enhance Survival (CARES) to measure outcomes of cardiac arrest. We report outcomes from 2011 to 2013. A t-test for survival rates was performed between 2011 and 2013. Significance was set for p<0.05.
Results: In 2013 the efforts covered an overall population of 30 million people. The average survival rate of the 5 states for a witnessed arrest presenting with all rhythms increased from 15.0±5.2% in 2011 to 15.4±5.6% in 2012 and to 16.9±5.7% (p=0.005). In patients with shockable rhythms, survival to hospital discharge increased from 27.4 ±13.0% to 28.7±13.6% to 31.8 ±15.7% (p = 0.04) from 2011 to 2013 respectively. During this same time period, bystander CPR rates increased from 36.2±9 to 39±10 to 43.4±9.6 (p<0.001) for 2011 to 2013 respectively. The collective number of patients surviving to hospital discharge also increased in the three years from 1,023, to 1,536 and up to 1,989 partly because of the expanded population served over the same period.
Conclusion: The Heart Rescue Project has led to a significant collective improvement in survival for patients with witnessed OHCA over 3 years in 5 states. This program provides a useful model for statewide quality improvement and is actively expanding to new partners and neighboring states.
Author Disclosures: D. Yannopoulos: Research Grant; Significant; NIH 1R01HL123227-02; R01HL108926-04, Medtronic Foundation. M. Eisenberg: Research Grant; Significant; Medtronic Foundation. C. Granger: Research Grant; Significant; Medtronic Foundation. J. Jollis: Research Grant; Significant; Medtronic Foundation. B. Bobrow: Research Grant; Significant; Medtronic Foundation. T. Eckstein: Consultant/Advisory Board; Significant; Medtronic Foundation. B. Abella: Research Grant; Significant; Medtronic Foundation. L.B. Becker: Research Grant; Significant; Medtronic Foundation. T.D. Rea: Research Grant; Significant; Medtronic Foundation.
- © 2014 by American Heart Association, Inc.