Implementation Strategies for Improving Survival After Out-of-Hospital Cardiac Arrest in the United States

Abstract

The goal of the 2009 American Heart Association (AHA) Cardiac Arrest Survival Summit was to develop consensus recommendations for implementation strategies to optimize the care of patients with out-of-hospital sudden cardiac arrest (OHCA). For the purposes of this conference, implementation was broadly defined as the translation of best practices into common practice. The scope was the entire system of care, including recognition and response by laypeople, emergency medical services (EMS) dispatch, EMS care, and hospital-based care. The conference planning committee included representatives from multiple disciplines involved in all stages of cardiac arrest care. Conference participants included stakeholders from the lay public, EMS systems, relevant clinical specialties, health insurance providers, and federal regulatory and funding agencies. Conference speakers were either selected by the conference planning committee on the basis of their content expertise or nominated by the organization they represented.Before the conference, participants provided written input by responding to a preconference questionnaire. The content of this questionnaire is available in the http://circ.ahajournals.org/cgi/content/full/CIR.0b013e31821d79f3/DC1. The questions were developed by the conference planning committee. All responses were free text. The responses were collated and distributed to the writing group for review. Writing group members drafted preliminary recommendations based on the survey results and the existing literature. These recommendations were refined through conference calls with invited speakers and panelists before the conference. Individual sessions focused on epidemiology, incidence and outcomes monitoring, systems of care, and culture change.The initial conference sessions consisted of invited speakers who highlighted key issues and presented evidence for best practices. These presentations were followed by panel discussions with audience participation. During the panel discussions, the preconference draft recommendations were further modified. The fourth session consisted of multiple breakout groups that addressed issues of culture change among lay providers, EMS providers, in-hospital providers, policy makers, and payers. These sessions …