Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties
Aim of the study: Survival to hospital discharge from out-of-hospital cardiac arrest (OHCA) after receiving treatment from emergency medical services (EMS) is less than 10% in the United States. Community-focused interventions improve survival rates, but there is limited information on how to gain s...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424000018 |
| _version_ | 1797242981343821824 |
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| author | Natalie Ezem Allison A. Lewinski Julie Miller Heather A King Megan Oakes Lisa Monk Monique A. Starks Christopher B. Granger Hayden B. Bosworth Audrey L. Blewer |
| author_facet | Natalie Ezem Allison A. Lewinski Julie Miller Heather A King Megan Oakes Lisa Monk Monique A. Starks Christopher B. Granger Hayden B. Bosworth Audrey L. Blewer |
| author_sort | Natalie Ezem |
| collection | DOAJ |
| description | Aim of the study: Survival to hospital discharge from out-of-hospital cardiac arrest (OHCA) after receiving treatment from emergency medical services (EMS) is less than 10% in the United States. Community-focused interventions improve survival rates, but there is limited information on how to gain support for new interventions or program activities within these populations. Using data from the RAndomized Cluster Evaluation of Cardiac ARrest Systems (RACE-CARS) trial, we aimed to identify the factors influencing emergency response agencies’ support in implementing an OHCA intervention. Methods: North Carolina counties were stratified into high-performing or low-performing counties based on the county’s cardiac arrest volume, percent of bystander-cardiopulmonary resuscitation (CPR) performed, patient survival to hospital discharge, cerebral performance in patients after cardiac arrest, and perceived engagement in the RACE-CARS project. We randomly selected 4 high-performing and 3 low-performing counties and conducted semi-structured qualitative interviews with emergency response stakeholders in each county. Results: From 10/2021 to 02/2022, we completed 29 interviews across the 7 counties (EMS (n = 9), telecommunications (n = 7), fire/first responders (n = 7), and hospital representatives (n = 6)). We identified three themes salient to community support for OHCA intervention: (1) initiating support at emergency response agencies; (2) obtaining support from emergency response agency staff (senior leadership and emergency response teams); and (3) and maintaining support. For each theme, we described similarities and differences by high- and low-performing county. Conclusions: We identified techniques for supporting effective engagement of emergency response agencies in community-based interventions for OHCA improving survival rates. This work may inform future programs and initiatives around implementation of community-based interventions for OHCA. |
| first_indexed | 2024-03-08T12:47:44Z |
| format | Article |
| id | doaj.art-ce1c05d9bf264ae2b32a9c030a8265ce |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-24T18:47:51Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-ce1c05d9bf264ae2b32a9c030a8265ce2024-03-27T04:53:03ZengElsevierResuscitation Plus2666-52042024-03-0117100550Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing countiesNatalie Ezem0Allison A. Lewinski1Julie Miller2Heather A King3Megan Oakes4Lisa Monk5Monique A. Starks6Christopher B. Granger7Hayden B. Bosworth8Audrey L. Blewer9Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United StatesDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States; School of Nursing, Duke University, Durham, NC, United StatesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United StatesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, United StatesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United StatesDuke Clinical Research Institute, Durham, NC, United StatesDuke Clinical Research Institute, Durham, NC, United States; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, United StatesSchool of Nursing, Duke University, Durham, NC, United States; Duke Clinical Research Institute, Durham, NC, United States; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, United StatesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States; School of Nursing, Duke University, Durham, NC, United States; Duke Clinical Research Institute, Durham, NC, United States; Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, United StatesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States; School of Nursing, Duke University, Durham, NC, United States; Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States; Corresponding author at: Duke University, Department of Family Medicine and Community Health, 2200 West Main Street, Suite 400, Room 461, Durham, NC, 27705, United States.Aim of the study: Survival to hospital discharge from out-of-hospital cardiac arrest (OHCA) after receiving treatment from emergency medical services (EMS) is less than 10% in the United States. Community-focused interventions improve survival rates, but there is limited information on how to gain support for new interventions or program activities within these populations. Using data from the RAndomized Cluster Evaluation of Cardiac ARrest Systems (RACE-CARS) trial, we aimed to identify the factors influencing emergency response agencies’ support in implementing an OHCA intervention. Methods: North Carolina counties were stratified into high-performing or low-performing counties based on the county’s cardiac arrest volume, percent of bystander-cardiopulmonary resuscitation (CPR) performed, patient survival to hospital discharge, cerebral performance in patients after cardiac arrest, and perceived engagement in the RACE-CARS project. We randomly selected 4 high-performing and 3 low-performing counties and conducted semi-structured qualitative interviews with emergency response stakeholders in each county. Results: From 10/2021 to 02/2022, we completed 29 interviews across the 7 counties (EMS (n = 9), telecommunications (n = 7), fire/first responders (n = 7), and hospital representatives (n = 6)). We identified three themes salient to community support for OHCA intervention: (1) initiating support at emergency response agencies; (2) obtaining support from emergency response agency staff (senior leadership and emergency response teams); and (3) and maintaining support. For each theme, we described similarities and differences by high- and low-performing county. Conclusions: We identified techniques for supporting effective engagement of emergency response agencies in community-based interventions for OHCA improving survival rates. This work may inform future programs and initiatives around implementation of community-based interventions for OHCA.http://www.sciencedirect.com/science/article/pii/S2666520424000018Out-of-hospital cardiac arrest (OHCA)Implementation scienceFirst responders and medical professionalsEmergency medical servicesCommunity-based interventions |
| spellingShingle | Natalie Ezem Allison A. Lewinski Julie Miller Heather A King Megan Oakes Lisa Monk Monique A. Starks Christopher B. Granger Hayden B. Bosworth Audrey L. Blewer Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties Resuscitation Plus Out-of-hospital cardiac arrest (OHCA) Implementation science First responders and medical professionals Emergency medical services Community-based interventions |
| title | Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties |
| title_full | Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties |
| title_fullStr | Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties |
| title_full_unstemmed | Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties |
| title_short | Factors influencing support for the implementation of community-based out-of-hospital cardiac arrest interventions in high- and low-performing counties |
| title_sort | factors influencing support for the implementation of community based out of hospital cardiac arrest interventions in high and low performing counties |
| topic | Out-of-hospital cardiac arrest (OHCA) Implementation science First responders and medical professionals Emergency medical services Community-based interventions |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424000018 |
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