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David B. Hiltz, NREMT-P American Heart Association Translating Science into Action:  Using Population and Criteria-based  ...
Conflict of Interest Disclosure <ul><li>Commercial/industry </li></ul><ul><ul><li>Full-time employment by the American Hea...
Objectives <ul><li>Discuss the rationale for addressing acute event and SCA </li></ul><ul><li>Visit current recommendation...
BIG  Issues <ul><li>CVD-SCA is number one killer </li></ul><ul><li>220,000 to 335,00 OOH SCA each year </li></ul><ul><li>7...
Other Issues <ul><li>VERY few get bystander CPR </li></ul><ul><li>Fewer get good CPR </li></ul><ul><li>Less than one-third...
Recommendations  <ul><li>“Community Coronary Care Units” </li></ul><ul><li>Organized response to emergencies </li></ul><ul...
<ul><li>Lay responder defibrillation significantly increases </li></ul><ul><li>survival after cardiac arrest if the progra...
 
 
Translating Science Into Action <ul><li>We have evidence based guidelines </li></ul><ul><li>We have excellent training pro...
Changing Behavior <ul><li>Commercial marketing expensive and often ineffective </li></ul><ul><li>Social marketing experien...
Disclaimer <ul><li>This presentation will discuss incentivizing and guiding implementation of strategies to save lives. </...
Emergency Medical Care Advisory Board –EMCAB- <ul><li>The board advises the DPH/OEMS on the development of EMS policy </li...
HEART Safe History Howard Koh, MD,MPh  Former Public Health Commissioner Now Director , Division of Public Health Practice...
Charge by Koh  to PIER Committee of EMCAB <ul><li>“Develop a program to increase awareness  </li></ul><ul><li>regarding CP...
Oh…and no, there isn’t any funding
~Jerry Garcia of the Grateful Dead <ul><li>“ Somebody has to do something, and it’s just incredibly pathetic that it has t...
Mike and David
HEART Safe   Community <ul><li>A population and criteria based incentive program designed to advance systems change and ch...
HEART Safe   Community <ul><li>Get credit or earn points in the form of Heartbeats for specific activities relating to the...
 
Population Based <ul><li>Up to 5,000 population:  40  heartbeats  </li></ul><ul><li>5,001 – 30,000 population:  50  heartb...
Criteria Based <ul><li>Conduct community CPR training sessions. </li></ul><ul><li>All EMS first response-designated vehicl...
HEART Safe   Community <ul><li>Is NOT limited to promoting AEDS! </li></ul>
“Heartbeats” <ul><li>Core to  HEART Safe </li></ul>
HEART Safe   Incentives <ul><li>Bragging rights! </li></ul>
Initial Funding $3,000
Promotion <ul><li>Announced at Statewide EMS Summit </li></ul><ul><li>Strategic alliances </li></ul><ul><li>Roadside signs...
Program Operations- Launch <ul><li>Letter and worksheet </li></ul><ul><li>Direct mail campaign to municipal leaders </li><...
Process
Process <ul><li>Self tabulation-requires communication </li></ul><ul><li>across lines </li></ul><ul><li>Inventory current ...
HEART Safe   Designation Events
The Partnership for a Heart Healthy and Stroke Free Massachusetts <ul><li>A coalition of more than 100 organizations and a...
 
One Hundred and Forty-Four Massachusetts  HEARTSafe  Communities Region 3 SUFFOLK PLYMOUTH DUKES as of May 19th, 2006 Regi...
Unique Designations
Unique Designations
Pending Designations
Unique Request
Promotion at ECCU
Outside of MA
Connecticut <ul><li>“ We looked at the program and saw it as an  </li></ul><ul><li>excellent way to promote awareness of t...
Connecticut <ul><li>“ Strategic placement of AEDs and larger numbers of  </li></ul><ul><li>people trained in CPR increases...
HEART Safe  RI <ul><li>Increase: </li></ul><ul><li>number of lay bystanders trained in CPR  </li></ul><ul><li>number of Fi...
HEART Safe  RI  Lifesaving Potential 200 50 1000 Rhode Island Goal – Lives Saved at 20% Survival Rate  Lives Saved at Curr...
RI Recommendations <ul><li>Systems reviewed </li></ul><ul><li>Discussion </li></ul><ul><li>Revisions </li></ul><ul><li>Con...
RI Recommendations <ul><li>Organization </li></ul><ul><li>EMD </li></ul><ul><li>CPR </li></ul><ul><li>AED </li></ul><ul><l...
 
HEART Safe  RI PSA
 
Inside RI Warwick Task Force
 
Warwick Task Force
 
Proposed Support from the AHA <ul><li>Project implementation staff, volunteers and support.  </li></ul>
Proposed Support from RI DOH <ul><li>Endorsement of program  </li></ul><ul><li>Use of the RI DOH stylized name and logo </...
HEART Safe  Review Process <ul><li>Completed HeartSafe applications are sent to the RI DOH </li></ul>Applications are revi...
Benefits <ul><li>Low cost mechanism for the advancement of efforts to reduce disability and death from SCA and other cardi...
Where is the DATA? <ul><li>We are certain that this is changing behavior  </li></ul><ul><li>NEMSIS data set implementation...
So David, How Can We Do This? <ul><li>Identify what the issues are, or more appropriately design the collective vision for...
Not Always So Easy!
HeartSafe Materials http://www.mari-ecc.org/
Where Can We Go From Here?
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Heart Safe Community ECCU 2006

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Communities are the ultimate coronary care units. Learn about HEARTSafe Communities, a population and criteria based incentive program to help communities save the lives of sudden cardiac arrest victims.

Published in: Health & Medicine, Business

Heart Safe Community ECCU 2006

  1. 1. David B. Hiltz, NREMT-P American Heart Association Translating Science into Action: Using Population and Criteria-based Incentive Programs to Advance Systems Change and Chain of Survival Priorities
  2. 2. Conflict of Interest Disclosure <ul><li>Commercial/industry </li></ul><ul><ul><li>Full-time employment by the American Heart Association </li></ul></ul><ul><li>Potential intellectual conflicts </li></ul><ul><ul><li>Full-time employment by the American Heart Association </li></ul></ul>
  3. 3. Objectives <ul><li>Discuss the rationale for addressing acute event and SCA </li></ul><ul><li>Visit current recommendations regarding acute event and SCA </li></ul><ul><li>Review the history of HEART Safe </li></ul><ul><li>Discuss adapting HEART Safe to address system change and COS priorities </li></ul>
  4. 4. BIG Issues <ul><li>CVD-SCA is number one killer </li></ul><ul><li>220,000 to 335,00 OOH SCA each year </li></ul><ul><li>70-80% occur in/around home </li></ul><ul><li>95% death rate </li></ul><ul><li>Not a reportable cause of death: </li></ul><ul><li>National Center for Vital Statistics </li></ul>
  5. 5. Other Issues <ul><li>VERY few get bystander CPR </li></ul><ul><li>Fewer get good CPR </li></ul><ul><li>Less than one-third of kids get CPR before EMS </li></ul><ul><li>Large numbers of </li></ul><ul><li>people will die this </li></ul><ul><li>year from SCA </li></ul>
  6. 6. Recommendations <ul><li>“Community Coronary Care Units” </li></ul><ul><li>Organized response to emergencies </li></ul><ul><li>EMD </li></ul><ul><li>Citizen CPR </li></ul><ul><li>Early defibrillation </li></ul><ul><li>Effective BLS and ACLS </li></ul><ul><li>Early detection of ACS </li></ul><ul><li>Early definitive intervention </li></ul>
  7. 7. <ul><li>Lay responder defibrillation significantly increases </li></ul><ul><li>survival after cardiac arrest if the program is able to </li></ul><ul><li>defibrillate prior to EMS arrival and the PAD </li></ul><ul><li>emergency response plan is effectively </li></ul><ul><li>implemented and sustained. </li></ul>
  8. 10. Translating Science Into Action <ul><li>We have evidence based guidelines </li></ul><ul><li>We have excellent training programs </li></ul><ul><li>We have top notch instructors </li></ul><ul><li>“Top down” strategies DO NOT WORK </li></ul><ul><li>Local situations </li></ul><ul><li>require local solutions </li></ul>
  9. 11. Changing Behavior <ul><li>Commercial marketing expensive and often ineffective </li></ul><ul><li>Social marketing experience is good </li></ul><ul><li>Incentive change methods offer a less expensive option </li></ul>
  10. 12. Disclaimer <ul><li>This presentation will discuss incentivizing and guiding implementation of strategies to save lives. </li></ul><ul><li>The intent HEART Safe is to permit the evolution of funding sources at the community level. </li></ul>
  11. 13. Emergency Medical Care Advisory Board –EMCAB- <ul><li>The board advises the DPH/OEMS on the development of EMS policy </li></ul><ul><li>Established by statute </li></ul><ul><li>Appointed by Commissioner </li></ul><ul><li>Key stakeholders </li></ul><ul><li>GENERAL LAWS OF MASSACHUSETTS </li></ul><ul><li>Chapter 111C: Section 13 EMS system advisory board; membership; </li></ul><ul><li>duties; advisory committees </li></ul>
  12. 14. HEART Safe History Howard Koh, MD,MPh Former Public Health Commissioner Now Director , Division of Public Health Practice Harvard University
  13. 15. Charge by Koh to PIER Committee of EMCAB <ul><li>“Develop a program to increase awareness </li></ul><ul><li>regarding CPR and early defibrillation and </li></ul><ul><li>improve survival in all communities” </li></ul>No problem!
  14. 16. Oh…and no, there isn’t any funding
  15. 17. ~Jerry Garcia of the Grateful Dead <ul><li>“ Somebody has to do something, and it’s just incredibly pathetic that it has to be us.” </li></ul>Mike and David
  16. 18. Mike and David
  17. 19. HEART Safe Community <ul><li>A population and criteria based incentive program designed to advance systems change and chain of survival priorities. </li></ul>
  18. 20. HEART Safe Community <ul><li>Get credit or earn points in the form of Heartbeats for specific activities relating to the designed criteria. </li></ul><ul><li>The number of Heartbeats required is specific to both the activity and the population base. </li></ul>
  19. 22. Population Based <ul><li>Up to 5,000 population: 40 heartbeats </li></ul><ul><li>5,001 – 30,000 population: 50 heartbeats </li></ul><ul><li>30,001 – 50,000 population: 60 heartbeats </li></ul><ul><li>50,001 – 100,000 population: 70 heartbeats </li></ul><ul><li>100,001 – 150, 000 population: 80 heartbeats </li></ul><ul><li>150,001 population or more: 90 heartbeats </li></ul>
  20. 23. Criteria Based <ul><li>Conduct community CPR training sessions. </li></ul><ul><li>All EMS first response-designated vehicles* have been equipped with AEDs </li></ul><ul><li>Placement of a permanent AED with AED-trained personnel in public or private areas </li></ul><ul><li>Advanced Cardiac Life Support (paramedics) *   </li></ul><ul><li>An ongoing process to evaluate and improve the “Chain of Survival”in the community. </li></ul>
  21. 24. HEART Safe Community <ul><li>Is NOT limited to promoting AEDS! </li></ul>
  22. 25. “Heartbeats” <ul><li>Core to HEART Safe </li></ul>
  23. 26. HEART Safe Incentives <ul><li>Bragging rights! </li></ul>
  24. 27. Initial Funding $3,000
  25. 28. Promotion <ul><li>Announced at Statewide EMS Summit </li></ul><ul><li>Strategic alliances </li></ul><ul><li>Roadside signs </li></ul>
  26. 29. Program Operations- Launch <ul><li>Letter and worksheet </li></ul><ul><li>Direct mail campaign to municipal leaders </li></ul><ul><li>Media Advisory </li></ul>
  27. 30. Process
  28. 31. Process <ul><li>Self tabulation-requires communication </li></ul><ul><li>across lines </li></ul><ul><li>Inventory current achievements </li></ul><ul><li>Launch strategies to meet criteria </li></ul><ul><li>Submit to DPH OEMS and Regional EMS </li></ul><ul><li>Schedule designation </li></ul><ul><li>Notify AHA </li></ul>
  29. 32. HEART Safe Designation Events
  30. 33. The Partnership for a Heart Healthy and Stroke Free Massachusetts <ul><li>A coalition of more than 100 organizations and agencies (est. 2001) </li></ul><ul><li>Funding from the U.S. Centers for Disease Control and Prevention </li></ul><ul><li>Devise strategies to reduce illness and death related to heart disease and stroke among Massachusetts residents </li></ul>
  31. 35. One Hundred and Forty-Four Massachusetts HEARTSafe Communities Region 3 SUFFOLK PLYMOUTH DUKES as of May 19th, 2006 Region 4 Region 2 Region 1 BERKSHIRE WORCESTER FRANKLIN HAMPSHIRE HAMPDEN NORFOLK MIDDLESEX ESSEX BRISTOL by Emergency Medical Service Regions and Counties Region 5 BARNSTABLE NANTUCKET HEART Safe Community Designation requires that a Community VIGOROUSLY support community training in CPR and strategic public placement of AEDs for trained users Source: Massachusetts Office of Emergency Medical Services, May 19, 2006
  32. 36. Unique Designations
  33. 37. Unique Designations
  34. 38. Pending Designations
  35. 39. Unique Request
  36. 40. Promotion at ECCU
  37. 41. Outside of MA
  38. 42. Connecticut <ul><li>“ We looked at the program and saw it as an </li></ul><ul><li>excellent way to promote awareness of the signs </li></ul><ul><li>and symptoms of heart attacks and to improve the </li></ul><ul><li>systems response to incidents.” </li></ul><ul><li>Gary St. Amand </li></ul><ul><li>Health Program Associate </li></ul><ul><li>State of Connecticut Dept. of Public Health </li></ul><ul><li>Heart Disease and Stroke Prevention Program </li></ul>
  39. 43. Connecticut <ul><li>“ Strategic placement of AEDs and larger numbers of </li></ul><ul><li>people trained in CPR increases the survival rate for </li></ul><ul><li>cardiac arrest patients.” </li></ul><ul><li>“ We would like to see all 169 of Connecticut’s </li></ul><ul><li>municipalities strive to adopt the HEARTSafe Community </li></ul><ul><li>designation.” </li></ul><ul><li>J. Robert Galvin, M.D., M.P.H. </li></ul><ul><li>DPH Commissioner </li></ul>
  40. 44. HEART Safe RI <ul><li>Increase: </li></ul><ul><li>number of lay bystanders trained in CPR </li></ul><ul><li>number of First Responders who are </li></ul><ul><li>equipped with AEDs </li></ul><ul><li>ensure appropriate pre-arrival instructions </li></ul><ul><li>improve the performance of our prehospital care system </li></ul><ul><li>and make a lifesaving difference . </li></ul>
  41. 45. HEART Safe RI Lifesaving Potential 200 50 1000 Rhode Island Goal – Lives Saved at 20% Survival Rate Lives Saved at Current Survival Rate – 5% Estimated SCA Frequency Location
  42. 46. RI Recommendations <ul><li>Systems reviewed </li></ul><ul><li>Discussion </li></ul><ul><li>Revisions </li></ul><ul><li>Consensus </li></ul>
  43. 47. RI Recommendations <ul><li>Organization </li></ul><ul><li>EMD </li></ul><ul><li>CPR </li></ul><ul><li>AED </li></ul><ul><li>LEA-D </li></ul><ul><li>12 Lead ECG </li></ul><ul><li>ACLS </li></ul>
  44. 49. HEART Safe RI PSA
  45. 51. Inside RI Warwick Task Force
  46. 53. Warwick Task Force
  47. 55. Proposed Support from the AHA <ul><li>Project implementation staff, volunteers and support. </li></ul>
  48. 56. Proposed Support from RI DOH <ul><li>Endorsement of program </li></ul><ul><li>Use of the RI DOH stylized name and logo </li></ul><ul><li>DOH staff and resources for program implementation <0.05 FTE? </li></ul><ul><li>Funding for HeartSafe signs in the amount of $1,200 </li></ul><ul><li>$15.50 to $16.00/sign (delivery and initial art charges included). </li></ul>
  49. 57. HEART Safe Review Process <ul><li>Completed HeartSafe applications are sent to the RI DOH </li></ul>Applications are reviewed for completeness by RI DOH Applications are reviewed for content by RI DOH using a special panel appointed by the Director (Division of EMS staff member, ASAB members [2], AHA ECC staff member, and AHA ECC Committee member) Determine Disposition No recommendation for Designation Notification and guidance for applicant Recommendation for Designation Community notified of successful designation by RI DOH Designation event scheduled AHA prepares paper plaque Community orders signs if desired AHA prepares media advisory and distributes to media contacts as needed. (Additional communications activities as needed) Designation Data entry into RIDOH system
  50. 58. Benefits <ul><li>Low cost mechanism for the advancement of efforts to reduce disability and death from SCA and other cardiovascular emergencies. </li></ul><ul><li>Improved dialog with community leaders and stakeholders. </li></ul><ul><li>Visibility for the DOH/DPH at the community level across State. </li></ul><ul><li>Use a previously and proven program. </li></ul><ul><li>Platform for other DOH/DPH efforts and programs. </li></ul>
  51. 59. Where is the DATA? <ul><li>We are certain that this is changing behavior </li></ul><ul><li>NEMSIS data set implementation will provide additional insight and validation </li></ul><ul><li>Until then, we believe that the absence of hard data should not stand in the way of a perfectly good idea! </li></ul>
  52. 60. So David, How Can We Do This? <ul><li>Identify what the issues are, or more appropriately design the collective vision for YOUR ultimate community based coronary care unit. </li></ul><ul><li>Use existing resources to package. </li></ul><ul><li>Form alliance with your State or local board of health. </li></ul><ul><li>JUST DO IT! </li></ul>
  53. 61. Not Always So Easy!
  54. 62. HeartSafe Materials http://www.mari-ecc.org/
  55. 63. Where Can We Go From Here?

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