When paramedic and AHA staffer Russell Griffin looks at translating science into survival, he sees strides but know we’re only part way through the journey. Here, he tells it in his own words:
My interest in pre-hospital systems is directly influenced by my background. I started my work in EMS in high school and continue it to this day. Through the years, I’ve seen a lot of variation in quality of care and in the design of pre-hospital systems across the U.S. and the globe. This lack of consistency leads to variations in systems of 500 percent or more. Obviously, this increases – or decreases – your likelihood to live.
AHA and seven other member councils have been involved with ILCOR since 1993, working to “translate science into survival.” We’re using advocacy, outreach, and marketing to put evidence, research and science into practice in the regions of the seven member councils – United States, Canada, Europe, Australia, New Zealand, South Africa, Latin America and Asia.
I see our biggest challenge with translating science into survival as measuring success and knowing where to focus next. This past September for World Heart Day, the World Heart Federation called upon global health organizations to step up their efforts to track the impact of cardiovascular disease and stroke. There are so many countries that don’t capture or report on critical cardiac metrics.
In the United States we do a pretty good job at measuring where we’re improving and where we could use more resources. It’s not a perfect system, as the 2015 Institute of Medicine Report on Cardiac Arrest pointed out, but it’s still on the leading edge compared to others.
I view it as our moral imperative to work with our fellow global health advocates to establish systems to set goals and measure against them so that we can truly determine where there are needs and how we are doing in meeting them. It’s about creating health equity and standardization. As my colleague Michael Hulley said so well in a blog last month, “Where you live should not determine if you live.”
Given my background, I choose to focus on pre-hospital care. There is so much variation in the design and process of EMS systems across the world. In the United States alone there are more than 100 different EMS designs.
It’s incredibly hard to standardize designs and processes given budget, staffing and cultural differences. So the AHA is looking at it from a Systems of Care perspective, seeking practical solutions that can be implemented reasonably to make a significant difference. One example is dispatcher-assisted CPR, also known at telephone CPR (T-CPR).
EMS World recently tweeted, “Your dispatch center really has no excuse not to be doing telephone CPR.” AHA was an early proponent of T-CPR and is now developing program and performance recommendations that set standards for timely and high-quality delivery of T-CPR.
T-CPR also demonstrates the importance of metrics. Research shows that as much as 50 percent of bystander CPR in communities that provide T-CPR instructions to 911 callers is directly attributable to those instructions. That’s why we are leading the T-CPR charge and why a major component of AHA’s recommendations will be a set of metrics against which EMS performance can be assessed.
It’s time to open up this entire spectrum of best practices and share it globally. It may not be easy, but the benefits will be immeasurable.