Resuscitation Centers of Excellence: A Collaborative Effort to Improve Outcomes for Sudden Cardiac Arrest Survivors
The Austin/Travis County Office of the Medical Director has proposed specific criteria and processes for hospitals wishing to be designated as a receiving center for Post Cardiac Arrest patients with return of spontaneous circulation (ROSC). This new designation is based on growing evidence supporting the need for Resuscitation Centers in order to improve overall outcomes for these patients. In the Austin/Travis County area, we believe the proportion of post cardiac arrest patients who are discharged neurologically intact from the hospital can be dramatically affected when these specific capabilities and processes are in place.
The concept of a Resuscitation Center of Excellence designation parallels that of the Trauma System development which occurred over the past several years. The concept uses a team approach involving multiple key players, both in-hospital and out-of-hospital. We recognize the value of coordination between the EMS System, the ED staff, Interventional Cardiology, the CCU/ICU staff, Electrophysiology, and Hospital Administration. In terms of cardiac arrest, the Resuscitation Center of Excellence concept emphasizes early use of proven interventions for resuscitation and post-resuscitation care.
This simple and straightforward process focuses on the efficacy of hospital processes as well as the ability to provide data demonstrating effective, ongoing performance.
The key components of the process are:
- commitment to seeking this designation
- demonstrated process and capabilities for 24/7 therapeutic hypothermia
- demonstrated process and capabilities for 24/7 selection of patients with a suspected acute myocardial infarction prior to cardiac arrest and provision of percutaneous coronary intervention to these patients
- demonstrated process and capabilities for continued post resuscitation care and risk reduction
- commitment to coordinate with the EMS System to exchange data for the purposes of quality improvement
Beginning in September 2008 (anticipated start date), post cardiac arrest patients with return of spontaneous circulation (ROSC) transported by the Austin/Travis County EMS System will only be transported to hospitals designated as a Resuscitation Center of Excellence.