1. AHA Response to The Institute of Medicine Cardiac Arrest Report
Clifton Callaway, MD, PhD
Chair, AHA ECC Committee

2. Conflicts of Interest
Employed – UPMC Health System, University of Pittsburgh
Grants – NHLBI, NINDS

3. What is ECC?

4. 3CPR

5. 3CPR and ECC ECC Committee Science Education Science and Programs
AHA Board of Directors
Science Advisory & Coordinating Committee (SACC)
Manuscript Oversight Committee
Council (3CPR)
ECC Committee
Science
Education Science and Programs
Systems of Care
Pediatric
Forum
Task Forces
Writing Groups

6. Extended ECC Volunteer Network
3CPR and ECC
AHA Board of Directors
Science Advisory & Coordinating Committee (SACC)
Manuscript Oversight Committee
Council (3CPR)
ECC Committee
Science
Education Science and Programs
Systems of Care
Extended ECC Volunteer Network

7. What Does ECC Do? International resuscitation science consensus
Guidelines & Statements
Education & Training Content
Public Awareness
Collaboration with Advocacy
Collaboration with QI
International Training
Strategic Alliance with Laerdal
ASA Warning Signs Campaigns

8. Institute of Medicine Report

9. Institute of Medicine Consensus Study
Treatment of Cardiac Arrest: Current Status & Future Directions
CPR and use of AEDs
EMS and hospital resuscitation systems of care
National cardiac arrest statistics
The state of resuscitation research in the US
Next steps to significantly enhance survival rates from cardiac arrest
Public meetings held March, June and August 2014
Final report published June 30, 2015
Study sponsors: AHA, Red Cross, NHLBI, CDC, ACC

10. Introduction
The full lifesaving potential of an optimized system of care remains elusive in most communities.
There are striking disparities in cardiac arrest survival, with some systems of care reporting a 5-fold difference survival.
Nichol 2008, ROC Data

11. Call to Action
To truly save as many lives as possible it will take additional novel and innovative approaches to improve outcomes
Intense commitment, dedication and collaboration of countless stakeholders and partners at a national, state and local level.
The successful development and implementation of solutions requires action by collaborators, partners and stakeholders.
Implementation and measuring outcomes have historically been difficult
Needs and gaps, such as politics, resources, leadership engagement, differ between communities and location.

12. AHA Supports IOM Recommendations
IOM Strategies for Improving Cardiac Arrest Survival
Recommendation 1
Establish a National Cardiac Arrest Registry
Recommendation 2
Foster a Culture of Action Through Public Awareness and Training
Recommendation 3
Enhance the Capabilities and Performance of Emergency Medical Services (EMS) Systems
Recommendation 4
Set National Accreditation Standards Related to Cardiac Arrest for Hospitals & Health Care Systems
Recommendation 5
Adopt Continuous Quality Improvement Programs
Recommendation 6
Accelerate Research on Pathophysiology, New Therapies, and Translation of Science for Cardiac Arrest
Recommendation 7
Accelerate Research on the Evaluation and Adoption of Cardiac Arrest Therapies
Recommendation 8
Create a National Cardiac Arrest Collaborative
AHA Supports IOM Recommendations

13. AHA Supports IOM Recommendations

14. AHA Response to IOM Cardiac Arrest Report Recommendations
AHA Commitments to Increase Cardiac Arrest Survival
Commitment 1
Provide funding to catalyze data interoperability. The AHA will provide up to $5 million over 5 years to incentivize and catalyze resuscitation data interoperability of existing and novel data sources into the AHA EMS Registry.
Commitment 2
Actively pursue philanthropic support for local and regional implementation opportunities to increase survival by improving OHCA & IHCA systems of care.
Commitment 3
Actively pursue philanthropic support to launch an AHA Resuscitation Research Network.
Commitment 4
Cosponsor a “National Cardiac Arrest Summit” to facilitate the creation of a national cardiac arrest collaborative that will unify the field and identify common goals to improve survival.

15. IOM Recommendations and AHA Response
Data

16. Data We Have AHA Databases CARES GWTG-R
IHCA
some OHCA
Rapid Response Teams
Mission LifeLine - Action Registry (with ACC)
STEMI, some EMS
Guideline Advantage
Outpatient cardiology and preventitive care
CARES
EMS data for OHCA

18. -> 5% of all 5700 hospitals in US 203 Hospitals (> 200 beds)
GWTG - Resuscitation
279 Hospitals
-> 5% of all 5700 hospitals in US
203 Hospitals (> 200 beds)
-> 15% of 1388 US hospitals (>200 beds)

21. Mission LifeLine / Action Registry 1010 hospitals
Mission LifeLine / Action Registry
1010 hospitals
-> 50% STEMI, NSTEMI

22. mycares.net

23. mycares.net
CARES – Prehospital Database
~ 45,000 OHCA / year
~ 800 EMS agencies
~ 1700 Hospitals
-> 25% OHCA

24. What we can do…
Get your local EMS agencies into CARES ( mycares.net)
Get your local hospital into GWTG-R or Mission Life Line Action Registry
Report the “optional” out-of-hospital arrests in the GWTG data
Advocate for mandatory national data warehouse…

25. What we can do…
AHA will explore “interoperability” with major electronic health record vendors
Quintiles is a company that specializes in this for GWTG for AHA
QCOR has special expertise
Hackathon?
Council of State and Territorial Epidemiologists
Talk to your local Department of Health

26. IOM Recommendations and AHA Response
These activities are what AHA does…
Guidelines, teach, promote awareness

27. Resuscitation Evidence Review

28. AHA ECC Products CPR Anytime series Family & Friends CPR
Heartsaver series
CPR in Schools
RQI
Healthcare Professional: BLS, ACLS, PALS, HeartCode
Educational Science and Programs Metrics:
# trained in ECC content / year
# trained with real-time CPR quality feedback
# enrolled in continuous training

29. IOM Recommendations and AHA Response
Help Increase Funding

30. Science - Increase CA grants
February submissions 2015: 47 submissions
Basic = 28 Clinical + Pop = 19
Basic 18% (5) success rate
Clinical 16% (3) success rate
June submissions 2015: 23 submissions
Basic = 10
Clinical/Pop = 13
17% success (4 funded)
January Submissions 2016: 26 submissions
Basic = 14
Clinical/Pop: 12+2 =14
June submissions 2016: 32 submissions
Clinical + Pop:15+3 =18
***These success rates equal or exceed the overall average success rate of 16% across AHA.

31. Metrics: NIH PI’s # of NIH–funded cardiac arrest Pis
Goal: doubling by 2020 Data Source: NIH Reporter

32. $54
Funding Year

33. What we can do… Submit Grants Lobby for Research Funding
Join You’re the Cure:
Advocacy for NIH Funding!
Help local investigators
Stakeholder involvement is major focus of PCORI and some other new funding initiatives
Communities should drive research
Educational / training research needed

34. IOM Recommendations and AHA Response

35. IOM Workshop
July 11-12, 2016, IOM hosted a cardiac arrest workshop to follow-on the IOM Cardiac Arrest Report.
~120 subject matter experts and stakeholders developed blueprints to address each of the 8 IOM recommendation
Stakeholders are meeting now separately to advance the recommendations….
Form a “Collaborative
Create a culture of action

36. IOM Workshop
Form a “Collaborative”

37. IOM Workshop http://www.pulsepoint.org/download/
Create a “Culture of Action”
Do not say “Bystander” anymore… Say “Layperson Rescuer”
Share your skills

38. Are YOU Missing? Join ECC – Join You’re the Cure Join AHA Send stories
Send an to Veronica Zamora (National AHA)
Join You’re the Cure
yourethecure.org
Join AHA
And pick the “3CPR Council” as your home council
Send stories