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Reducing Ethnic-racial Disparities in Cardiac Arrest Survival Outcomes (RED-CASO)

减少心脏骤停生存结果的种族差异 (RED-CASO)

基本信息

批准号：
10338932
负责人：
Paul Sheung-Yan Chan
金额：
$ 67万
依托单位：
SAINT LUKE'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10338932
关键词：
911 call Accident and Emergency department Address Administrator Adopted Adoption Affect American Heart Association Baseline Surveys Black Populations Black race Blood Circulation Cardiology Cardiopulmonary Resuscitation Caring Cause of Death Censuses Centers for Disease Control and Prevention (U.S.)Communities Community Services Data Effectiveness Emergency Medicine Emergency medical service Ensure Epidemiology Ethnic Origin Face Fire - disasters Focus Groups Foundations Future Goals Heart Arrest Hispanic Hispanic Populations Hospitals Immigration Individual Interview Knowledge Language Life Low income Medical Staff Methodology Methods Mission Morbidity - disease rate National Heart, Lung, and Blood Institute Native Americans Neighborhoods Outcome Outcome Study Paramedical Personnel Patient-Focused Outcomes Patients Peer Review Persons Police Policies Practice Guidelines Pre-hospital setting Pre-hospitalization care Process Public Health Publications Registries Research Research Methodology Research Personnel Resources Resuscitation Risk Sampling Site Site Visit Surveys Survival Rate System Time Universities Variant Work care systems community engagement cost design disparity reduction emergency settings first responder health equity health equity promotion hispanic community improved improved outcome innovation insight mortality multidisciplinary novel out-of-hospital cardiac arrest premature racial and ethnic disparities response routine practice survival outcome

项目摘要

PROJECT SUMMARY / ABSTRACT The public health burden of out-of-hospital cardiac arrest (OHCA) is enormous, affecting ~350,000 individuals each year in the U.S. and is the third leading cause of death. To improve our understanding of OHCA, the Cardiac Arrest Registry to Enhance Survival (CARES) was launched by Emory University and the Centers for Disease Control and Prevention. Through >70 peer-reviewed publications over the past 2 decades, CARES has transformed our understanding of the epidemiology and outcomes of patients with OHCA. Yet, little is known as to how some emergency medical service (EMS) agencies achieve higher survival rates for their patients with OHCA than other agencies. While variation in OHCA survival is largely believed to be due to adoption of key care processes by EMS agencies in the prehospital setting, how these processes are employed in routine practice, the underlying factors contributing to their successful implementation, and effective interactions between EMS agencies with the community, first responders (e.g., police, fire), 911 dispatchers, and hospitals have not been systematically defined. Moreover, despite the fact that Black and Hispanic patients have lower survival rates for OHCA than White patients, there is scant research on how to reduce disparities in OHCA survival and how top-performing EMS agencies that work in majority Black or Hispanic communities overcome additional barriers to prehospital OHCA response and care. Accordingly, we propose the RED-CASO (Reducing Ethnic-racial Disparities in Cardiac Arrest Survival Outcomes) study to address these critical gaps in knowledge and to lay the foundation for quality improvement efforts to reduce disparities in OHCA survival. First, we will identify top-performing and bottom-performing EMS agencies in OHCA survival, with a focus on those that work in majority Black or Hispanic communities. Second, we will identify ‘best practices’ at top-performing EMS agencies in OHCA survival through detailed interviews with key stakeholders during site visits. We will intentionally sample EMS agencies which work in majority Black or Hispanic communities, and these agencies will comprise at least half of the sites visited. And third, we will validate these best practices associated with EMS agencies with the highest survival rates for OHCA. We will use a sequential mixed-methods approach with a focus on identifying best practices at top- performing EMS agencies which work in communities where most residents are Black or Hispanic. We will build on work by our investigative team to systematically understand factors associated with survival for other emergency settings (in-hospital cardiac arrest) and leverage our team’s multidisciplinary expertise in cardiology, emergency medicine, epidemiology, and mixed methods research. Findings from this study will be used to construct a ‘best practices guide’ for OHCA that can be implemented by EMS agencies both within CARES and with national partners such as the American Heart Association to improve OHCA survival in predominantly non-White communities and, in turn, reduce racial and ethnic disparities in OHCA outcomes.

项目摘要/摘要