Enhancing Public Access Defibrillator Registries: Motivations, Data Quality and Communication in Out-of-Hospital Cardiac Arrest Response

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BackgroundOut-of-hospital cardiac arrest (OHCA) is a time critical and life-threatening medical emergency. Prompt bystander defibrillation using public access defibrillators (PADs) can increase odds of survival by up to seven-fold. Despite the efficacy of bystander defibrillation, PADs are rarely used and ensuring timely access to PADs remain a significant challenge.In the UK, there has been an increase in the use of technologies to enable rapid identification and deployment of PADs to OHCAs including the introduction of a i) national PAD registry (The Circuit) and subsequent integration of Circuit data with emergency dispatch to direct bystanders to nearby PADs and ii) the GoodSAM responder app, a mobile application that crowdsources nearby responders through mobile positioning to provide resuscitation care including PAD retrieval.The effective use of these technologies to enable prompt bystander defibrillation are underpinned by voluntary registration of PADs by citizens and organisations and the quality of data provided. Incomplete registries and poor data quality can lead to delays in defibrillation as bystanders may not be directed to the nearest PAD or cause issues with retrieving the PAD (e.g. inaccurate location data, code not provided to get into locked cabinet containing the PAD).ObjectivesThis research aims to facilitate early bystander defibrillation and improve OHCA survival outcomes by:Investigating the motivations for voluntary PAD registration on online registry platforms and barriers to citizen participation.Identifying what data should be recorded in registries to enable emergency dispatch to effectively communicate to bystanders.Define what quality means in the context of PAD registry data and its subsequent use to support rapid identification and retrieval of PADs by bystanders.Developing a design intervention and user-facing tool to support quality data collection on PAD registry platforms based on users' experiences with existing registry platforms.Research Questionsa) What are the motivations for citizens and organisations to register their PADs on voluntary PAD registry platforms and what are the barriers and facilitators to participation?b) What data should be recorded on PAD registries to allow emergency dispatch to effectively communicate to bystanders where to locate and retrieve a PAD during an emergency?c) What are the barriers and facilitators to contributing quality data and how can PAD registry platforms be better designed to enable quality data collection?MethodologyPrevious studies looking to improve timely access to PADs through the use of digital technologies predominately take a clinical prescriptive with emphasis on the efficiency of these technologies such as response time of volunteers to an OHCA. This study will be underpinned by methods from the field of human-computer interaction and the principles of human-centered design, focusing on understanding users' motivations, experiences and interactions with existing PAD registries before and during an emergency. Before an emergency: Surveys, semi-structured interviews and contextual inquiries of individuals registering their PAD on their existing platforms will be conducted and analysed. This will systematically define stakeholder groups involved in PAD registration and their motivations, barriers and facilitators to participation. During an emergency: Semi-structured interviews with emergency dispatch personnel to learn what PAD registry data is available to dispatchers, how they use this data, and what information they would find most helpful when communicating with bystanders to retrieve a PAD. Based on the needs identified by stakeholders before and during an OHCA, I will develop a PAD registry platform prototype to enable quality data collection. This prototype will be tested with stakeholders and evaluated through test sessions with participants.