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

院外心脏骤停（OHCA）是一种关键且危及生命的医疗紧急情况。使用公共通道除颤器（pad）的快速旁观者除颤可以将生存几率提高七倍。尽管旁观者除颤有效，但pad很少使用，确保及时获得pad仍然是一个重大挑战。在英国，越来越多地使用技术来实现快速识别和部署PAD到ohca，包括引入i)国家PAD注册（the Circuit），随后将Circuit数据与紧急调度相结合，将旁观者引导到附近的PAD，以及ii) GoodSAM响应者应用程序，这是一种移动应用程序，通过移动定位众包附近响应者，提供包括PAD检索在内的复苏护理。公民和组织自愿登记pad并提供高质量的数据，是有效利用这些技术实现及时的旁观者除颤的基础。不完整的注册表和较差的数据质量可能导致除颤延迟，因为局外人可能无法被引导到最近的PAD或导致检索PAD的问题（例如，不准确的位置数据，未提供进入包含PAD的锁柜的代码）。本研究旨在通过调查在线登记平台上PAD自愿登记的动机和公民参与的障碍，促进早期旁观者除颤和改善OHCA生存结果。确定应在登记册中记录哪些数据，以使应急调度能够有效地与旁观者沟通。定义质量在PAD注册表数据上下文中的含义及其后续使用，以支持旁观者快速识别和检索PAD。根据用户使用现有注册表平台的经验，开发设计干预和面向用户的工具，以支持PAD注册表平台上的高质量数据收集。研究问题a)市民和机构在自愿登记平台上登记他们的PAD的动机是什么？参与的障碍和促进因素是什么？b)应在PAD注册表中记录哪些数据，以便应急调度人员能够有效地与旁观者沟通，在紧急情况下在何处定位和检索PAD ？c)提供高质量数据的障碍和促进因素是什么？如何更好地设计PAD注册平台以实现高质量的数据收集？先前的研究希望通过使用数字技术来改善及时获得pad的机会，主要采取临床处方，强调这些技术的效率，如志愿者对OHCA的反应时间。本研究将以人机交互领域的方法和以人为中心的设计原则为基础，重点了解用户的动机、体验以及在紧急情况发生之前和期间与现有PAD注册表的交互。在紧急情况发生之前：将对在现有平台上注册PAD的个人进行调查、半结构化访谈和背景调查并进行分析。这将系统地定义参与PAD注册的利益相关者群体及其参与的动机、障碍和促进因素。在紧急情况期间：与紧急调度人员进行半结构化访谈，以了解调度员可以使用哪些PAD注册表数据，他们如何使用这些数据，以及在与旁观者沟通以检索PAD时，他们认为哪些信息最有帮助。根据利益相关者在OHCA之前和期间确定的需求，我将开发PAD注册平台原型，以实现高质量的数据收集。该原型将与利益相关者一起进行测试，并通过与参与者的测试会议进行评估。

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.