Enhancing Prehospital Outcomes for Cardiac Arrest (EPOC) study: sequential mixed-methods study protocol in Michigan,...

Area of Science:

• Emergency medicine
• Public health
• Quality improvement science

Background:

• Out-of-hospital cardiac arrest (OHCA) is a critical medical emergency with significant survival variations.
• Existing knowledge gaps hinder effective quality improvement strategies for OHCA care.
• First responders (police, fire, EMS) are crucial in OHCA response.

Purpose of the Study:

• To investigate regional variations in OHCA survival rates.
• To identify modifiable factors associated with improved OHCA survival.
• To develop a practical toolkit for enhancing prehospital cardiac arrest outcomes.

Main Methods:

• Mixed-methods approach combining quantitative data analysis and qualitative research.
• Analysis of OHCA survival data from the Michigan Cardiac Arrest Registry to Enhance Survival (CARES).
• Site visits with key informant interviews and focus groups in high- and low-survival communities, followed by a statewide survey.

Main Results:

• Identification of EMS agencies with high and low OHCA survival rates.
• Qualitative themes emerging from site visits will highlight factors contributing to survival.
• A survey will test the generalizability of these factors across Michigan.

Conclusions:

• The study will yield an 'EPOC Toolkit' to guide quality improvement efforts.
• Dissemination through partnerships with policymakers and EMS leadership is planned.
• The toolkit aims to standardize and improve OHCA care, ultimately increasing survival rates.