In a nutshell: The Improvement Academy worked with partner organisations to determine the location and details of public access defibrillators throughout Yorkshire & Humber region and identify where further defibrillators need to be deployed. Overall we aimed to increase the use of public access defibrillators and increase survival rates.
The Cardiovascular Disease Outcomes Strategy from the Department of Health (2013) recognised the need to prioritise resuscitation from “out of hospital cardiac arrest” (OHCA) as an area for improvement. It is estimated that up to 75,000 OHCAs occur each year in the UK and ambulance services attempt resuscitation in approximately 40% of cases. At present, only a small number of individuals survive. If survival rates were increased from the overall national average (around 7%) to that of the best reported (12%), it is estimated that an additional 1,000 lives could be saved each year.
There is a ‘Chain of Survival,’ advocated by the UK Resuscitation Council in the event of a cardiac arrest. Timely cardiopulmonary resuscitation (CPR) and defibrillation have been identified as the most important factors in determining survival.
Public access defibrillator’ (PAD)’s have been shown to be safe and can be used without first aid training. The use of a defibrillator prior to the arrival of ambulance services has shown to approximately double rates of survival after OHCA.
- There is patchy intelligence on the number of PADs per health area with registered numbers ranging between 65 and 2000.
- Information on where best to deploy the PAD devices is not routinely available. Data on the location and outcomes of OHCA is available through ambulance trusts but this is not consistently matched to PAD figures.
- Further barriers to defibrillator use were identified as even when PADs are available, they are frequently not used by members of the public.
What did we do?
We worked collaboratively with British Heart Foundation and Yorkshire Ambulance Service to deliver the following 3 key elements:
- Providing standardised location and access information for currently unknown PADs using crowd-sourcing methods and adding this information to the current PAD register.
- Cross referencing cardiac arrest data with PAD location and determining whether there are patterns or hotspots that will allow the intelligent deployment of subsequent devices.
- Employing behaviour science methodologies to understand barriers to the use of identifiable PADs by members of the public.
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Considerations were being made for identification and definition of a model that is successful and transferrable to other regions of the UK.