The 2015 Institute of Medicine (IOM) report on Cardiac Arrest and 2013 AHA consensus on CPR Quality recognized that there is considerable variation in the in-hospital cardiac arrest treatment and care delivery across hospitals. Thus, the IOM recommends creating Cardiac Arrest Centers of Excellence to improve survival and recovery of patients. With this, it is essential that we build future clinical studies upon a foundation of understanding the implementation and effectiveness of existing therapies and guidelines, with generation of data streams to inform evidence-based practices. Specific collaborative quality improvement strategies for cardiac arrest include measuring processes and outcomes associated with resuscitation, benchmarking performance against best practices and data from comparable systems, and providing feedback to providers and teams.
Catalyzed by initial startup funding from the Laerdal Foundation for Acute Medicine, followed by unrestricted research grant funding from ZOLL Medical and matching grants targeted to sustain a fiscally independent pediRES-Q collaborative in the future, we aspire to build a sustainable and collaborative pediRES-Q discovery clinical learning laboratory network of at least 40 sites of diverse size, geographic location, and academic support using CHOP as the clinical, data and program coordinating center. We conservatively estimate that we will collect robust data for identification of risk, pre-arrest training, intra-arrest performance and feedback, post-arrest feedback, post-cardiac arrest care, discharge and neurologic outcome from approximately 1,000 pediatric cardiac arrest events. We aim to efficiently discover, measure, analyze, publish, implement, and disseminate improved evidence-based CPR data to inform current and future evidence-based resuscitation guidelines that saves more lives and improves quality of life for children.
The pediRES-Q Collaborative incorporates two main “projects":
The Prospective, Observational Study: Collection of pediatric cardiac arrest data (quantitative chest compression data) and post cardiac arrest management to characterize current, and determine future best practices for, resuscitation care.
The Quality Improvement Program: Implementation and validation of an innovative resuscitation quality improvement “bundle” to optimize the quality and safety of care to children.
Rea T, Eisenberg M. Sudden cardiac arrest: a call to action from the Institute of Medicine. Ann Intern Med. 2015;163(10):794-795.
Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128(4):417-435.
Travers AH, Rea TD, Bobrow BJ, et al. Part 4: CPR overview: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):S676-684.