Systems of Care

In this month's issue of Critical Care Medicine, there was a fantastic article on systems-based cardiac arrest care. The authors showcase implementation of the "Take Heart America" program in two Minnesota towns. The study objective was to evaluate care before and after implementing the program. The focus of the THA program is to train entire communities from the lay public to providers of emergency services in early recognition and evidence-based intervention of cardiac arrests. Such interventions include:

• AEDs widely available in communities


• Public education to include CPR & AED training


• Early activation of EMS


• Quality pre-hospital care to include: advanced airways, intra-osseous drug delivery, ipedence threshold devices and automated CPR devices


• Hospital care, centers of excellence to include: accessibility to revascularization, ICDs and EP, therapeutic induced hyptothermia


• Data collection and analysis

The goal: to improve survivability after cardiac arrest events by ensuring all stakeholders have the knowledge and resources they need to reach that goal. This is a excellent example of how a system-wide evidence-based and standardized approach to care can greatly impact patient outcomes.

I have provided a link to the abstract below.

Take Heart America: A comprehensive, community-wide, systems-based approach to the treatment of cardiac arrest Lick et al. Critical Care Medicine: January 2011 - Volume 39 - Issue 1 - pp 26-33
doi: 10.1097/CCM.0b013e3181fa7ce4