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221 Addendum: Resuscitation Academy Measure, improve, measure, improve . . . If you’ve seen one EMS system, you’ve seen one EMS system It’s not complicated, but it’s not easy Change occurs step by step Performance, not protocol Everyone in VF survives It takes a system to save a victim —“Mantras” at the Resuscitation Academy The tag line for the Resuscitation Academy is “improving cardiac arrest survival, one community at a time.” Since the first Academy class in 2009, we have been trying to do just that. The Resuscitation Academy, held twice a year in Seattle, is a joint effort of King County EMS (Public Health—Seattle and King County), Seattle Medic One (Seattle Fire Department), and the Medic One Foundation. Additional support comes from Harborview Medical Center, University of Washington, Medtronic Foundation HeartResue Program, Asmund S. Laerdal Foundation for Acute Medicine, and Life Sciences Discovery Fund. Many of the faculty you have met in chapter 6—Drs. Cobb, Copass, Rea, Kudenchuk, Nichol, and Sayre. The executive director is Ann Doll, head of the Medical QI Section in King County EMS, who provides direction, leadership, and tremendous organizational skills. The strong partnership between Seattle Medic One and King County EMS is personified by the contributions of Captain Jonathan 222 Addendum Larsen and Senior Paramedic Norm Nedell, both from the Seattle Fire Department; Linda Culley, Randi Phelps, Steve Perry, Jennifer Blackwood, Megan Bloomingdale, and Susan Damon from King County EMS; Michele Olsufka from Seattle Medic One; Dr. Hendrika Meischke from the University of Washington, and Jan Sprake, executive director of the Medic One Foundation. The faculty members are veterans in directing EMS programs and distinguished researchers in resuscitation science. My back of the envelope calculation says that the faculty members collectively represent 300 years of EMS experience. The Resuscitation Academy is offered tuition-free and attendees come from throughout the country and the world. The small class size allows for a two-way exchange of information—the faculty provides evidence-based information and tools to improve cardiac arrest survival and the attendees share the real-life challenges they face. Every community has a different constellation of culture, leadership, resources, and opportunity. Above all we (the faculty) have learned that change is very challenging and one should never assume that a good idea will always be embraced and implemented. Impediments to change, whether they stem from habit, inertia, malaise , or lack of resources, can overwhelm the best of intentions. We have also learned that no system will transform itself overnight. Change is not only difficult, it occurs slowly—tiny step by tiny step. (I use “we” throughout this description of the Resuscitation Academy to acknowledge the fantastic team effort.) Resuscitationacademy.org Information about the Academy may be found at resuscitationacademy.org. The most recent curriculum is posted on the site, as well as upcoming Academy classes and registration information. Though we have experimented with different lengths for the Academy, ranging from five days to one day, we have settled into a two-day length that allows a nice mixture of lectures, small group discussions, workshops, and breakout sessions. We expect every student to select a project to implement in his or her home community upon return from the Academy. We limit each Academy to 35-40 students in order to maintain a small-group seminar feel to the class. Plus the small class allows the faculty to get to know the individuals and vice versa. The Academy’s Mantras The Academy’s mantras, although bordering on the simplistic, attempt to encapsulate a kernel of wisdom. The first, “Measure, improve, measure, improve . . . ,” defines the essence of ongoing quality improvement. If you don’t measure something you can’t improve it. And once you measure it you will reveal things that need improving. And once you improve the system, measure it again to see if it has improved. And so on and Addendum 223 so on. Measurement and improvement can apply to many elements of an EMS system. First and at the most basic level, they refer to measuring cardiac arrest events and outcomes (death, survival, neurological recovery). But they also apply to components of the EMS system, such as time metrics (time for dispatch, time for response, time for scene arrival, time for patient arrival), high-performance CPR metrics (CPR density, depth of compression, full recoil, duration of pauses), and dispatcher assisted CPR metrics (recognition of agonal breathing, time to recognition of cardiac arrest, time to delivery of chest compression instructions). The next...

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