Establishing a Process for Community AED Data Transmission
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Background
Community Automated External Defibrillators (AED) contain valuable clinical data that can impact decision making and care during a patient’s subsequent hospitalization. However, there are no nationally established standards for obtaining, managing, and transmitting this data. Current practice at Virginia Commonwealth University Medical Center (VCUMC), an urban quaternary academic system, was such that clinicians rarely had this data available for clinical decision making, and for those few patients whose data they did obtain, the process took up to nine days.
Methods
This project aimed to implement a process to deliver community AED data to clinical care teams as quickly as possible. Using Lean Six Sigma methodology, DMAIC (Define, Measure, Analyze, Interpret, Control) framework, and PDSA (Plan-Do-Study-Act) cycles, we established an improved process for obtaining and transmitting clinical data following use of community AEDs. We used both real events and simulations to analyze and hone our process. The multidisciplinary project team consisted of clinicians, emergency medical services (EMS), emergency department (ED) leads, information technology, legal/risk, and quality improvement team members. Manufacturers that are known to be in the central Virginia area include: Zoll, Philips, and Stryker. The project we describe targeted Zoll AEDs in VCUMC’s outpatient clinics and surrounding Richmond communities.
Results
The new process was designed and tested with a demonstration of decreased time from cardiac arrest event to data availability in the electronic medical record (EMR). Following each case, we completed additional PDSA cycles to further align EMS and ED workflows.
Conclusions
Establishing a process for obtaining and uploading community AED data to the EMR is feasible and shows faster turnaround than ad hoc efforts. Obtaining the necessary software for AEDs of varying manufacture remains a challenge, but Phase I effectiveness supported advancement to Phase II to include additional AED manufacturers and remaining Central Virginia communities in collaboration with community EMS partners.
