The inaugural meeting of the National Cardiac Arrest Collaborative took place on May 11th at the National Institutes of Health in Bethesda, Maryland. The meeting was a follow up to a workshop conducted in Washington, D.C. in July 2016, which explored recommendations of a Institute of Medicine (IOM) report on improving survival from cardiac arrest.
Among many other focus areas, the IOM report called for fostering a culture of action by improving public awareness and training and creating a national cardiac arrest collaborative.
The IOM report points out that cardiac arrest is the third leading cause of death in the U.S. The latest statistics from the American Heart Association (AHA) indicate that sudden cardiac arrest affects 356,500 people annually—outside hospitals alone—including 7,037 children. About 90% of cases are fatal.
The Bethesda meeting was the first official step toward formation of a collaborative of healthcare, government and nonprofit organizations that aspire to speak with one voice about cardiac arrest. The purpose of creating a formal collaborative is to unify the cardiac arrest field, identify common goals, build momentum and ultimately improve survival from cardiac arrest with good neurologic and functional outcomes.
Tom Aufderheide, MD of the Medical College of Wisconsin, and Lance Becker, MD of Hofstra North Shore-Long Island Jewish School of Medicine, both members of the IOM workshop committee, facilitated the Bethesda meeting.
Other IOM workshop committee members in attendance were Dianne Atkins, MD of the University of Iowa Carver College of Medicine; Richard Bradley, MD of the University of Texas Health Science Center; Jeremy Brown, MD of the National Institutes of Health (NIH); and Marina Del Rios, MD of the University of Illinois at Chicago.
Bradley, a member of the American Red Cross (ARC) Scientific Advisory Council, and Clifton Callaway MD, PhD of the University of Pittsburgh, who chairs the AHA Emergency Cardiovascular Care Committee, were designated co-chairs of the new group’s steering committee.
A representative of the U.S. Department of Health and Human Services will also be named as a co-chair of the steering committee. Drs. Aufderheide and Becker will serve on the committee along with Brown, Lana Gent, PhD, of the AHA, and Jonathan Epstein MEMS, NRP, of the ARC.
About 35 people participated in the Bethesda meeting, including several representatives of the American Heart Association, American Red Cross, NIH, and Sudden Cardiac Arrest Foundation. Representatives of the U.S. Department of Transportation, Children’s Cardiomyopathy Foundation, Citizen CPR Foundation, EMS for Children, Journal of Emergency Medical Services, Parent Heart Watch and Take Heart America also participated.
Sudden Cardiac Arrest Foundation representatives included board members Carissa Caramanis, a social media expert; Robert Davis, a communications director at the U.S Department of Justice; Martin Gannon, a survivor and financial advisor; and volunteer Matthew Strauss, who works in law enforcement. Davis, a former reporter for USA Today, presented information on crystallizing messaging to promote public awareness at the IOM meeting last July. Gannon and Strauss described their shared real-world experience at the meeting. Strauss saved Gannon’s life in 2003 when he was a 17-year-old high school student.
While industry members did not participate in the initial meeting of the collaborative, it was resolved that industry should play an important role in the collaborative going forward.
The rationale for limiting the size of the preliminary planning meeting was to enable organizers to construct the framework for the collaborative—exploring objectives, operational structures, funding models, and membership criteria. The vision is for members to work collaboratively on joint objectives, while at the same time maintaining organizational independence and preventing duplication of efforts.
Once established, the collaborative will be open to all interested stakeholders, including:
- Accreditation and certification organizations
- Survivors, families and friends of survivors and non-survivors and rescuers and the organizations serving these communities
- Consumer organizations
- Government agencies
- Healthcare providers and medical specialty organizations
- Marketing, branding, communication and strategic planning organizations
- National associations for state and local leaders
- The research community
- Resuscitation guidelines and training organizations
- Sports-related organizations
Creating Messaging That Works
The formative meeting focused primarily on improving messaging about cardiac arrest targeted to the general public. Dr. Becker kicked off the discussion with an overview of the current state of cardiac arrest messaging.
Gent spoke about the power of urban legends. In addition, she presented information on the benefits of using “sticky messaging,” based on guidance from “Teaching that Sticks,” by Chip and Dan Heath.
Sticky messages, she said, are simple, unexpected, concrete, credible, and emotional and are often illustrated through stories. She reported the AHA worked with Proctor & Gamble and the Ad Council to develop the “Hands-Only CPR” campaign, which has proven to be effective, based on AHA metrics.
Dominick Tolli, from the ARC, discussed the effectiveness of multiple targeted public awareness campaigns, such as those related to fires and drowning. He echoed the essential importance of story-telling. Various communications campaigns were highlighted during the discussion.
The benefits of using provocative messages to raise awareness were discussed. For example, a Newsweek cover article on survivor Brian Duffield, stating “This Man Was Dead. He Isn’t Anymore” was highlighted. Another provocative and effective message from the United Kingdom urging bystander action was “They’re dead. So what’s the harm?”
Lessons from the Brain Collaborative
Mark Alberts, MD from the University of Texas who represented the Brain Attack Coalition, a multidisciplinary group of organizations and government agencies dedicated to the prevention and treatment of stroke, provided key guidance during the meeting. According to Alberts, lessons learned from the Brain Attack Coalition include the following:
- All representatives should speak with one voice
- Representatives should be inclusive
- It’s important to own both successes and failures
- Representatives should recognize that efforts are not permanent and they will invariably revert to baseline
- Effective messaging is expensive
- Effective messaging should be targeted to the local level
Who Is the Audience?
Participants debated whether to target messaging toward people with prior CPR training, businesses, schools, places of worship, high-risk populations, people who spend time near AEDs and/or influencers. Ultimately, discussants settled on targeting the general public, with customized messaging, focusing on three key subgroups: laypersons, healthcare providers and policy-makers.
Participants recognized that creating effective messaging will depend on conducting communications research. In the meantime, some key messages that might be tested, participants suggested, are the following:
- Immediate action by bystanders is critical.
- Anyone can save a life/ You can save a life.
- CPR is easy to do—much easier than in the past.
- AEDs are easy to use, even by untrained bystanders.
- You cannot harm the victim. Your actions can only help.
- It’s important to do something.
“We were honored to be invited to the foundational meeting of the ‘National Cardiac Arrest Collaborative,’” said Mary M. Newman, MS, president of the Sudden Cardiac Arrest Foundation, a national nonprofit organization that represents survivors, and family members of survivors and non-survivors. “We appreciate the opportunity to have several seats at the table, to provide our insights on public awareness about sudden cardiac arrest, and to share personal stories of survival.”
The next meeting of the “National Collaborative on Cardiac Arrest” is scheduled as a pre-conference meeting at the Emergency Cardiovascular Care Update in New Orleans, LA, in December 2017.