Lessons from a Successful Public Access Defibrillation Program

Manager shares strategies behind one of the country’s best programs

About Project Heart Beat

Maureen O’Connor is the program manager for San Diego Project Heart Beat (SDPHB). She also co-chaired the planning committee for the Emergency Cardiovascular Care Update conference held in San Diego in December.


One of the largest public access defibrillation (PAD) programs in the U.S., SDPHB was voted “Best Large Community Program” in 2003 by the National Center for Early Defibrillation for its structural organization and success. In 2009, The International Association of Fire Chiefs named SDPHB its Heart Safe Large Community PAD Program of the Year, and the Sudden Cardiac Arrest Association honored SDPHB with its Public Service Award.


Since the program launched in 2001, SDPHB has deployed more than 6,000 AEDs throughout San Diego County, resulting in 78 lives saved to date. SDPHB is completely self-sustaining and offers its clients a complete PAD management program–from AED installation, CPR/AED training and medical and administrative oversight, to critical incident stress management services in the event of an AED deployment. In November, SDPHB will celebrate its 10th anniversary.


San Diego Medical Services is a public-private partnership between San Diego Fire Rescue and Rural/Metro Corp.


Q: How did Project Heart Beat get off the ground, and how is it funded?


San Diego Medical Services was the governing agency that created San Diego Project Heart Beat. The project began in 2001 and was opened up to all public and private venues with a red ribbon ceremony at San Diego International Airport, which was one of our first private partnerships through the program. That was in November of 2001.


We operate at no cost to taxpayers. The public-private partnership allows us to use the San Diego Foundation as our umbrella non-profit 501(c)(3) fundraising vehicle. All donations to Project Heart Beat are deposited into a specific San Diego Foundation fund to exclusively support our mission. We also solicit grant funding from local organizations, city governments and private companies to raise money. Our goal is to never turn away any organization that would like an AED.


Q: What role does San Diego’s Corporate Partnership Program play in Project Heart Beat?


As part of the Corporate Partnership Program, the City of San Diego has an agreement with Cardiac Science–our AED supplier–to be the city’s official AED partner. A percentage of the sale of AEDs sold through Project Heart Beat goes back into the PAD program, and Cardiac Science is promoted on our Project Heart Beat promotional materials. In turn, for allowing us to use that process, all the AED PAD programs throughout the city have free program management services through Project Heart Beat. It’s kind of a barter system.


Q: What services do you provide to a typical PAD program member?


Medical director oversight is part of the package. Then, our program management tools give them the resources to manage their program–where the AEDs are located, the serial numbers, who’s trained at the facility, etc. We developed our own database to manage the program, and through the database we send them friendly e-minders to check the status of their AED to keep them compliant. We also send them e-minders if their electro pads are getting ready to expire or for other issues. It helps to really keep a high compliance on their program.


Beyond that, our staff is on-call for the program 24 hours a day, seven days a week to respond to AED deployment or AED issues. When there is an AED deployment, we will go to the scene, take care of their AED, download the data, fill out the report and put their unit back into service. Each of the deployment team members is also certified in Critical Incident Stress Management, so we can support the people who were involved, because it can be a very traumatic situation.


Q: How many full-time employees work for Project Heart Beat?


We currently have four full-time employees, but we have more than 100 CPR instructors who teach courses through our American Heart Association Training Center.


Q: What happens to the ECG data after a deployment?


We have access to all the emergency departments throughout the county, so we’re able to transport the actual cardiac arrest rhythm, which is an incredible resource for the ED docs and cardiologist when they have that victim in their hands. There have been doctors that are absolutely adamant that this person did not experience cardiac arrest until we enter the ED and say, “Take a look.”


Q: You maintain such a large AED database. Are you also using the data for any sort of research?


Nobody has the statistics of how these programs work, and nobody has collected the data to prove it, but we have. Our deployment database is basically owned by the city’s medical director, James Dunford, though we maintain it through Project Heart Beat. He’s conducted some great research.


We are looking at not just AED placement, but how awareness through mass training, etc., is affecting society as a whole. We’re also looking to understand where the highest occurrences of cardiac arrest occur and where bystander response is the lowest so that we can target our educational campaigns where the lowest occurrences of bystander CPR are. The program has provided a great resource to our community, but it’s also providing incredible statistical research opportunities to see where we need to go out and focus on more education.


Q: Do you provide any type of financial grant assistance to organizations that don’t have the funding to start a PAD program?


We do provide financial grant assistance, not only for the procurement of AEDs to initiate a PAD program but also for our program management services to any nonprofit organization or 501(c)(3), and a good majority of those are schools and places of worship–obvious areas in need of public access defibrillation.


Q: Are all the public schools throughout San Diego County outfitted with AEDs?


That’s an ongoing effort. We’ve gotten the San Diego Unified School District onboard for a district-wide program, but it’s a 100% grassroots fundraising effort, because the school district has not invested any funding into the program. Through generous donations from community advocates and organizations, we’ve placed approximately 60 AEDs throughout the San Diego Unified School District.


Q: San Diego has a unique building code that requires AED installation in all new construction. How did that come to pass?


To the best of my knowledge, it is the first municipal code that requires the installation of AEDs in new building construction. It became law in December of 2008. It’s very specific and does not apply to retrofitting or reconstruction or remodeling, and the number of AEDs is tied to building use and occupancy load. (Single- and multi-family dwellings are excluded.)


San Diego Project Heart Beat did not actually write the law, but it was a joint team effort working closely with the city’s code compliance department with leadership from a strong City of San Diego councilmember and PAD advocate over a three-year period.


(Access a PDF of the ordinance at http://docs.sandiego.gov/municode/MuniCodeChapter14/Ch14Art05Division39.pdf).


Q: What’s the takeaway message for agencies considering implementing a PAD program in their community?


These programs do work. We’ve saved 78 lives, and we’ve achieved a 70—72% survival rate for cardiac arrest in the locations where we manage the program.

For more information on San Diego Project Heart Beat, visit www.sdprojectheartbeat.com. O’Connor encourages questions and is happy to lend support to other PAD programs in development. Contact her at (619) 243-0911 or MOConnor@sandiego.gov.
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