The effectiveness of ART is best reflected by the results achieved at UC San Diego Medical Center (see graph below). ART has reduced the incidence of cardiopulmonary arrest by almost 50 percent. This reduction in arrest frequency has occurred predominantly in the non-ICU environment where the current incidence of arrests is about one-quarter of baseline. These results support the IOM goals of reducing preventable arrests and fostering an environment of enhanced patient safety. For the remaining patients who suffer cardiopulmonary arrest, neurologically intact survival has more than doubled. Survival-to-discharge rates have been sustained at a level more than twice that of the benchmark established by the American Heart Association’s Get With The Guidelines database for eight consecutive years. The ART program has resulted in a 20 percent reduction in overall hospital mortality.
As a result, ART has been designated as a Best Practices Model by the Joint Commission and recognized as a Best Patient Safety Initiative by both the National Association of Public Hospitals and the University of California Regents. Most recently, UC San Diego Health System received a Quality Leadership Award from the University Health System Consortium (UHC) based on rapid improvements in overall mortality and patient safety and a top-five ranking in overall quality of care. Perhaps the most telling statistic for ART is that observed mortality at UC San Diego Health System is 38 percent below expected values, leading to UC San Diego’s recognition as one of the safest hospitals in the county, state and country.
In the pre-hospital environment, ART training has resulted in similar outcomes. For patients arresting in the presence of air medical providers, survival-to-ED-admission more than doubled following training. Survival from out-of-hospital cardiac arrest increased 50 percent following ART training in a cohort of San Diego County EMS agencies, and survival among patients arriving to the UC San Diego Emergency Department with ongoing chest compressions rose from zero to more than 9 percent.
Since the initiation of the ART program:
- Cardiopulmonary arrest survival has doubled and is currently more than twice the national average (defined by the American Heart Association Get With The Guidelines).
- Neurologically intact arrest survival has tripled in non-ICU patients.
- The incidence of non-ICU arrests has decreased by more than 60%.
- The improved survival and decreased arrest incidence in non-ICU patients have dramatically enhanced patient safety.
- Expenditures for life support training have decreased by over 35%.