TY - JOUR
T1 - A knowledge translation collaborative to improve the use of therapeutic hypothermia in post-cardiac arrest patients
T2 - Protocol for a stepped wedge randomized trial
AU - Dainty, Katie N.
AU - Scales, Damon C.
AU - Brooks, Steve C.
AU - Needham, Dale M.
AU - Dorian, Paul
AU - Ferguson, Niall
AU - Rubenfeld, Gordon
AU - Wax, Randy
AU - Zwarenstein, Merrick
AU - Thorpe, Kevin
AU - Morrison, Laurie J.
N1 - Funding Information:
Dr. Morrison is the Robert and Dorothy Pitts Chair in Acute Care and Emergency Medicine, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Past Chair of the Advance Cardiac Life Support Committee of the American Heart Association and the Co Chair of the Advance Life Support Task Force of the International Liaison Committee on Resuscitation for Consensus 2010. She is the Principal Investigator for the SPARC grant which was awarded peer reviewed funding from Heart and Stroke Foundation of Canada, CIHR and the Laerdal Medical Foundation. The remaining authors list no competing interests.
Funding Information:
This study has been funded by the Heart and Stroke Foundation of Canada, the Canadian Institutes of Health Research, and by the Laerdal Foundation for Acute Medicine (Norway). Neither funding agency will be involved in any collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the results for publication. DCS holds a New Investigator Award from the Canadian Institutes for Health Research.
PY - 2011/1/14
Y1 - 2011/1/14
N2 - Background: Advances in resuscitation science have dramatically improved survival rates following cardiac arrest. However, about 60% of adults that regain spontaneous circulation die before leaving the hospital. Recently it has been shown that inducing hypothermia in cardiac arrest survivors immediately following their arrival in hospital can dramatically improve both overall survival and neurological outcomes. Despite the strong evidence for its efficacy and the apparent simplicity of this intervention, recent surveys show that therapeutic hypothermia is delivered inconsistently, incompletely, and often with delay.Methods and design: This study will evaluate a multi-faceted knowledge translation strategy designed to increase the utilization rate of induced hypothermia in survivors of cardiac arrest across a network of 37 hospitals in Southwestern Ontario, Canada. The study is designed as a stepped wedge randomized trial lasting two years. Individual hospitals will be randomly assigned to four different wedges that will receive the active knowledge translation strategy according to a sequential rollout over a number of time periods. By the end of the study, all hospitals will have received the intervention. The primary aim is to measure the effectiveness of a multifaceted knowledge translation plan involving education, reminders, and audit-feedback for improving the use of induced hypothermia in survivors of cardiac arrest presenting to the emergency department. The primary outcome is the proportion of eligible OHCA patients that are cooled to a body temperature of 32 to 34°C within six hours of arrival in the hospital. Secondary outcomes will include process of care measures and clinical outcomes.Discussion: Inducing hypothermia in cardiac arrest survivors immediately following their arrival to hospital has been shown to dramatically improve both overall survival and neurological outcomes. However, this lifesaving treatment is frequently not applied in practice. If this trial is positive, our results will have broad implications by showing that a knowledge translation strategy shared across a collaborative network of hospitals can increase the number of patients that receive this lifesaving intervention in a timely manner.Trial Registration: ClinicalTrials.gov Trial Identifier: NCT00683683.
AB - Background: Advances in resuscitation science have dramatically improved survival rates following cardiac arrest. However, about 60% of adults that regain spontaneous circulation die before leaving the hospital. Recently it has been shown that inducing hypothermia in cardiac arrest survivors immediately following their arrival in hospital can dramatically improve both overall survival and neurological outcomes. Despite the strong evidence for its efficacy and the apparent simplicity of this intervention, recent surveys show that therapeutic hypothermia is delivered inconsistently, incompletely, and often with delay.Methods and design: This study will evaluate a multi-faceted knowledge translation strategy designed to increase the utilization rate of induced hypothermia in survivors of cardiac arrest across a network of 37 hospitals in Southwestern Ontario, Canada. The study is designed as a stepped wedge randomized trial lasting two years. Individual hospitals will be randomly assigned to four different wedges that will receive the active knowledge translation strategy according to a sequential rollout over a number of time periods. By the end of the study, all hospitals will have received the intervention. The primary aim is to measure the effectiveness of a multifaceted knowledge translation plan involving education, reminders, and audit-feedback for improving the use of induced hypothermia in survivors of cardiac arrest presenting to the emergency department. The primary outcome is the proportion of eligible OHCA patients that are cooled to a body temperature of 32 to 34°C within six hours of arrival in the hospital. Secondary outcomes will include process of care measures and clinical outcomes.Discussion: Inducing hypothermia in cardiac arrest survivors immediately following their arrival to hospital has been shown to dramatically improve both overall survival and neurological outcomes. However, this lifesaving treatment is frequently not applied in practice. If this trial is positive, our results will have broad implications by showing that a knowledge translation strategy shared across a collaborative network of hospitals can increase the number of patients that receive this lifesaving intervention in a timely manner.Trial Registration: ClinicalTrials.gov Trial Identifier: NCT00683683.
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U2 - 10.1186/1748-5908-6-4
DO - 10.1186/1748-5908-6-4
M3 - Article
C2 - 21235799
AN - SCOPUS:78651375691
SN - 1748-5908
VL - 6
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 4
ER -