Scottish Out-of-Hospital Cardiac Arrest data linkage project: initial results

Future

This report is just a start. The process of assembling this baseline dataset has laid the foundations for an OHCA epistry (epidemiological registry) in Scotland. This will allow us to track the impact of Scotland's OHCA Strategy to 2020 and beyond. In addition, the OHCA Data Linkage Project Analytical Team are collaborating with others in the international community who share our aspiration to improve survival after OHCA (including the UK wide OHCA registry and the Global Resuscitation Alliance ^{[3], [17], [50], [51]} to share data and ideas for system improvement.

Data development

One of the aims of the OHCA Data Linkage Project is to understand and improve data quality, particularly in datasets which have not been extensively analysed. The OHCA Data Linkage Project Analytical Team will work with data providers to improve data quality to enhance the use of the data locally as well as for research.

The linked dataset will be updated at least once a year to monitor the 'Out-of-Hospital Cardiac Arrest: A Strategy for Scotland'. Subject to permissions, the linked dataset will be expanded to include:

• co-responder data from the Scottish Fire and Rescue Service,
• co-responder data from Police Scotland, and
• geographical data on Public Access Defibrillators ( PADs) from the Scottish Ambulance Service.

The 'Out of Hospital Cardiac Arrest: A Strategy for Scotland' proposed that there should be an on-going OHCA Registry. The experiences from this data linkage project will inform the development of a long term OHCA epidemiological registry ('epistry').

Making this OHCA data available for the first time in Scotland has involved drawing together the expertise and organisational commitment of a range of key partners from organisations caring for critically ill and deteriorating patients. The power of providing key metrics and analysis in helping build a system that saves lives is evident. We hope to build on this project to develop a wider group of partners working towards improving outcomes for patients with a range of life-threatening emergency conditions requiring a time-critical response with both pre-hospital and in-hospital components - a Scottish Resuscitation Outcomes Consortium.

Box 3

A vision for the future: Scottish Resuscitation Outcomes Consortium ( Scot-ROC)

In order to ensure on-going improvements in OHCA outcomes, there is a need for a collaborative hub in Scotland around which ideas can be developed, research progressed, data analysed, information shared and support and expertise offered. Based on the experience in other countries ^{[6], [8], [22]}, it is proposed that a consortium - the Scottish Resuscitation Outcomes Consortium (or Scot-ROC) - should be developed.

• To work with key partners to put in place the ethical, data protection, statistical and IT frameworks required to assemble key datasets required to analyse systems of care, identify strategic research areas and drive quality improvement.
• To provide infrastructure and project support for clinical trials and other outcome-oriented research into cardiopulmonary arrest that will rapidly lead to evidence-based change in clinical practice and pathways of care in Scotland.
• To maintain a focus on pre-hospital and early hospital-based emergency interventions recognising the critical importance of this timeframe and the common challenges of data collection, research and service improvement in these clinical domains.
• Scot-ROC investigators could conduct collaborative trials and tests of change of variable size and duration leveraging the combined power of the member institutions and promoting the rapid translation of promising scientific and clinical advances for the public good.
• Scot-ROC would report regularly with information available to stakeholders, Scottish Government and the general public, present at relevant meetings and publish in the peer reviewed literature. The consortium could also act as an advisory group for Scottish Government and other organisations.

Excerpted from Scotland's Strategy for Out-of-hospital cardiac arrest ^[2]