Out-of-Hospital Cardiac Arrest: A Strategy for Scotland

Annex A: Data to Drive Improvement: Establishing a Scottish OHCA Registry

Improving OHCA outcomes and delivering and monitoring the many components of a comprehensive OHCA strategy requires a whole-system approach and will require significant improvements in the availability of high quality, timely and comparable data. Consequently, one the key objectives of this strategy is the creation of an OHCA Registry.

Once established, in addition to the benefits of healthcare professionals being able to access better data to support patient care, the registry will allow the development of a raft of short- and long-term indicators to assess and drive improvement. This will support on-going improvement of services, but also provide the information needed to assess the progress of the strategy and the aims within it.

There is also evidence that providing meaningful feedback of performance data motivates staff to ensure that data capture is comprehensive, thereby ensuring that the information becomes more accurate and more useful.

Although a great deal of data is already collected and available it has to date not been systematically collated, analysed and used for OHCA. The Registry will link several existing data sources to form a 'patient journey' for each OHCA episode in Scotland. This linked-data will provide patient outcome figures (e.g. survival, neurological status), system benchmarking measures, and case mix data for patients suffering OHCA). By isolating fixed and alterable factors in each OHCA case, a more useful determination of targets for quality improvement will be made.

OHCA Registry - the Patient Journey

The Registry will facilitate analysis of the full patient journey after OHCA, a journey which for some will, regrettably, end in death. However, being able to look at the underlying causes of death following OHCA, and integrating autopsy data where available, will make it easier to identify cases with a genetic component. For these cases, the registry will create an opportunity for the Familial Arrhythmia Network for Scotland (FANS) to contact families in order to investigate whether other family members carry a similar risk of cardiac arrest and so be offered preventative treatment.

The establishment of a high quality Scottish OHCA Registry brings with it the opportunity to benchmark Scottish performance against that of other countries. It is important that Scotland builds strong links with other UK and international OHCA databases.