COMPARING EMERGENCY MEDICAL SERVICES. The David Brown article concludes by identifying an area where more reductions in heart disease deaths can be obtained: “A big focus in cardiology right now is to get more heart attack victims to the hospital. Today, about 40 percent of them delay longer than six hours, by which time optimal treatment isn’t possible.” Some of that improvement would have to come from educating the public. But USAToday, which has always done a wonderful job of providing cross-sectional data (such as state by state breakdown) on important issues, had a wonderful series about emergency medical service responses in fifty major cities. Here is part of the series. Another part of the series explained how Seattle has outperformed other cities by coordinating the actions of firefighters and ambulance crews and by “meticulously measuring the performance of the system, chiefly by monitoring sudden cardiac arrest survival.” This part of the series tells how Boston went from saving 14% of cardiac arrest victims in 1993 to saving 40%. I think that there should be a lot more of this kind of comparative determination of best practices.

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  1. Nick says:

    There was a lengthy chapter in Malcolm Gladwell’s BLINK discussing how a lot of resources in the ER had been gobbled up by people who thought they had a heart attack, and doctor’s had to decide whether or not it was a heart attack. Much of that has been streamlined by an algorithm.

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