(5 min read) Lauren Emanuelson has been with Advanced Medical Transport for 10 years. She manages the “Race to the Top” Program, focused on cardiac arrest resuscitation using the data from the X-Series monitors. This program was originally developed in 2014 with the assistance of physician experts, medical centers and biomedical manufacturers. As of 2018, Lauren has guided the program to improve survivability from cardiac arrests in their service area.

For a number of years, AMT has been using data pulled from the ZOLL X-Series monitors to dissect cardiac arrest episodes down to the second. As a result, they have tweaked their protocols to optimize their efforts and “Race to the Top” was recognized with the 2016 AMBY Award for the best Clinical Outcome Project with resuscitation numbers among the best in the nation. That is why she is an EMS Pulse Award recipient in 2019.

Her Story

Lauren has worked in emergency medical services since high school. She began her career as a volunteer in Marseilles, Illinois, as a first responder. From there, Lauren volunteered with a larger municipality in Peru, Illinois, to gain a higher call volume as she trained at every pre-hospital level (from EMT-Basic to Intermediate, to Paramedic, to Critical Care paramedic). After graduating from the University of St. Francis in 2008 with a BS in Nursing, she worked in a Level 1 trauma center as an emergency department nurse for just shy of nine years. Lauren began her career with AMT in 2010 as a pre-hospital registered nurse and critical care paramedic. In 2018, she started to work part-time as the Race to the Top Coordinator.

The Race to the Top program is an all-encompassing quality improvement program targeting continuous improvement in cardiac arrests. Historically, the patients who achieved spontaneous circulation were the only indicator that was truly measured and reported. After further analysis, they realized there was a huge opportunity to improve the process of resuscitation and improve chances of survival.

This program focuses on education through a review process while utilizing best practice, evidence-based medicine and internal data-driven changes to protocols. The program requires every provider to attend a Resuscitation Academy yearly to further enhance their skills and learn new techniques. Finally, each cardiac arrest that occurs in the market receives a data-driven review where AMT thoroughly scrutinizes the ePCR (patient care report) against the data. A report of the strengths and weaknesses of the process serves to identify recurring themes and target an educational plan based on actual events.

Emanuelson is the coordinator of the Race to the Top program and lead educator in the initiative.

This solution continues to evolve with new ideas and is always open to protocol changes. Ideas are discussed by the Race to the Top committee and if the decision is made to move forward, it’s taken to the medical director for final approval. If approved at that level, the information is written up and sent out to crews along with subsequent education.  

By engaging employees in the on-going process of improvement, there is little push-back and a lot of buy-in. There is a team of educators within the field employees to teach Resuscitation Academies and handle post-call reviews. These individuals have become a team of “cardiac arrest champions” who spread and spark energy surrounding the program.

“Gaining employee buy-in is the key to a successful program,” Emanuelson said. “We have built a team of educators within the field employees to teach Resuscitation Academies and to help distribute post call reviews. These individuals help to own the program as well as to spread energy surrounding the cardiac arrest program. Mandatory Resuscitation Academy training for internal employees has made the protocol and expectations clear and transparent. Within the first year, remarkable individual growth was noted with providers.”

Lauren’s advice to other organizations looking to improve their ROSC rates? “The bottom line is that you have to track and trend data to know where any deficiencies lie. Once you do that, you are compelled to do something about it! Create an open environment where people are talking about cardiac arrest and get employees engaged. When the employees own the process, it’s possible to drastically move the needle towards improvement that matters. I recommend you set high expectations, but understand the realistic limitations that no one can control. Break down each process and make sure it makes sense. Use the data. Once you make a change, train on that change. Then move on to the next area for improvement. Celebrate the small victories and keep working to move the needle toward better care.”

By the numbers:

• Last year, Advanced Medical Transport invested nearly $40,000 to train and equip their partner first responder agencies with the ZOLL ResQ Pod and ResQ Pump devices. They had a 100% success rate on witnessed vfib/vtach arrest in which the ResQ Pump was used.  
• AMT’s Utstein Survival Report (for arrests while utilizing the ResQPCR system) in 2018:
• 30 total lives saved (19 in Peoria)

From June 4, 2018 – December 31, 2018:

• Survival rate of unwitness cardiac arrests: 0% (31/63)
• Survival rate of bystander witnessed cardiac arrests: 40.9% (22/63)
• Survival rate of Utstein bystander patients: 100% (6/6)

Closing thoughts from Lauren:

“Always remember that you have to own everything that you touch...the good, the bad, and the ugly! Make every opportunity worthwhile. Identify and praise what is working well and learn from all other experiences. Be willing to adapt, modify, and change. Remember not to lose sight of the end goal. In a very big picture of resuscitative care, the encompassing small and finite details make the biggest impact. No detail is too small to focus on. Ultimately remember that the bundle of care that an organization establishes is more than the equipment used, the personnel trained, or the protocols established. The true bundle of care is the entire process from start to finish!”

About EMS Pulse Awards

To coincide with National EMS Week, ZOLL created the EMS Pulse Awards. The awards recognize professionals who are the pulse of their EMS organization, working behind the scenes of prehospital care and empowering their organization to provide better care and ultimately enable their teams to save more lives within their communities. Winners were selected based on the information provided in their nominations, which was also used in their story above. This year’s winners were recognized at our yearly user conference, SUMMIT. Congratulations to all of our winners who are successfully streamlining the business side of EMS!

Interested in nominating a coworker for their achievements on the business side of EMS? Nominations will open again in Spring 2020.