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Heart Rescue - An impact evaluation of the Heart Rescue India program: Assessing the effectiveness of a quality improvement program to improve access and care of acute cardiovascular disease

Details

Description:

  1. Background: An impact evaluation of the Heart Rescue India program: Assessing the effectiveness of a quality improvement program in improving pre-hospital and hospital care for patients with acute cardiovascular disease.
  2. This study is being conducted in China and India. We are collaborating with the University of Washington, Institute for Health Metrics and Evaluation (IHME)
  3. For India we are collaborating with Community medicine to conduct the evaluation at 7 Heart rescue sites in Bangalore
  4. Aim:- To assess the impact of a novel quality improvement program aimed at improvingtimely and appropriate pre-hospital and hospital care for patients with acute cardiac eventsincluding ST-elevation myocardial infarction (STEMI) and out-of-hospital cardiac arrest (OHCA).
  1. Objective :

Landscape analysis:

  1. Elucidate community knowledge, attitudes and practice regarding cardiovascular (CVD) disease.
  2. Assess the capacity of health facilities and their providers to provide services foracute CVD events, including STEMI and OHCA.
  3. Assess the ability of pre-hospital emergency medical services to provide timelyand appropriate care for patients suffering from acute CVD events, including STEMI and OHCA.
  4. Identify barriers, needs, and opportunities to improve access to and delivery ofservices for STEMI and OHCA.
  5. Idenify variation in care between the public and private sectors.
  6. Inform the HeartRescue India program in order to allow for modification of interventions to more clearly focus on gaps in the continuum of care.

Impact evaluation:

  1. Identify the health impact (death and disability) of the HeartRescue India program on patients who present with STEMI and OHCA.
  2.  Identify the effect of process changes implemented as part of the Heart Rescue India program to improve timely and appropriate pre-hospital and hospital care for patients with STEMI and OHCA.
  3. Evaluate the effect of community interventions as described in the Heart Rescue India program that are designed to improve CVD knowledge, attitudes and practices.
  4. Estimate the cost of STEMI and OHCA care, and cost per life saved through the Heart Rescue India Program.

f. Methods:- Qualitative Methods:

IHME developed topic guides and SJRI conducted interviews with personnel in October 2020.

  • Participants include:
    • 11 interviews across 3 hub hospitals
    • 10 interviews across 5 spoke hospitals
    • 2 interviews with Karnataka health officials
    • 1 interview with 108
  • Interviews were transcribed, de-identified, and analysed. Data were then grouped by topic, and essential portions of each comment were assigned a code that captured the primary message of the statement. Codes were assigned following the Framework Method for qualitative analysis.

g. Sample size : 25

h. Study update: -Qualitative evaluation of Heart rescue India program was conducted through key informant interviews.

Total participants – 25

  1. 11 interviews across 3 hub hospitals
  2. 10 interviews across 5 spoke hospitals.
  3. 2 interviews with Karnataka health officials
  4. 1 interview with 108ambulance service

i.   Updated as on: 2nd Dec 2023

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