Utstein registration used as a tool in organisational development.
OBJECTIVE
To evaluate the results of out-of-hospital CPR in a county after seven independent local EMS organisations were merged into one, and to evaluate the use of Utstein registration as a tool in the reorganisation process.


METHODS
All out-of-hospital cardiac arrests in Ostfold county in which the EMS system was responded to in 1997 were registered according to the Utstein template. The results were reported back to the EMS personnel and presented to the media.


RESULTS
Of 163 cardiac arrests of cardiac origin where CPR was attempted, 59% received bystander CPR. 13% were discharged from hospital alive (9.1/100 000 inhabitants), 32% of those with VF/VT. At discharge 18 of 22 patients functioned normally with cerebral performance category 1 and Overall performance category 1. The media had previously been very critical of the decision to centralise the emergency services. There was large media coverage when the results were presented, and criticism virtually disappeared. The registration and presentation appeared to create a feeling of unity among the EMS personnel.


CONCLUSIONS
The Utstein registration functioned well as a tool both internally and externally in an EMS reorganisation process.
Weydahl
P G
PG
Division for Emergency Medicine, Ostfold Hospital, Fredrikstad, Norway.
Stoen
A M
AM
Jorgensen
B
B
Arnulf
V
V
Steen
P A
PA
D016887:Cardiopulmonary Resuscitation / Q000401:mortality; D004632:Emergency Medical Services / Q000458:organization & administration*; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D009664:Norway / Q000453:epidemiology; D009935:Organizational Affiliation; D010043:Outcome and Process Assessment, Health Care