title: Translation of evidence-based clinical standards into a new prehospital resuscitation policy in Los Angeles County.
abstract: OBJECTIVE
  To translate a set of evidence-based clinical standards designed to allow paramedics to forego unnecessary and potentially harmful resuscitation attempts into a feasible new policy.
  
  
  METHODS
  Policy documents, meeting minutes, and personal communications between a large urban Emergency Medical Services (EMS) agency serving all of Los Angeles County (LAC) and a research group were reviewed over 12 months.
  
  
  METHODS
  LAC EMS and University of California, Los Angeles (UCLA) formed a partnership (the EMS-UCLA Collaborative) to develop and translate the standards into new EMS protocols. Clinical indicators considered appropriate and feasible by an expert panel were submitted to the agency for inclusion in the new policy.
  
  
  RESULTS
  The Collaborative submitted the results to the LAC EMS Commission and a physician advisory group for review. Of the 41 indicators approved by the expert panel, 22 would have resulted in changes to the current policy. All six involved asking family members about or honoring written and verbal Do Not Attempt Resuscitate requests, but only 4 of the 16 indicators based on clinical characteristics were included in the new policy. Ultimately, 10 of the 22 indicators that would have changed policy were approved and implemented.
  
  
  CONCLUSIONS
  By collaboration, a large EMS agency and a research team were able to develop and implement a revised resuscitation policy within 1 year.
authors.affiliation: Department of Emergency Medicine, Mount Sinai School of Medicine, One Gustave L Levy Place, New York, NY 10029, USA.
authors.forename: Corita R
authors.initials: CR
authors.lastname: Grudzen
authors.forename: Lynne D
authors.initials: LD
authors.lastname: Richardson
authors.forename: William J
authors.initials: WJ
authors.lastname: Koenig
authors.forename: Jerome R
authors.initials: JR
authors.lastname: Hoffman
authors.forename: Karl A
authors.initials: KA
authors.lastname: Lorenz
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
mesh_terms: D002985:Clinical Protocols; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000592:standards; D055416:Evidence-Based Emergency Medicine / Q000458:organization & administration* / Q000592:standards; D006302:Health Services Research; D006801:Humans; D015141:Los Angeles; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D057240:Patient Preference; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000592:standards*; D016414:Resuscitation Orders
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