# Enhancing Pre-Hospital Outcomes for Cardiac Arrest (EPOC)

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $702,022

## Abstract

PROJECT SUMMERY
Out-of-hospital cardiac arrest (OHCA) is a common, life-threatening event that is
associated with poor patient outcomes. Only ~30% of patients survive to hospital
admission and less than 10% are ultimately discharged alive. Yet as a recent Institute of
Medicine (IOM) report highlighted, some communities have been consistently more
successful in responding to and treating OHCA than others. While this is largely believed
to be due to the adoption of key care processes by emergency medical services (EMS)
agencies in the pre-hospital setting, how these processes are actually utilized in routine
practice and the underlying factors contributing to their successful implementation is
largely unknown. Further, an integrative systems approach that examines the interaction
of EMS agencies with other important stakeholders who provide care before and after
EMS arrives – such as first-responders (e.g., police, fire) and hospitals – has not been
undertaken. A better understanding and dissemination of strategies to improve care
processes employed by high-performing EMS agencies across the continuum of OHCA
care is a critical yet unfulfilled step for improving outcomes. Accordingly, the Enhanced
Pre-Hospital Outcomes for Cardiac Arrest (EPOC) study will lay the foundation for future
quality improvement efforts in OHCA through the following three aims: (1) Identify top-
and bottom-performing EMS agencies in survival for OHCA.; (2) Define `best
practices' at top-performing EMS agencies; (3) Validate factors associated
with high survival at top-performing EMS agencies. We will use a sequential
mixed methods approach to accomplish these aims. We build on extensive prior work by
our investigative team to systematically understand factors associated with delivering
optimal care in other emergency settings (mass casualty incidents, heart attacks, in-
hospital cardiac arrest) and leverage our team's multidisciplinary expertise in emergency
care, cardiology, clinical epidemiology, and mixed methods research. Findings from this
study will be used to construct a toolkit of `best practices' – the EPOC Toolkit – that may
be implemented by EMS agencies both within and beyond CARES through key state and
national partners to improve OHCA outcomes in communities across the U.S.

## Key facts

- **NIH application ID:** 9970242
- **Project number:** 5R01HL137964-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Mahshid Abir
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $702,022
- **Award type:** 5
- **Project period:** 2017-08-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970242

## Citation

> US National Institutes of Health, RePORTER application 9970242, Enhancing Pre-Hospital Outcomes for Cardiac Arrest (EPOC) (5R01HL137964-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9970242. Licensed CC0.

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