Mending broken hearts: The American Heart Association and its life-saving treatment guidelines

The American Heart Association’s official guidelines on cardiopulmonary resuscitation and emergency cardiovascular care are some of the most respected around the world, not just in the United States. Their mission to save lives and prevent heart disease and stroke begins with up-to-date and reliable research and ends with hands-on education on an international scale. Tools, services and training are made available by the Association to healthcare workers, patients and the public alike because saving lives is everyone’s problem.

In this interview with Research Outreach, American Heart Association’s Chief of Mission Aligned Businesses and Healthcare Solutions, John Meiners, tells us more about the Association’s key strategies and how they aim to carry these out.

Can you tell us more about the American Heart Association (AHA) in terms of its background, history and core mission?
The American Heart Association’s mission is to be a relentless force for a world of longer, healthier lives. For nearly 100 years, we have been fighting heart disease and stroke, striving to save and improve lives. The Association was started in 1924 by six cardiologists as a professional society for doctors and has evolved to unite more than 33 million volunteers and supporters as well as our 3,400 employees.

Can you tell us more about your role and responsibilities at AHA?
I oversee several revenue-generating mission delivery departments at the association, including Emergency Cardiovascular Care (ECC), Workplace Health, International Programs and Patient Quality Systems Improvement. The Emergency Cardiovascular Care business is comprised of more than 4,000 training centres and 450,000 instructors who last year trained 22 million people in over 100 countries.

Our Patient Quality Systems Improvement team works to improve outcomes for patients by putting knowledge into practice. We do this by converting scientific research into treatment guidelines, then translating guidelines into clinical processes that take patient population characteristics into account. We help healthcare providers and patients achieve improved health with evidence-based information and tools for heart failure, stroke, blood pressure and cholesterol management through quality improvement initiatives and certification programmes.

The Workplace Health department offers a suite of science-based, evidence-informed tools and services to help build and maximise an effective workplace culture of health, which can increase productivity, reduce absenteeism and control healthcare costs.

Our International team collaborates with governments and non-governmental organisations to adapt successful solutions from the United States to extend the quality and lives of communities elsewhere.

Can you tell us what your global lifesaving programmes are and how the AHA works with many partners, across many countries to address the issue of non-communicable diseases and help save more lives?
About 8 years ago, the organisation began to increase its effort to address cardiovascular disease around the world, offering technical support, scientific exchange and training to governments, health care providers, hospital and pre-hospital systems, workplaces and communities.

The American Heart Association system of care approach – in coordination with local cardiovascular societies, heart and brain health advocates, business and government leaders – now drives global heart and brain health at all levels of society around the world.

In support of a country’s health priorities, we provide our technical expertise and experience in developing both patient and public programmes to improve the quality and length of people’s lives. With our partners, we share the best in science with people around the world through our annual Scientific Sessions, International Stroke Conference and ten speciality conferences, and by supporting joint science sessions with other countries’ cardiology societies at their local meetings.

We create educational programmes and tools that help people improve their health, such as Go Red For Women®, which educates women about their greatest health risk, cardiovascular disease, and is now promoted in more than 40 countries. We help improve hospital systems of care with programmes like Get with the Guidelines and Saving Children’s Lives in Botswana, Tanzania and India, an initiative designed to empower community health workers with skills to reduce under-fives mortality in low to middle-income areas.

We train 22 million people around the world annually – from advanced healthcare providers and corporate employees to new parents – in first aid, cardiopulmonary resuscitation (CPR) and advanced life support. And, we advocate for stronger public health policies that support improved nutrition availability, obesity reduction initiatives and improved hospital treatment and systems of care.

The American Heart Association’s mission is to be a relentless force for a world of longer, healthier lives.

The Association is a strategic partner with the World Heart Federation and celebrates World Heart Day on 29th September – can you tell us about this collaboration, what this World Heart day consists of and its global impact?
The American Heart Association is a founding partner of the World Heart Federation and an enthusiastic supporter of the commitment to reduce premature deaths from non-communicable diseases by 25% by 2025. World Heart Day was started in 2000 and aims to increase awareness of heart disease and stroke. The campaign for World Heart Day is about what you can do to get and keep your heart healthy. This year’s campaign – My Heart, Your Heart – was about creating a sense of commitment around the common cause of heart health. World Heart Day resonates around the world and plays a key role in spreading awareness of cardiovascular disease and the simple steps we can all take to reduce our risk.

The American Heart Association encourages everyone to learn how to perform CPR. Can you tell us why this is so important?
It is estimated that more than six million sudden cardiac deaths occur worldwide each year. Globally, the incidence of out-of-hospital cardiac arrest ranges from 20 to 140 per 100,000 people, and survival ranges from 2% to 11%.

Statistics prove that if more people knew CPR, more lives could be saved. When a person has a cardiac arrest, survival depends on immediately receiving CPR from someone nearby. CPR, especially if performed immediately, can double or triple a cardiac arrest victim’s chance of survival. It is also a fact that most cardiac arrests happen at home so if you need to give CPR in an emergency, you will most likely be trying to save the life of someone you love: a child, a spouse, a parent or a friend.

The American Heart Association is the leader in resuscitation science, education and training, and publisher of the official AHA Guidelines for CPR and ECC. How are the Association’s guidelines helping save lives around the world?
Healthcare professionals use CPR/basic life support/advanced cardiac life support/paediatric advanced life support to save lives because that is the right thing to do. At the time they are using one of these skills, they know they only have a very few minutes to save a life. Many healthcare providers know that the American Heart Association does a tremendous job in evaluating research behind recommendations and that you can trust what the Association says as being cutting edge and reliable. We has been writing these guidelines for a long time so we are a trusted organisation.

When international training centres open, they know that they will be teaching reliable, proven techniques/skills/medications to their students. When a health minister in China comes to us asking if we can teach resuscitation to 10% of their population, it is because they have done their homework and recognise that the Association guidelines are developed in a rigorous way, and our business processes are uncompromising with the patients survival and full recovery as the critical outcome.

This system of care approach drives global heart and brain health at all levels of society around the world.

What are the plans for the American Heart Association next year?
As part of our mission to be a relentless force for a world of longer, healthier lives, we recently revised our Strategic Impact Statement, which guides how we go about our work: the American Heart Association is a catalyst to achieving maximum impact in equitable health and well-being.

For more than 90 years, we have focused on treating cardiovascular disease. Over the last decade, we have turned our attention to preventing cardiovascular events. That effort requires improving health factors and risks that contribute to not just cardiovascular disease but many others including cancer and diabetes, so we find ourselves focusing increasingly on total health. Over the next decade, we will address overall health and well-being, anchored in cardiovascular and brain health, as well as health equity across all populations.

Additionally, we are seeking a paradigm shift in hospital resuscitation practice. Poor quality CPR is a preventable harm, and timely delivery of high-quality CPR is the greatest determinant of survival from cardiac arrest. Unfortunately, even with trained professionals, poor quality CPR is common. Advances in technology and evidence now show that low-dose, high-frequency psycho-motor training is significantly more effective at increasing and maintaining CPR competency, and that resuscitation quality improvement initiatives are both necessary and effective at saving lives of cardiac arrest patients in the hospital.

Developed through our strategic relationship with Laerdal, and launched in February 2015, the Resuscitation Quality Improvement programme develops high-quality resuscitation skills through low-dose, high-frequency CPR skills practice and high-fidelity coaching. Validated by early evidence on actual patient care and survival, more lives are being saved.

• To find out more about the American Heart Association, visit www.heart.org/en/