Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Strategies for Post Arrest Resuscitation and Care Network
Brief Summary: Background: One of the 2010 Impact Goals of the Emergency Cardiac Care (ECC) Committee of the American Heart Association is to double survival from cardiac arrest. Currently, approximately 60% of adults and 50% of paediatric patients that regain spontaneous circulation following cardiac arrest die before leaving the hospital. A key piece of the "chain of survival" is this fifth link; the care of patients post-arrest. Although there are several modalities recommended for post arrest care, therapeutic hypothermia is the only in-hospital therapy that has been demonstrated in randomized clinical trials to improve patient outcome after cardiac arrest. Despite the strong evidence for its efficacy and the apparent simplicity of this intervention, recent surveys show that hypothermia is delivered inconsistently, incompletely, and with undue delay in hospitals receiving resuscitated patients; only 26% of physicians and 26% of hospitals regularly institute a hypothermia protocol.

Primary Objective: To design and apply a knowledge translation program for the 2005 AHA guideline on hypothermia post cardiac arrest and enable effective implementation of hypothermia in 100% of eligible OHCA patients. The integration of two robust data collection systems, which include both pre-hospital and in-hospital indicators, will give complete process of care and clinical outcome information for all cardiac arrest patients.

Primary Endpoint: the proportion of eligible out of hospital cardiac arrest patients cooled to 32-34°C within 6 hours of ED arrival.

Study Design: This project will be implemented through an established research collaborative of 43 hospitals in southern Ontario currently participating in the Toronto site of the Resuscitation Outcomes Consortium. A stepped wedge study design will be employed, whereby the intervention will be rolled-out sequentially to the participating hospitals over a number of time periods as sites reach pre-defined benchmarks. The multifaceted KT strategy will include 1) local multidisciplinary champions in ED, ICU, and Cardiology 2) A simple protocol for application of hypothermia, tailored to local needs and policy; 3) Identification of perceived and actual barriers to knowledge use; 4) Development of an implementation tool kit and 5) Providing timely feedback on benchmarks for hypothermia and outcomes


Options:
A: Inclusion Criteria:

* Members of the Henry Ford Health System

Exclusion Criteria:

* Individuals who are not members of the Henry Ford Health System
B: Inclusion Criteria:

* Age 18 or over.
* Treated during the study duration
* Primary or secondary discharge diagnoses of NVUGIB (per charted ICD-10 code). Additional confirmation of NVUGIB using endoscopic findings or patient symptoms done as previous.

Exclusion Criteria:

* Patients initially assessed at another institution for the present episode of NVUGIB and subsequently transferred to the participating site with unavailable initial data.
* Endoscopy noted no gastro-duodenal ulcer bleeding, to ensure patient homogeneity.
C: Inclusion Criteria:

* patients not up-to-date with CRC screening guidelines based on their responses to baseline survey
* patients with a positive personal history of CRC

Exclusion Criteria:

* patients with personal history of CRC or inflammatory bowel disease
* patients with a family history of hereditary conditions that put them at high risk for CRC (familial adenomatous polyposis or hereditary, nonpolyposis CRC)
* inability to read and comprehend the Informed Consent or written survey
* patients who are up-to-date with CRC screening guidelines based on their response to the baseline survey
D: Inclusion Criteria:

* Hospitals participating in the ROC network

Exclusion Criteria:

* Hospitals who do not receive out-of-hospital cardiac arrest patients

Answer: D