HBI Awards 2017: Training the community as first responders to combat cardiac arrests

Apollo Hospitals Dhaka is the only JCI Accredited 450-bed multi-disciplinary super-specialty tertiary care hospital in Bangladesh, providing health care with the latest medical, surgical and diagnostic facilities.

To build a brand that represents ‘Patient Centric’, Apollo Hospitals Dhaka conducted a market and found that individuals appreciated and respected learning activities. To identify itself as THE neighbourhood hospital, Apollo Hospitals Dhaka took up a community support program to educate and enlighten the residents of the area in its vicinity with first aid and basic life support training.

The goal of the initiative was to educate more community participants so that they are confident enough to attempt cardiopulmonary resuscitation (CPR) to improve survival rates of people experiencing cardiac arrest or heart attack.

So far 1,100 people have been trained as first responders. The project is considered as a social activation and brand enhancing initiative as a part of Corporate Social Responsibility of Apollo Hospitals Dhaka to the community.

Full application

1. Briefly describe the organisation giving the number of facilities, staff, revenue numbers.

Apollo Hospitals Dhaka is the only JCI Accredited 450-bed multi-disciplinary super-specialty tertiary care hospital in Bangladesh, confidently providing comprehensive health care with the latest medical, surgical and diagnostic facilities. The hospital is a showcase of the synergy of medical technology and advances in IT through paperless medical records.

Dedicated to providing multidisciplinary medical care and backed by state-of-the-art facilities, Apollo Hospitals Dhaka offers team-based quality patient care that is widely acknowledged to be amongst the best in Bangladesh. At Apollo Hospitals Dhaka, patients have ready access to more than 29 specialized departments and services, which are established as national referral centres. We have five Centers of Excellence and five Strategic Business Units. Modern lithotripsy service, i.e. the treatment of kidney and ureter stones without surgery, is provided by the hospital using extracorporeal shock wave.

The hospital also offers a complete Dialysis Unit for the treatment of patients with kidney disorders. The hospital has 1.5 Tesla MRI, 64 Slice CT Scan, Color Doppler, Ultrasound, and Gamma Camera, which have created the most modern Radiology and Nuclear Medicine service in the country, with equipment that is faster and capable of conducting a wide range of examinations with a higher degree of detail. This is in addition to EEG, EMG, neurophysiology, ECG, stress test, pulmonary function test, etc. Our international standard Lab Medicine conducts External Quality Control Program with Bio-Rad, USA and offers a variety of modern tests and diagnostic tools, some of which are not available anywhere else in Bangladesh, with regular additions.

Facilities Available
• Total 450 beds
• 24-hour Trauma and Emergency Care
• 24-hour Ambulance services
• OPD with all specialties
• 9 Operating Rooms
• 24-hour diagnostic services
• 24-hour Pharmacy
• 24-hour Blood Bank
• Physical Medicine & Rehabilitation Centre
• Vaccination Centre
• Radial Lounge Total staff 1663 (Physicians 270, Nursing staff 415, Paramedics 200, support services 700, pharmacy 56 and contract 22). Revenue number in September 2016: BDT 163,107,088 (EBITDA), USD $ 2,058,969.28

2. Please describe what steps the nominated organisation carried through in the best building of a brand. These are likely to include market research, changes to services, the communication of brand values and the measurement of brand impact.

In order to build a brand that represents ‘Patient Centric’ a market research was conducted and it was concluded that individuals appreciated and respected activities through which we learnt that, nearly 80% of cardiac arrest occurs outside the hospital. Despite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in the community. Substantial number of victims who suffer an arrest without attempted resuscitation. There are many lives and life-years lost because resuscitation is not attempted. We had been receiving many cases that could have been rescued if early intervention like basic life support techniques were known and attempted. The vast majority of cardiac arrest victims are adults, but a good many number of infants and children suffer cardiac arrest each year.

Cardiac arrest continues to be an all-too-common cause of premature death, and small incremental improvements in survival can translate into thousands of lives saved every year.

Deaths due to sudden cardiac arrest are growing concern to the community. When a victim suffers from cardiac arrest, they have but a few short minutes before brain damage, organ damage, or even death. Rescue breathing coupled with chest compressions buys the victim the time that may be required to save their life. This technique is trained and disseminated among all to make them aware to save life within golden hour.

CPR, or cardio-pulmonary resuscitation, an important skill that everyone should learn. You do not need to be a medical professional to know or use CPR. You never know when you may need this skill to save someone you love or to be a hero to a stranger. To identify itself as the friendliest neighborhood hospital, Apollo Hospitals Dhaka has taken up a community support program to educate and enlighten the residents of the area in its vicinity with first aid and basic life support trainings.

The ultimate goal of this initiative is to cover more area involving more community participants under this initiative so that they dare to attempt to improve survival rates while facing the reality that most people don’t know how to give cardiopulmonary resuscitation (CPR).

The targets are to disseminate appropriate and effective knowledge among all so that they can
– assess of collapsed victims within golden hours
– distinguish the cardiac arrest and heart attack.
– respond immediately to the situation of medical emergency
– perform chest compression and rescue breathing.
– perform First Aid effectively and safely.

Apollo Priyojon, a Good Samaritan has started its endeavor with thirty volunteers residing in Basundhara Residential Area. Now we have trained a good number of participants so far in the surrounding community. We have been capturing feedbacks from them on a regular basis to know the effectiveness of the program. After launching of the campaign we have received more than 30 cardiac patients so far in our emergency who were well managed at home and taken to our Emergency within golden hours and outcome was positive survival.

A trained person is known to all in the community which gives the people a real sense of assurance and confidence when emergency strikes.

In these programs the participants actively learn as much as they can from the doctors. Our physician who is a certified trainer from American Heart Association (AHA) conducts the session in the best way to perform CPR. The trained individuals are called ‘Apollo Priyojon’. At present more than 1100 trained Apollo Priyojon, know what to do in emergency situation. They immediately call to our emergency and start CPR to rescue patient from imminent danger. Due to these activities, the brand perception is gradually changing in the minds of the patients. The impacts can be measured through the increase in the patient turnover in these events and activities as well their verbal feedback.

3. When were the brand changes launched?

Month : March

Year : 2015

4. What has been the impact of the change?

Currently, all 1100 trained Apollo Priyojon, know what to do in emergency situation. They immediately call for our emergency and start CPR to rescue the patient from imminent danger. We have received more than 30 patients in our emergency those were managed at home after immediate cardiac attack and brought them into hospital within golden hours. These kind of good responses after our Priyojon program were very positive outcome of the effectiveness of the program.

Now inhabitants of the community know that they have got one or two trained person “Apollo Priyojon, in the community to help them out during emergency. There are other quantifiable results/ outcomes are but not limited to

• Now they can assess of collapsed victims within golden hours (< 1hr)
• They respond immediately to medical emergency of the victims.
• They dare to perform chest compression and rescue breathing. They can identify the case when victim becomes unresponsiveness and won’t breathe normally and they know when CPR is needed to have any chance of survival.
• They have been trying and improving survival rates while facing the reality that most people don’t know how to give cardiopulmonary resuscitation (CPR).
• Now they can distinguish the cardiac arrest and heart attack.
Management has a strong commitment to keep continuing this program as CSR activities and also encourage other to come forward to extend help to such activities so that consolidated effort will bring change in the communities.

We have been extending this program beyond Basundhara area to cover more area in and around Dhaka city to provide this support to the inhabitants. The areas like Uttara, Gulshan and Banani will have the support of Apollo Priyojon.

Offering a mix of workshop, training, consultancy and communications counsel, we design and deliver robust programs and campaigns unique to in line with key priority areas of the community people.

A vibrant response and query from the community people play an important driving force in spreading such endeavour.

We have been spending a lump sum amount of BDT 30,000 per program to promote this program to ensure patient safety who need basic life support.

5. How has this impact been measured?

We have introduced a dedicated number 10678 for getting and dealing with emergency calls efficiently. Now “Priyojon” or anyone can directly call to our 24/7 Emergency for availing any support and services. Our ER team is promptly providing services to the case of cardiac arrest brought in within golden hours. A telephonic assessment is done to know the clinical conditions of the patient and required equipment with trained paramedic or physician is sent with the ambulance to rescue and manage a patient.

We have been monitoring some quality improvement measures as mentioned below to keep up the quality of services.
(i). Ambulance calls are monitored to track time taken to respond to each call (benchmark 5 minutes)
(ii). Average Door to CT scan time for patients requiring CT (Benchmark 25 minutes)
(iii). Average door to balloon time is also tracked to measure time to ballooning in Cath Lab (Benchmark 90 minutes)

The process of creating and enlightening “Priyojon” in the residents of the area in its vicinity with first aid and basic life support training is well supported by the management of the hospital.

3 to 4 training sessions are conducted every month and 30 to 40 participants take part in each session. The training session, lasting for 4 hours, has required training materials and tools. Our physician who is a certified trainer from American Heart Association (AHA) conducts the session in the best way to perform CPR. The training process is designed to identify adequately the need and evaluation of the program. All required pieces for the training like manikins, audiovisual, and training materials are used to train the participants. Refreshers training is also arranged on a routine basis to stimulate the learning. There is a plan to recall the old participants when the number of Priyojon volunteer reaches to 1100. The trainer demonstrates the techniques of CPR before participants. Participants also take part in the practice session to learn CPR appropriately.

An expert dedicated team comprising of Physicians, staff members from Business Development, Nursing Services, Medical Services and senior leaders from different medical and non-medical departments are assigned to carry forward this initiative of Apollo Priyojon. Now Priyojon becomes as routine activities as this is incorporated in the organisation wide year long program.

Priyojon is considered as a social activation and brand enhancing initiative as a part of Corporate Social Responsibility of Apollo Hospitals Dhaka to the community to provide the required confidence, spirit and basic knowledge to the volunteers, to make them able to provide immediate timely support to friends and families at times of any medical need.

We would welcome your thoughts on this story. Email your views to Daisy Hotopf or call 0207 183 3779.