Download docx Responses to Core Innovation Questions Dr

1 What was the specific challenge met by this innovation?
The challenge was to meet the need for emergency care to be delivered by trained
paramedics to local people who had suffered a heart attack in their homes or at work. But
there were no EMTs or paramedics in 1968 – the training simply didn’t exist.
2 What was the solution? The innovation?
Medic One brought the intensive cardiac care available in a hospital emergency room to the
patient in his or her home, including CPR, airway management, intubation and breathing
assistance, and administration of medications.
3 How does Medic One work?
Volunteer paramedics are rigorously trained and certified, in a lengthy, hands-on
apprenticeship that coordinates efforts from the moment the paramedics step into an
emergency situation well into hospital care in the emergency room, integrating the
emergency cardiac experience.
4 What was the UW effect? Why here? Why then?
Such programs were “in the air” in the U.S. and abroad, but Medic One in Seattle was the
first success. In Washington, the state legislature passed Senate Bill 188, which authorized
the program and indemnified the partners – Seattle Fire Department, Seattle/King County
Department of Health, Harborview Medical Center and the University of Washington –
against lawsuit. Seattle was a small enough city that the partners from city, university and
hospital all knew one another, and could collaborate to “cook up” this experiment. The
public and the media were very supportive of Medic One, from the start.
5 Who solved the problem or met the challenge?
Seattle Fire Department Chief Gordon Vickery, Seattle Mayor Wes Uhlman, Emergency
Room resident Dr. Michael Copass and UW cardiologist Dr. Leonard Cobb began the project,
with help from dozens of others. Medic One was a collaborative project.
6 How was the problem solved? What was the creative or experimental process?
The program was tested for its first two years, with the promise from Seattle Mayor Wes
Uhlman that the City of Seattle would take it over, if it proved effective. During the first two
years, Medic One recorded the training and outcomes, tweaking the program as needed.
7 What was hardest? What obstacles were faced?
At the beginning, it was very difficult to find the money to get the program going at a robust
enough level to really test the use of emergency paramedics without a physician attending
at the scene. And at the beginning, no paramedics were certified. Medic One started from
scratch.
8 What came next? How did this innovation advance the field?
Medic One was widely emulated, worldwide.
9 What was the public benefit?
Medic One provides immediate, high quality coronary care OUTSIDE the hospital
emergency room. “The most important thing is what the public thinks of Medic One,”
commented Dr. Leonard Cobb, and the public has proven grateful for its life-saving service,
passing levies to continue its funding.
It was – and remains – difficult to really quantify the effectiveness of Medic One. The only
way to do so is to track death from cardiac arrest before and after the introduction of Medic
One. However, Medic One has definitely made a difference - the survival rate in metro
Seattle for ventricular fibrillation, in 2013, rose to 56% compared with 2 and 25%
nationally.