b'18Our Chest Pain Committee, which is comprised of pre-hospital and hospital/departmental senior leaders, physician champions, and front-line staff, all supported the adoption of a standardized care model and it was accepted into practice almost immediately. Shifting to an increased focus on metabolic stabilization following cardiac arrest directly correlated to a higher percentage of OHCA patients transferred to ICU rather than to CCL for diagnostic cardiac angiography. Often times this delayed, but not eliminated, a heart catheterization to explore potential causes for the arrest. Targeted-temperature management remained a priority as well for eligible patients, as it had been prior to implementation. To assess compliance with this care pathway, every admitted OHCA patient was tracked and evaluated quarterly by our interdisciplinary team for appropriate disposition. Any outliers were referred to and discussed by a peer review committee. When 2018 finalized data became available, a drastic improvement was seen in reduction of in-hospital mortality for our OHCA patient population as tracked by CARES. A previous 70% mortality rate had fallen to approximately 45%. Furthermore, the number of patients discharged with a Cerebral Performance Category (CPC) Score of 1 or 2 had also risen from 18.4% to 30.9%, indicating that more people who survived remained neurologically intact.Success of this project is credited to the engagement and actions of a multi-disciplinary team that spans the full spectrum of representation including EMS, ED, CCL, ICU and beyond. Utilization of a pathway supported standardization of care and minimized deviation between providers and specialties adding consistency to how we treated our patients, and ultimately was associated with a decrease in in-hospital mortality. A thorough review and feedback process ensured accountability and helped to drastically reshape and simplify the decision-making process for continued treatment of the OHCA patient. As a result, more patients are returning to their families with optimal neurological functioning. Metro HealthUniversity of Michigan Health is an integrated healthcare system located in Wyoming, Michigan that includes a 208-bed general acute-care osteopathic teaching hospital. Metro Health Hospital is a primary PCI center with a fully staffed CCL 24/7 and nationally recognized heart and vascular services. Other hospital certifications include Level 2 Trauma and Comprehensive Stroke care.'