b"20 YEARS OF CARESMICHIGAN: A STATEWIDE PURSUIT OF SURVIVALMichigan joined CARES as a statewide effort in 2014. Home to approximately 10 million people, the state sees nearly 8,800 EMS-treated OHCA each year, yet only about 600 individuals survive with good neurological function. In 2016, SaveMiHeart was established as a nonprofit initiative to improve survival from sudden cardiac arrest through research, education, and community awareness. Teri Shields has coordinated the MiCARES program since its inception and plays a central role in identifying opportunities for improvement using CARES data. My nursing background in critical care, cardiac surgery, and research is rooted in evidence based best practices, she says.Shields ensures the accuracy of CARES data entry and regularly shares performance reports to help communities and systems of care improve their cardiac arrest response. Over the past decade, MiCARES data has found wide variability in survival rates. Michigan is committed to improving survival no matter where you live, says Shields.It's hard to imagine a better example of successfully using CARES dataDetroit has gone for dramatic improvement than Detroit. The city declared bankruptcyfrom less than 1% the year before the state joined CARES. At that time, we published theoverall survival from lowest cardiac arrest survival of any city willing to publish, says Dr. RobertOHCA to 3.5% in the Dunne, EMS Medical Director for Detroit. We had no first responders.first year, and 8.1% We did not have early defibrillation. At times, there were fewer than 10in 2024, with much ambulances operating. Bankruptcy was our inflection point. Like thehigher survival for saying, never let a crisis go to waste. witnessed arrests with bystander CPR.Dunne and his team didnt. When a new mayor and city council tookDr. Robert Dunneoffice, Dunne was ready. We were able to beat them over the head withEMS Medical Director for Detroitthe CARES data, he says. Thanks to CARES, we could show them exactly how badly we were doing and what we needed to fix it.Fix it they did. The Detroit Fire Department team renegotiated contracts with the Fire Union, enabling firefighters to serve as medical first responders, an initiative that had been blocked for decades. The City Council funded a pilot project to equip 50 AEDs, and Detroit reopened its own paramedic education program.Detroit has gone from less than 1% overall survival from OHCA to 3.5% in the first year, and 8.1% in 2024, with much higher survival for witnessed arrests with bystander CPR, says Dunne. Bystander CPR has gone from around 13% to 36% in 2024, or 46% if events occurring in a nursing home or healthcare facility are included. Today, Detroit is recognized as a HEARTSafe Community. They have used CARES data to drive meaningful, ongoing improvement, and continue to do so every day.8.1% 12.5% 36% 46%OverallBystanderBystander BystanderSurvival WitnessedCPR CPRSurvival (including nursing home/healthcare facility events)24"