Coronary care units developed in the 1960s when it became clear that close monitoring by specially trained staff, cardiopulmonary resuscitation and medical measures could reduce the mortality from complications of cardiovascular disease. The first description of a CCU was given in 1961 to the British Thoracic Society by Dr. Desmond Julian, who founded the first CCU at the Royal Infirmary of Edinburgh in 1964. Early CCUs were also located in Sydney, Kansas City, Toronto and Philadelphia. The first coronary care unit in the US was opened at Bethany Medical Center in Kansas City, Kansas by Dr Hughes Day, and he coined the term. Bethany Medical Center is also where the first "crash carts" were developed. Studies published in 1967 revealed that those observed in a coronary care setting had consistently better outcomes.