The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency.

Background: The Adelaide Score is an artificial intelligence system that integrates objective vital signs and laboratory tests to predict likelihood of hospital discharge.

Methods: A prospective implementation trial was conducted at the Lyell McEwin Hospital in South Australia. The Adelaide Score was added to existing human, artificial intelligence, and other technological infrastructure for the first 28 days of April 2024 (intervention), and outcomes were compared using parametric, non-parametric and health economic analyses, to those in the first 28 days of April 2023 (control).

Factors that influence recruitment to COVID-19 vaccine trials: a qualitative evidence synthesis.

Background: The COVID-19 pandemic marked a unique period characterised by an extraordinary global virus spread. The collective effort to halt the transmission of the virus led to various public health initiatives, including a variety of COVID-19 vaccine trials. Many of these trials used adaptive methods to address the pandemic's challenges, such as the need for rapid recruitment.

Impact of frailty, malnutrition and socioeconomic status on perioperative outcomes.

Background: Frailty, malnutrition and low socioeconomic status may mutually perpetuate each other in a self-reinforcing and interdependent manner. The intertwined nature of these factors may be overlooked when investigating impacts on perioperative outcomes. This study aimed to investigate the impact of frailty, malnutrition and socioeconomic status on perioperative outcomes.

Copying in medical documentation: developing an evidence-based approach.

Background: Electronic medical records (EMRs) provide multiple efficiencies in communication to clinicians. The ability to copy and paste text in an EMR can be useful; however, it also conveys a risk of inaccurate documentation. Studies in international settings have described such overuse of copying to result in 'note bloat', with the dilution of relevant clinical information and potential clinical detriment.

Medication shortage behaviour change with multidisciplinary clinician-designed digital notification intervention.

Objectives: To evaluate the effect of a clinician-designed digital notification system on the use of intravenous paracetamol during a medication shortage.

Methods: An in-house digital notification platform was designed through multidisciplinary collaboration. A 4-week pre- and post-implementation methodology was employed to evaluate the effect of the intervention.

Rule-based clinician-developed programmes can facilitate haemodialysis clinical workflows.

There are routine hospital workflows that are not addressed by certain institutional electronic medical records, including the detection of patients requiring haemodialysis who are admitted under non-nephrology services. In this study, the feasibility and performance of a clinician-developed automated haemodialysis patient finder was evaluated. The programme ran with zero downtime for 6 months and had zero false negatives or false positives.

Optimising digital clinical consultations in maternity care: a realist review and implementation principles.

Objectives: The COVID-19 pandemic has led to increased use of digital clinical consultations (phone or video calls) within UK maternity services. This project aimed to review the evidence on digital clinical consultations in maternity systems to illuminate how, for whom and in what contexts, they can be used to support safe, personalised and equitable care.

Design: A realist synthesis, drawing on diverse sources of evidence (2010-present) from OECD countries, alongside insights from knowledge user groups (representing healthcare providers and service users).

Topological and Morphological Membrane Dynamics in Giant Lipid Vesicles Driven by Monoolein Cubosomes.

Lipid nanoparticles have important applications as biomedical delivery platforms and broader engineering biology applications in artificial cell technologies. These emerging technologies often require changes in the shape and topology of biological or biomimetic membranes. Here we show that topologically-active lyotropic liquid crystal nanoparticles (LCNPs) can trigger such transformations in the membranes of giant unilamellar vesicles (GUVs).

Large language models can effectively extract stroke and reperfusion audit data from medical free-text discharge summaries.

Introduction: Audits are an integral part of effective modern healthcare. The collection of data for audits can be resource intensive. Large language models (LLM) may be able to assist.

Scoping review of the effectiveness of 10 high-impact initiatives (HIIs) for recovering urgent and emergency care services.

Introduction: Prolonged ambulance response times and unacceptable emergency department (ED) wait times are significant challenges in urgent and emergency care systems associated with patient harm. This scoping review aimed to evaluate the evidence base for 10 urgent and emergency care high-impact initiatives identified by the National Health Service (NHS) England.

Methods: A two-stage approach was employed.

Interventions to minimise hospital winter pressures related to discharge planning and integrated care: a rapid mapping review of UK evidence.

Background: Winter pressures are a familiar phenomenon within the National Health Service and represent the most extreme of many regular demands placed on health and social care service provision. This review focuses on a part of the pathway that is particularly problematic: the discharge process from hospital to social care and the community. Although studies of discharge are plentiful, we identified a need to focus on identifying interventions and initiatives that are a specific response to 'winter pressures'.

Exploring the impact of housing insecurity on the health and wellbeing of children and young people in the United Kingdom: a qualitative systematic review.

Background: Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Many aspects of housing have all been shown to impact children/young people's health and wellbeing. However, the pathways linking housing and childhood health and wellbeing are complex and poorly understood.

Signposting services for people with health and care needs: a rapid realist review.

Background: Signposting typically refers to an informal process that involves giving information to patients to enable them to access external services and support. It is perceived to reduce demand on primary care and other urgent care services.

Methods: This focused realist review was conducted rapidly within time constraints.

Push or pull? Digital notification platform implementation reduces dysglycaemia.

Pushing selected information to clinicians, as opposed to the traditional method of clinicians pulling information from an electronic medical record, has the potential to improve care. A digital notification platform was designed by clinicians and implemented in a tertiary hospital to flag dysglycaemia. There were 112 patients included in the study, and the post-implementation group demonstrated lower rates of dysglycaemia (2.

Patients' perspectives of epilepsy care by specialists and generalists: qualitative evidence synthesis.

Background: In the UK, epilepsy care involves both specialists (for example, neurologists) and generalists (for example, GPs). Policymakers typically consider that epilepsy care should be integrated and involve both specialists and generalists. However, few understand exactly how patients view and compare specialist and generalist care.

Exploring how the design and provision of digital self-management technology can improve the uptake by older adults with chronic kidney disease, diabetes and dementia: A modified e-Delphi study.

As development and introduction of digital self-management technologies continues to increase, the gap between those who can benefit, and those who cannot correspondingly widens. This research aimed to explore the use of digital self-management technology by older adults with three highly-prevalent long-term conditions (chronic kidney disease, diabetes and dementia), and build expert consensus across the conditions on changes needed to improve effective usage. This qualitative research involved a modified e-Delphi Study.

A Retrospective Analysis of Characteristics Favouring In-Hospital Resuscitation Plan Completion, Their Timing, and Associated Outcomes.

Comprehensive resuscitation plans document treatment recommendations, such as 'Not for cardiopulmonary resuscitation'. When created early in admission as a shared decision-making process, these plans support patient autonomy and guide future treatment. The characteristics of patients who have resuscitation plans documented, their timing, and associations with clinical outcomes remain unclear.

Adaptability, Scalability and Sustainability (ASaS) of complex health interventions: a systematic review of theories, models and frameworks.

Background: Complex health interventions (CHIs) are increasingly used in public health, clinical research and education to reduce the burden of disease worldwide. Numerous theories, models and frameworks (TMFs) have been developed to support implementation of CHIs. This systematic review aims to identify and critique theoretical frameworks concerned with three features of implementation; adaptability, scalability and sustainability (ASaS).

Contrast Sensitivity, Visual Field, Color Vision, Motion Perception, and Cognitive Impairment: A Systematic Review.

Objectives: To examine relationships between visual function (ie, contrast sensitivity, visual field, color vision, and motion perception) and cognitive impairment, including any definition of "cognitive impairment," mild cognitive impairment, or dementia.

Design: Systematic review and meta-analyses.

Setting And Participants: Any settings; participants with (cases) or without (controls) cognitive impairment.