Improved management of acute kidney injury in primary care using e-alerts and an educational outreach programme.

Purpose: Acute kidney injury (AKI) detected in primary care is associated with increased morbidity and mortality. AKI electronic alerts (e-alerts) and educational programmes have recently been implemented but their contribution to improve AKI care is unknown. This project aimed to improve response to AKI detected in primary care and used a factorial design to evaluate the impact of the UK National Health Service (NHS) AKI e-alert and AKI educational outreach sessions on time to response to primary care AKI stages 2 and 3 between April and August 2016.

Primary Care Collaboration to Improve Diagnosis and Screening for Colorectal Cancer.

Background: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis.

Methods: The project featured triannual learning sessions, monthly conference calls, practice coach support, and monthly reporting.

Implementation and effects of Enhanced Recovery After Surgery for hip and knee replacements and fractured neck of femur in New Zealand orthopaedic services.

Aim: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results.

Method: ERAS protocols were developed for hip and knee TJA and fractured NOF.

An Estimation of Potential Vector Control Effect of Gravid Mosquito Trapping in Fort Worth, Texas.

Entomological surveillance is an essential component for integrated vector management (IVM), the current best practice for West Nile virus (WNV) prevention and control. The significance of vector mosquito surveillance, however, is not always recognized by the public, which increases vulnerability of IVM programs to elimination or downsizing when virus activities are low, particularly during interepidemics of WNV. In order to increase public recognition, the unrecognized contribution of mosquito surveillance with gravid (egg-carrying) mosquito trapping to WNV vector control was estimated using a novel approach.

Target CLAB Zero: A national improvement collaborative to reduce central line-associated bacteraemia in New Zealand intensive care units.

Aim: Central line-associated bacteraemia (CLAB) is a preventable cause of patient morbidity and mortality in intensive care units. Target CLAB Zero was a national campaign that ran from October 2011 to March 2013 across all New Zealand ICUs (intensive care units). The campaign aimed to reduce the national CLAB rate to less than one incident per 1,000 line days and to establish a national measurement system for CLAB.

Challenges for routine health system data management in a large public programme to prevent mother-to-child HIV transmission in South Africa.

Background: Recent changes to South Africa's prevention of mother-to-child transmission of HIV (PMTCT) guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major challenge. We assessed the completeness and accuracy of routine PMTCT data submitted to the district health information system (DHIS) in three districts of Kwazulu-Natal province, South Africa.

Strategies for the scale-up of antiretroviral therapy in South Africa through health system optimization.

In the face of the massive burden created by human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious diseases, developing nations must find ways to rapidly begin treatment for infected persons. Although infusions of personnel, supplies, and diagnostics would make a major contribution to expanding the capacity to treat these diseases, the lack of these resources creates a long-term challenge, and there is a need for additional approaches to spread effective interventions that can leverage existing resources and the much-needed infusions of new resources. This article describes one such approach-applied in several forms in South Africa-that aims to significantly increase the number of patients receiving antiretroviral therapy.