What factors predict ambulance prealerts to the emergency department? Retrospective observational study from three UK ambulance services.

Objectives: Ambulance clinicians use prealert calls to advise emergency departments (ED) of the arrival of patients requiring immediate review or intervention. Consistency of prealert practice is important in ensuring appropriate ED response to prealert calls. We used routine data to describe prealert practice and explore factors affecting variation in practice.

Aphasia partnership training: What outcomes do people with aphasia, family members and speech and language therapists expect?

Introduction: Life with aphasia affects the whole family with shorter, less frequent conversations, frustration, reduced social networks, isolation and tension in relationships. Evidence suggests communication partner training (CPT) benefits families. However, expected improvements are poorly articulated.

Understanding good communication in ambulance pre-alerts to the emergency department: findings from a qualitative study of UK emergency services.

Objectives: Prehospital notifications (pre-alerts) enable emergency department (ED) staff to prepare for the arrival of patients requiring a time-critical response. Effective communication of the pre-alert is key to enabling the ED to prepare appropriately, but evidence on communication practices is lacking. We undertook qualitative research to understand how pre-alert communication may be improved to optimise the ED response for pre-alerted patients.

Variation in ambulance pre-alert process and practice: cross-sectional survey of ambulance clinicians.

Background: Ambulance clinicians use pre-alert calls to inform emergency departments (EDs) about the arrival of critically ill patients. However, there is variation in guidance between local ambulance service policies in terms of what should be pre-alerted and how pre-alerts should happen. We conducted a national online survey to understand the use of ambulance pre-alerts and to inform recommendations for practice and guidance.

FAIRSTEPS study - Framework Addressing Inequities in pRimary care using STakEholder PerspectiveS: Integrative evidence review and Delphi consensus.

Objectives: Health inequities are unjust and avoidable differences in health outcomes across populations and between population groups. Though these arise predominantly from social determinants of health, healthcare is estimated to contribute around 20 % and primary healthcare reduces inequities in healthcare outcomes. As each provider works in their local context, we sought to provide an evidence-informed framework for designing, implementing, and evaluating local health inequity interventions in primary care.

Adoption of a semi-elective lung transplantation practice by safely extending cold ischemic times.

Objective: Lung transplantation is a complex surgical procedure performed by specialized teams. Practice changes to eliminate overnight lung transplants were implemented at our center and patient outcomes were evaluated.

Methods: Patient and donor organ selection were performed in the standard fashion.

How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments.

Background: Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response ('pre-alerts') have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them. This study aimed to understand how pre-alerts influence patient care in the ED.

What influences ambulance clinician decisions to pre-alert emergency departments: a qualitative exploration of pre-alert practice in UK ambulance services and emergency departments.

Background: Ambulance clinicians use pre-alerts to inform receiving hospitals of the imminent arrival of a time-critical patient considered to require immediate attention, enabling the receiving emergency department (ED) or other clinical area to prepare. Pre-alerts are key to ensuring immediate access to appropriate care, but unnecessary pre-alerts can divert resources from other patients and fuel 'pre-alert fatigue' among ED staff. This research aims to provide a better understanding of pre-alert decision-making practice.

Risk Factors, Incidence, and Outcomes Associated With Clinically Significant Airway Ischemia.

Airway complications following lung transplantation remain an important cause of morbidity and mortality. We aimed to identify the incidence, risk factors and outcomes associated with clinically significant airway ischemia (CSAI) in our center. We reviewed 217 lung transplants (386 airway anastomoses) performed at our institution between February 2016 and December 2020.

Performance status at the time of lung retransplant predicts long-term function.

Background: Lung retransplantation is offered to select patients with chronic allograft dysfunction. Given the increased risk of morbidity and mortality conferred by retransplantation, post-transplant function should be considered in the decision of who and when to list. The aim of this study is to identify predictors of post-operative disability in patients undergoing lung retransplantation.

Implementation of an enhanced recovery protocol for lung volume reduction surgery: an observational cohort study.

Objectives: Lung volume reduction surgery (LVRS) is an established therapeutic option for advanced emphysema. To improve patients' safety and reduce complications, an enhanced recovery protocol (ERP) was implemented. This study aims to describe and evaluate the short-term outcome of this ERP.

How consistent are pre-alert guidelines? A review of UK ambulance service guidelines.

Aims: Ambulance pre-alerts are used to inform receiving emergency departments (EDs) of the arrival of critically unwell or rapidly deteriorating patients who need time-critical assessment or treatment immediately upon arrival. Inappropriate use of pre-alerts can lead to EDs diverting resources from other critically ill patients. However, there is limited guidance about how pre-alerts should be undertaken, delivered or communicated.

Immediate Postoperative COVID-19 Infection after Lung Transplantation: A Systematic Review and Case Series.

Background: With new variants challenging the effectiveness of preventive measures, we are beginning to recognize the reality that COVID-19 will continue to pose an endemic threat. The manifestations of COVID-19 in lung transplant recipients during index admission are poorly understood with very few cases reported in recent lung transplant recipients. Optimal management of immunosuppression and antiviral therapy in recent transplant recipients is challenging.

How could online NHS 111 reduce demand for the telephone NHS 111 service? Qualitative study of user and staff views.

Background: Online NHS111 was introduced in 2018 in response to increasing and unsustainable demand for telephone NHS111. Despite high levels of use, there is little evidence of channel shift from the telephone to the online service. We explored user and staff perspectives of online NHS111 to understand how and why online NHS111 is used and whether there may be potential for shift from the telephone to online service.

Determining the relative salience of recognised push variables on health professional decisions to leave the UK National Health Service (NHS) using the method of paired comparisons.

Objective: The primary and secondary impacts from the COVID-19 pandemic are claimed to have had a detrimental impact on health professional retention within the UK National Health Service (NHS). This study set out to identify priorities for intervention by scaling the relative importance of widely cited push (leave) influences.

Design: During Summer/Autumn 2021, a UK-wide opportunity sample (n=1958) of NHS health professionals completed an online paired-comparisons exercise to determine the relative salience of work-related stress, workload intensity, time pressure, staffing levels, working hours, work-homelife balance, recognition of effort and pay as reasons why health professionals leave NHS employment.

Impact of gastro-jejunostomy tube in lung transplant patients: a propensity-matched analysis.

Objectives: During the postoperative phase of lung transplantation, the surgical creation of a gastro-jejunostomy (GJ) may be deemed necessary for patients with severe oesophageal dysmotility, prolonged oral intake difficulties stemming from use of a ventilator or marked malnutrition. We explored the effects of postoperative GJ tube on survival and bronchiolitis obliterans syndrome in lung transplant recipients.

Methods: We retrospectively reviewed all lung transplants performed at our institution between 2011 and 2022.

Natriuresis-guided diuretic therapy in acute heart failure: a pragmatic randomized trial.

Measurement of natriuresis has been suggested as a reliable, easily obtainable biomarker for assessment of the response to diuretic treatment in patients with acute heart failure (AHF). Here, to assess whether natriuresis-guided diuretic therapy in patients with AHF improves natriuresis and clinical outcomes, we conducted the pragmatic, open-label Pragmatic Urinary Sodium-based algoritHm in Acute Heart Failure trial, in which 310 patients (45% female) with AHF requiring treatment with intravenous loop diuretics were randomly assigned to natriuresis-guided therapy or standard of care (SOC). In the natriuresis-guided arm, natriuresis was determined at set timepoints, prompting treatment intensification if spot urinary sodium levels were <70 mmol l.