Opportunities to optimise care and choice in joint replacement surgery using a digitally delivered, holistic PreHab pathway.

Purpose: To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (: MPP for adults referred for elective joint replacement.

Methods: MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible.

Development of a feasible and acceptable digital prehabilitation pathway to improve elective surgical outcomes.

Objectives: To codesign and assess the feasibility, acceptability, and appropriateness of a hospital-initiated, community delivered approach to health optimization (prehab) prior to planned surgery.

Design: Participatory codesign combined with a prospective, observational cohort study (April-July 2022).

Setting: A large metropolitan tertiary referral service with 2 participating hospitals.

Automated Decision Support For Community Mental Health Services Using National Electronic Health Records: Qualitative Implementation Case Study.

Background: A high proportion of patients with severe mental illness relapse due to nonadherence to psychotropic medication. In this paper, we use the normalization process theory (NPT) to describe the implementation of a web-based clinical decision support system (CDSS) for Community Mental Health Services (CMHS) called Actionable Intime Insights or AI. AI has two distinct functions: (1) it provides an overview of medication and treatment history to assist in reviewing patient adherence and (2) gives alerts indicating nonadherence to support early intervention.

The Potential of Integrated Nurse-Led Models to Improve Care for People With Functional Gastrointestinal Disorders: A Systematic Review.

Functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia are extremely common, debilitating, and costly. Although diagnostic guidelines and effective management options exist, management is suboptimal, with long waiting lists, delayed diagnosis, and poor patient outcomes. The aim of this systematic review was to explore and evaluate evidence for existing models of care for functional gastrointestinal disorders.

Faecal calprotectin testing for identifying patients with organic gastrointestinal disease: systematic review and meta-analysis.

Objectives: To assess the clinical effectiveness of faecal calprotectin (FC) testing for distinguishing between organic gastrointestinal diseases (organic GID), such as inflammatory bowel disease (IBD), and functional gastrointestinal disorders (functional GIDs).

Study Design: Studies that assessed the accuracy of FC testing for differentiating between IBD or organic GID and functional GIDs were reviewed. Articles published in English during January 1998 - June 2018 that compared diagnostic FC testing in primary care and outpatient hospital settings with a reference test and employed the standard enzyme-linked immunosorbent FC assay method with a cut-off of 50 or 100 μg/g faeces were included.

Referrals to a tertiary hospital: A window into clinical management issues in functional gastrointestinal disorders.

Background And Aim: To investigate the quality of and reasons for referrals of patients with likely functional gastrointestinal disorders (FGID) and explore patients' experience of clinical management.

Methods: A cross sectional, mixed-methods study was undertaken. Referrals (July 2013-2015) to one gastroenterology outpatient department triaged as "likely FGID", the referred patients and their referring primary healthcare providers were examined.

A mixed methods thematic review: Health-related decision-making by the older person.

Aims And Objectives: To undertake a mixed methods thematic literature review that explored how elderly adults approached decision-making in regard to their health care following discharge.

Background: A critical time for appropriate health decisions occurs during hospital discharge planning with nursing staff. However, little is known how the 89% of elderly living at home make decisions regarding their health care.

Diagnosis and management of irritable bowel syndrome: a guide for the generalist.

Irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs) are so prevalent they cannot reasonably have their diagnoses and management based within specialty care. However, delayed diagnosis, lengthy wait times for specialist review, overinvestigation and lack of clear diagnostic communication are common. The intrusive symptoms of IBS and other FGIDs impair patient functioning and reduce quality of life, and come with significant costs to individual patients and the health care system, which could be reduced with timely diagnosis and effective management.

Uncertain Diagnostic Language Affects Further Studies, Endoscopies, and Repeat Consultations for Patients With Functional Gastrointestinal Disorders.

Background & Aims: Although guidelines state that functional gastrointestinal disorders (FGIDs) can be diagnosed with minimal investigation, consultations and investigations still have high costs. We investigated whether these are due to specific behaviors of specialist clinicians by examining differences in clinician approaches to organic gastrointestinal diseases vs FGIDs.

Methods: We performed a retrospective review of 207 outpatient department letters written from the gastroenterology unit at a tertiary hospital after patient consultations from 2008 through 2011.

The implementation of intentional rounding using participatory action research.

'Intentional'/'hourly rounding' is defined as regular checks of individual patients carried out by health professionals at set intervals rather than a response to a summons via a call bell. Intentional rounding places patients at the heart of the ward routine including the acknowledgement of patient preferences and in anticipation of their needs. The aim of this study was to implement intentional rounding using participatory action research to increase patient care, increase staff productivity and the satisfaction of care provision from both patients and staff.