Exploring Patient, Proxy, and Clinician Perspectives on the Value and Impact of an Inpatient Portal: A Reflexive Thematic Analysis.

Background: Research exploring perspectives on inpatient portals reports that patients desire the information affordances of inpatient portals, and clinicians recognize their value for improving patient experience but also express caution regarding sharing aspects of the medical record. This study contributed to the existing literature on inpatient portals by considering the psychosocial dimension of clinician resistance to information sharing with inpatients and the power dynamic associated with clinician-patient information asymmetry. Along with the information affordances commonly discussed in this area, this study explored perspectives on the novel option to audio record consultations via an inpatient portal.

Enabling awareness, agency and participation: Haematology patient experiences of an (in)patient portal's information affordances.

This study examines patient experiences of an inpatient portal's information affordances, including access to results, notes, vital signs, medication information and a schedule. Patient participants were recruited from an inpatient ward primarily catering to patients with haematological malignancies including leukaemia and bone marrow transplant recipients at the Royal Melbourne Hospital. Although focused on the inpatient experience of a portal's information affordances accessed via a hospital-provided tablet, due to limited patient access to notes in the inpatient context, this study also explored patient experiences of their outpatient portal notes accessed via their smartphone.

Feasibility of an allied health led, workplace delivered Long COVID service for hospital staff: a mixed-methods study.

Objective This study aimed to evaluate the feasibility of a workplace-delivered outpatient multidisciplinary service (ReCOV) for staff experiencing post COVID-19 condition ('Long COVID'). Methods A mixed-methods study of staff at a large, tertiary hospital with Long COVID who attended the service was conducted. Participants completed questionnaires to determine baseline symptoms and were offered allied health appointments for up to 12weeks each based on clinical indication.

Recovering from COVID-19 (ReCOV): Feasibility of an Allied-Health-Led Multidisciplinary Outpatient Rehabilitation Service for People with Long COVID.

Background: A multidisciplinary approach is required for the management of long COVID. The aim of this study was to determine the feasibility (demand, implementation, practicality, acceptability, and limited efficacy) of an allied-health-led multidisciplinary symptom management service (ReCOV) for long COVID.

Methods: A single-group observational cohort feasibility study was conducted to determine demand (referrals), acceptability (survey), implementation (waitlist times, health professions seen), practicality (adverse events), and limited efficacy (admission and discharge scores from the World Health Organization Disability Assessment Scale, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire, and EuroQol 5D-5L).

The Canadian Hypoglycemia During Hospitalization Score Is Externally Valid in the Australian Diabetes IN-hospital: Glucose & Outcomes (DINGO) Cohort.

Objectives: The Hypoglycemia During Hospitalization (HyDHo) score predicts hypoglycemia in a population of Canadian inpatients by assigning various weightings to 5 key clinical criteria known at the time of admission, in particular age, recent presentation to an emergency department, insulin use, use of oral hypoglycemic agents, and chronic kidney disease. Our aim in this study was to externally validate the HyDHo score by applying this risk calculator to an Australian population of inpatients with diabetes.

Methods: This study was a retrospective data analysis of a subset of the Diabetes IN-hospital: Glucose & Outcomes (DINGO) cohort.

A Randomized Noninferiority Trial to Compare Enteral to Parenteral Phosphate Replacement on Biochemistry, Waste, and Environmental Impact and Healthcare Cost in Critically Ill Patients With Mild to Moderate Hypophosphatemia.

Objectives: Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste.

Design: Prospective, randomized, parallel group, noninferiority clinical trial.

Hyperglycemia in Hospital: An Independent Marker of Infection, Acute Kidney Injury, and Stroke for Hospital Inpatients.

Context: Hyperglycemia in hospital inpatients without pre-existing diabetes is associated with increased mortality. However, the independent contribution of hyperglycemia to health care-associated infection (HAI), acute kidney injury (AKI), and stroke is unclear.

Objective: To investigate the relationship between hyperglycemia and adverse clinical outcomes in hospital for patients with and without diabetes.

Feasibility of Embedding a Randomised Clinical Trial (RCT) into an Electronic Medical Record (EMR) for Patients Admitted to an Intensive Care Unit (ICU).

To establish the feasibility of embedding an RCT into EMR in the ICU, we evaluated the route of phosphate replacement. The EMR screened 207 patients who met the inclusion criteria from 20 April 2022 to 30 June 2022. 162 patients were randomised and 145 patients allocated to treatment.

The impact of electric scooters in Melbourne: data from a major trauma service.

Background: The proliferation of electric scooters globally has been associated with an increase in related injuries and consequent economic burden. This study aims to assess the injury patterns and the economic impact associated with electric scooter use in Melbourne, Australia.

Methods: A retrospective cohort study was conducted using hospital and registry data from January 2022 to January 2023.

Pharmacodynamics, safety, tolerability and pharmacokinetics of a single oral dose of an engineered phenylalanine ammonia-lyase in patients with phenylketonuria.

The cornerstone treatment of hyperphenylalaninemia (HPA) and phenylketonuria (PKU) is a lifelong low-protein diet with phenylalanine (Phe) free L-amino acid supplements. However, the PKU diet has significant shortcomings, and there is a clinically unmet need for new therapeutics to improve patient outcomes. CDX-6114 is a modified phenylalanine ammonia-lyase (PAL) enzyme obtained by a mutation in the PAL sequence.

Venous thromboembolism prophylaxis and related outcomes in patients with traumatic brain injury and prolonged intensive care unit stay.

Traumatic brain injury (TBI) patients with prolonged intensive care unit (ICU) stay are at risk of secondary intracranial haemorrhage (ICH) and venous thromboembolism (VTE). We aimed to study VTE prophylaxis, secondary ICH, and VTE prevalence and outcomes in this population. Retrospective observational study.

'A Missed Therapeutic Opportunity? SGLT-2 Inhibitor Use in General Medicine Patients With Heart Failure: A Retrospective Audit of Admissions to a Tertiary Health Service'.

Objective: Sodium-glucose co-transporter-2 inhibitors (SGLT2-I's) are novel oral hypoglycaemic agents, with proven decreased MACE and re-hospitalisation risk in type 2 diabetic patients with concomitant heart failure. This study aimed to assess the current practice in the use of SGLT2-I's in general medical units at a large metropolitan health service.

Methods/results: A retrospective audit was conducted of patients admitted to general medicine over a 12 month period (between April 2018 and 2019).

A serendipitous journey to a promoter variant: The c.-106C>A variant and its role in late-onset ornithine transcarbamylase deficiency.

Ornithine transcarbamylase deficiency (OTCD) is an X-linked urea cycle disorder characterised by reduced or absent OTC enzyme activity, resulting in the accumulation of neurotoxic ammonia. Approximately 80%-90% of the causative variants are identified by Sanger sequencing or multiplex ligation-dependent probe amplification (MLPA) of the gene. A 23-year-old male with biochemical evidence of OTCD was referred for molecular analysis.

Community-acquired versus hospital-acquired acute kidney injury at a large Australian metropolitan quaternary referral centre: incidence, associations and outcomes.

Background: There is increasing global incidence of acute kidney injury (AKI) and significant short- and long-term impacts on patients.

Aims: To determine incidence and outcomes of community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI) among inpatients in the Australian healthcare setting using modern health information systems.

Methods: A retrospective cohort study of adult patients admitted to a quaternary hospital in Melbourne, Australia, between 1 January 2018 and 31 December 2019 utilising an electronic data warehouse.

Hospital Acquired Infections in Surgical Patients: Impact of COVID-19-Related Infection Prevention Measures.

Background: Hospital acquired infections are common, costly, and potentially preventable adverse events. This study aimed to determine the effect of the COVID-19 pandemic-related escalation in infection prevention and control measures on the incidence of hospital acquired infection in surgical patients in a low COVID-19 environment in Australia.

Method: This was a retrospective cohort study in a tertiary institution.

Effect of a Multiorgan Focused Clinical Ultrasonography on Length of Stay in Patients Admitted With a Cardiopulmonary Diagnosis: A Randomized Clinical Trial.

Importance: There are accumulating data about the utility of diagnostic multiorgan focused clinical ultrasonography (FCU) in the assessment of patients admitted with cardiopulmonary symptoms.

Objective: To determine whether adding multiorgan FCU to the initial clinical evaluation of patients admitted with cardiopulmonary symptoms reduces hospital length of stay, hospital readmissions, and in-hospital costs.

Design, Setting, And Participants: This is a prospective, parallel-group, superiority, randomized clinical trial with a 1:1 allocation ratio.

Quality of care was not compromised during the COVID-19 pandemic at a level 1 trauma centre.

Background: The COVID-19 pandemic has had a profound effect on the presentation and management of trauma at the Royal Melbourne Hospital, a level 1 adult major trauma service and a designated COVID-19 hospital. This study compares the changes in epidemiology and trauma patient access to emergency imaging and surgery during the pandemic response.

Methods: The population of interest was all trauma patients captured in the hospital's trauma registry from 16 March 2016 to 10 September 2020.

Threat of COVID-19 impacting on a quaternary healthcare service: a retrospective cohort study of administrative data.

Objectives: The threat of a pandemic, over and above the disease itself, may have significant and broad effects on a healthcare system. We aimed to describe the impact of the SARS-CoV-2 pandemic (during a relatively low transmission period) and associated societal restrictions on presentations, admissions and outpatient visits.

Design: We compared hospital activity in 2020 with the preceding 5 years, 2015-2019, using a retrospective cohort study design.