Acute Respiratory Infection Hubs: A Service Model with Potential to Optimise Infection Management.

Patients with acute respiratory infections (ARI)-including those with upper and lower respiratory infections from both bacterial and viral pathogens-are one of the most common reasons for acute deterioration, with large numbers of potentially avoidable hospital admissions. The acute respiratory infection hubs model was developed to improve healthcare access and quality of care for these patients. This article outlines the implementation of this model and its potential impacts in a number of areas.

NEWS2 and improving outcomes from sepsis.

The cause of deterioration is often unclear, so it is vitally important that we spot the sick and deteriorating patient from all causes. As a result, warning scores must cater for all conditions, and - where possible - be standardised across all healthcare settings. This article summarises the importance of an 'unblinkered' approach to acute illness assessment, comparing and examining the evidence for different historical scoring systems and looking at the early impact of national alignment to NEWS2 in patients admitted to hospital with suspected bacterial infections.

Feasibility and accuracy of the 40-steps desaturation test to determine outcomes in a cohort of patients presenting to hospital with and without COVID-19.

Desaturation on exercise has been suggested as a predictive feature for deterioration in COVID-19. The objective of this paper was to determine the feasibility and validity for the 40-steps desaturation test.A prospective observational cohort study was undertaken in patients assessed in hospital prior to discharge.

COVID-19 Oximetry @home: evaluation of patient outcomes.

Background: COVID-19 has placed unprecedented demands on hospitals. A clinical service, COVID-19 Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of COVID-19 patients in the community. Remote monitoring through CO@h aims to identify early patient deterioration and provide timely escalation for cases of silent hypoxia, while reducing the burden on secondary care.

Direct and indirect evidence of efficacy and safety of rapid exercise tests for exertional desaturation in Covid-19: a rapid systematic review.

Background: Even when resting pulse oximetry is normal in the patient with acute Covid-19, hypoxia can manifest on exertion. We summarise the literature on the performance of different rapid tests for exertional desaturation and draw on this evidence base to provide guidance in the context of acute Covid-19.

Main Research Questions: 1.

"Bow-tie" optimal pathway discovery analysis of sepsis hospital admissions using the Hospital Episode Statistics database in England.

Objective: The "Bow-tie" optimal pathway discovery analysis uses large clinical event datasets to map clinical pathways and to visualize risks (improvement opportunities) before, and outcomes after, a specific clinical event. This proof-of-concept study assesses the use of NHS Hospital Episode Statistics (HES) in England as a potential clinical event dataset for this pathway discovery analysis approach.

Materials And Methods: A metaheuristic optimization algorithm was used to perform the "bow-tie" analysis on HES event log data for sepsis (ICD-10 A40/A41) in 2016.

Asthma and COVID-19: review of evidence on risks and management considerations.

Background: Respiratory illnesses typically present increased risks to people with asthma (PWA). However, data on the risks of COVID-19 to PWA have presented contradictory findings, with implications for asthma management.

Objective: To assess the risks and management considerations of COVID-19 in people with asthma (PWA).