Point-of-Care Testing for Hepatitis C in the Priority Settings of Mental Health, Prisons, and Drug and Alcohol Facilities-the PROMPt Study.

BACKGROUND: A barrier to hepatitis C virus (HCV) cure is conventional testing. The aim of this study was to evaluate the effect of HCV antibody and RNA point-of-care testing (POCT) on testing rates, linkage to care, treatment, and acceptability of testing in 3 priority settings in Australia. METHODS: Participants were enrolled in an interventional cohort study at a reception prison, inpatient mental health service, and inpatient alcohol and other drug unit, between October 2020 and December 2021. HCV POCT was performed using SD Bioline HCV antibody fingerstick test and a reflexive Xpert HCV Viral Load Fingerstick test using capillary blood samples. A retrospective audit of HCV testing and treatment data was performed at each site for the preceding 12-month period to generate a historical control. RESULTS: A total of 1549 participants received a HCV antibody test with 17% (264 of 1549) receiving a positive result, of whom 21% (55 of 264) tested HCV RNA positive. Across all settings the rate of testing per year significantly increased between the historical controls and the study intervention period by 2.57 fold (rate ratio, 2.57 [95% confidence interval, 2.32-2.85]) for HCV antibody testing and 1.62 (rate ratio, 1.62 [95% confidence interval, 1.31-2.01]) for RNA testing. Treatment uptake was higher during the POCT intervention (86% [47 of 55]; P = .01) compared to the historical controls (61% [27 of 44]). CONCLUSIONS: This study demonstrated across 3 settings that the use of HCV antibody and RNA POCT increased testing rates, treatment uptake, and linkage to care. The testing model was highly acceptable for most participants. CLINICAL TRIALS REGISTRATION: ACTRN-12621001578897.

Evaluation of the impact of assistive artificial intelligence on ultrasound scanning for regional anaesthesia.

BACKGROUND: Ultrasound-guided regional anaesthesia relies on the visualisation of key landmark, target, and safety structures on ultrasound. However, this can be challenging, particularly for inexperienced practitioners. Artificial intelligence (AI) is increasingly being applied to medical image interpretation, including ultrasound. In this exploratory study, we evaluated ultrasound scanning performance by non-experts in ultrasound-guided regional anaesthesia, with and without the use of an assistive AI device. METHODS: Twenty-one anaesthetists, all non-experts in ultrasound-guided regional anaesthesia, underwent a standardised teaching session in ultrasound scanning for six peripheral nerve blocks. All then performed a scan for each block; half of the scans were performed with AI assistance and half without. Experts assessed acquisition of the correct block view and correct identification of sono-anatomical structures on each view. Participants reported scan confidence, experts provided a global rating score of scan performance, and scans were timed. RESULTS: Experts assessed 126 ultrasound scans. Participants acquired the correct block view in 56/62 (90.3%) scans with the device compared with 47/62 (75.1%) without (P=0.031, two data points lost). Correct identification of sono-anatomical structures on the view was 188/212 (88.8%) with the device compared with 161/208 (77.4%) without (P=0.002). There was no significant overall difference in participant confidence, expert global performance score, or scan time. CONCLUSIONS: Use of an assistive AI device was associated with improved ultrasound image acquisition and interpretation. Such technology holds potential to augment performance of ultrasound scanning for regional anaesthesia by non-experts, potentially expanding patient access to these techniques. CLINICAL TRIAL REGISTRATION: NCT05156099.

Improving rib fracture management in Morriston hospital: using QI to develop an erector spinae plane catheter service.

INTRODUCTION: Trauma audit research network (TARN) data for 2018 indicated that we admitted 100 patients with chest wall injuries in our District General Hospital (DGH). Our own retrospective audit of pain team referrals confirmed long length of stay (median 14 days), with 59% requiring level 2/3 care and 11% mortality risk. We noticed that Regional anaesthesia was offered to less than 25% of patients despite 63% reporting severe pain and decided to introduce an erector spinae plane (ESP) catheter service for rib fractures. Our aims were to reduce length of stay and pain scores. METHODS: We set up an email alert system, where TARN data collectors notified us when patients were admitted through the emergency department with rib fractures. Using a secure social media app (Whatsapp), we organised a group of regional anaesthetists who were willing to provide an ESP service. Process mapping and driver diagrams helped to streamline the service. RESULTS: Mean length of hospital stay was reduced from 10 to 7 days after introduction of the service with significant reduction in variability. Mean pain scores improved from 8.9/10 to 5/10 with an average improvement of pain score of 2.78 points on a numerical scale out of 10. (n=9) CONCLUSIONS: This service improvement relied on a team of hospital clinicians who agreed to provide an extra pain service for patients with rib fracture. The reduction in LOS may be explained by improved respiratory physiology with ESP catheter placement. The ability to deep breathe, cough and engage in physiotherapy treatment are important factors in recovering from rib fractures. The small reduction in pain scores may be explained by the presence of other injuries. Ongoing improvements in training should improve reliability of catheter placement and reduce practitioner variation.

Medical City introduces new magazine for Dallas community.

Medical City, Dallas, launches a quarterly magazine titled, IN: Mind Body Life, as the final phase in its two-year branding campaign. In search of a unique style, the hospital worked with American Airlines' publishing house, AAP Custom.

Thought about annual reports.

Editor Tom Rees shares the observations of other experts on the subject of creating your annual report.

Web site offers evidence hospital is county's most preferred hospital.

We review the recently-renovated web site for Bridgeport Hospital, Bridgeport, Conn., or "Fairfield County's Most Preferred Hospital." The site, www.bridgeporthospital.com, offers a wide-ranging selection of links to afford its readers plentiful information about its various specialties, special events, and available physicians.

Press kit leads to wide, consistent coverage of Parma Hospital honor.

At Parma Community General Hospital, Parma, Ohio, a press kit was created to recognize the hospital's designation as Ohio's number one hospital for joint replacement surgery. If you're proud of your press kit, we hope you'll consider sending it to us for this new feature.

Media Monday tip sheet builds Spartanburg's media relations.

Media Monday is published weekly and sent to area newsrooms by the Spartanburg Regional Healthcare System, Spartanburg, S.C. The news and feature tip sheet was started in 1998 in order to disperse a lot of information with a limited number of staff.

Hospitals target-marketing wound centers to build profit statements.

Wound care centers add to the hospital's' profits as well as serving as a marketing vehicle for other services. Learn how the program is promoted by Shawnee Mission Medical Center, Shawnee Mission, Kan., Stamford Hospital, Stamford, Conn., and Good Samaritan Hospital, Suffern, N.Y.

Detroit's Henry Ford Health System awarded Foster G. McGaw Prize.

Henry Ford Health System, Detroit, is named winner of the prestigious Foster G. McGaw Prize for excellence in community service. The organization received 100,000 dollars from the sponsors, the American Hospital Association, The Baxter International Foundation and the Cardinal Health Foundation.

Publicist's advice: hire a PR firm before you need one.

Tom Rees, self-confessed former PR representative for the University of Colorado Health Sciences Center, addresses the value healthcare organizations can find in public relations consultation.

Cambridge Health's outreach earns alliance an AHA NOVA Award.

Cambridge Health Alliance, (CHA), Somerville, Mass., has been named for one of the five NOVA Awards given this year by the American Hospital Association. It is recognized for leading a program to improve community health by extending help to low-income and uninsured children and adults, as well as to the chronically ill and racial and ethnic minorities.

Vermont hospital's web site focuses on valuable healthcare information.

Brattleboro Memorial Hospital's web site celebrates a century of caring in the region of Brattleboro, Vt. The web site, bmhvt.org, is loaded with information, including a local links page that enables site visitors to hook up with the Brattleboro Chamber of Commerce, the Area Health Education Council, Lifeline Personal Response Service, and more.

Mini-medical school enhances hospital's stature in market area.

There is a waiting list for each eight-week session of the "Mini-Medical School" run by Baystate Medical Center in Springfield, Mass. The program offers classes on medical subjects to the general public. Its goal is to bring together physicians and people of the community. The faculty members, who hold teaching appointments at Tufts University School of Medicine in Boston, are as enthusiastic about the program as their students.

Historic Washington, D.C., hospital reopens in new $96 million facility. The George Washington University Hospital attracts fanfare.

A diverse gathering of political leaders, entertainment and sports personalities and government officials attended the grand opening ceremony of George Washington University Hospital's brand-new 371-bed hospital building in Washington, D.C. The new facility was introduced to the Washington community by a series of tours for the media, physicians, nurses, hospital employees and their families.

Research, CME, media relations boost diabetes center's profile.

For Boston's Joslin Diabetes Center, media relations rather than formal advertising is the key to a high-profile image. The communications office targets newspaper, magazine and TV reporters and editors with public service announcements and news about research and clinical care advances. Other successful tools include a high-end quarterly magazine, a fact-filled information kit, disease-specific support programs and a catalog of educational materials.

Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.

East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

N.Y. Methodist tops annual reports. Seventeen competitors recognized for excellent products.

NewYork Methodist Hospital, Brooklyn, N.Y., takes the top award for this year's competition. Running close behind are The Children's Hospital of Philadelphia, second place; and Evangelical Community Hospital, Lewisburg, Pa., third place. While there are considerable differences among these institutions and their approaches to an annual report, they share some common qualities: all are attractive products which meet their objectives. They all produce strong, positive impressions through clear language and imagery. Incidentally, New York Methodist was the very first hospital to submit a report in this year's competition--a factor which played no part in the judging for awards!

M.D. Anderson report celebrates people, 60 years of history. Anne Arundel, Integris review cancer programs.

Always a winner, the report by The University of Texas, M.D. Anderson Cancer Center, Houston, takes first-place in this category, with second place going to Anne Arundel Medical Center, Annapolis, Md., and third to Integris Oncology Services, Oklahoma City, Okla.