Point of care testing for hepatitis C in the priority settings of mental health, prisons and drug & 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 three priority settings in Australia. METHODS: Participants were enrolled in an interventional cohort study at a reception prison, inpatient mental health service (MHS), and inpatient alcohol and other drug (AOD) 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: 1,549 participants received a HCV antibody test with 17% (264/1,549) receiving a positive result, of which 21% (55/264) 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 three-fold (RR:2.57 95% CI: 2.32, 2.85) for HCV antibody testing and four-fold (RR:1.62; 95% CI:1.31, 2.01) for RNA testing. Treatment uptake was higher during the POCT intervention (86%, 47/55; P=0.010) compared to the historical controls (61%, 27/44). CONCLUSIONS: This study demonstrated across three settings that the use of HCV antibody and RNA POCT increased testing rates, treatment uptake linkage to care. The testing model was highly acceptable for most participants. CLINICAL TRIAL 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.

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.

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.

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.

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.

Media dramatize need for center. Oregon friends rally for burn center remodeling cause.

A carefully orchestrated fund-raising and media relations campaign contributed to the opening earlier this year of the new Oregon Burn Center on Legacy Health System's Emanuel Hospital campus, Portland, Ore. The new $5 million center is the only facility of its kind between Sacramento, Calif., Salt Lake City and Seattle. It replaces the original 12-bed facility built in 1973. The expanded center has 16 beds in 16 private rooms, treatment areas designed for children and a host of other state-of-the-art improvements that make the Oregon Burn Center among the nation's finest. Between Legacy's investment of $3 million and contributions from Oregonians, more than $5 million was raised for the new center. Beyond that, annual giving, which amounted to $85,000 in fiscal 2001, is holding steady in 2002.

HCA Richmond Hospitals' new marketing strategy a winning plan.

HCA Richmond Hospitals, a five-hospital system in Richmond, Va., is positioning itself as a winner in a highly competitive, healthcare-saturated market since overhauling is marketing strategy a little over a year ago. The marketing strategy enables individual hospital to target their own unique constituencies. "Understanding the intricate marketing dynamics of hospital systems is today of critical importance and equal complexity," said Tony Bejamin, principal of Oxygen Advertising Inc., New York, the agency that remodeled HCA Richmond Hospitals' marketing strategy.

St. John Health integrating new corporate identity, brand. Brand/logo to be rolled out over two-year period.

St. John Health, Warren, Mich., is integrating a new corporate identity and brand strategy for its network of nine wholly-owned and two affiliated hospital, along with more than 100 physician offices and specialty centers in southeast Michigan. "A new identity is a great rallying cry. It automatically says. 'We have a new mission. We have a new system. We are reaching new people,'" said Eunice O'Loughlan, VP, corporate communications for St. John Health.

The Methodist Hospital Web site comprehensive, user friendly.

The Methodist Hospital, Houston, has an award winning Web site that truly deserves its wide recognition. This comprehensive Web site, www.methodisthealth.com, is taking on a new look with the beginning of the new year. It's still loaded with information that's easily accessed in both English and Spanish.

Baldrige Award cites two hospitals. Baptist, Saint Luke's hospitals honored for quality, performance.

Baptist Hospital Inc., Pensacola, Fla.; and Saint Luke's Hospital, Kansas City, Mo., have received the prestigious Malcolm Baldrige National Quality Award in the category of healthcare. Named for a former secretary of commerce, the award recognizes efficiency, effectiveness and excellence. The two hospitals are among only seven companies in the U.S. to be so recognized this year.

King's Daughters Medical Center web site is an award winner.

King's Daughters Medical Center, Ashland, Ky., has an award-winning web site, www.kdmc.com, that attracts an average of 24,000 visits a month. Designed to be user-friendly and informative. The web site for the 366-bed regional referral center uses a newspaper-like style that makes it easily to update.