Staff Publication

Increasing productivity & workflow within the ward office of Ward 32 (2025)

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Type of publication:

Service improvement case study

Author(s):

*Danyal Fiaz

Citation:

SaTH Improvement Hub, August 2025

SMART Aim:

To improve ward office productivity by increasing staff reporting the space as suitable for meetings from 0% to at least 60%, and those able to access all necessary shift documents from 50% to 100%, by 20th July 2025.

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Mental Health Liaison Team (2025)

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Type of publication:

Service improvement case study

Author(s):

*Gemma Styles (on behalf of the working group)

Citation:

SaTH Improvement Hub, August 2025

SMART Aim:

To bridge the gap between physical and mental health care in PRH ED by June 2025, as evidenced by robust triage documentation and early referral to the mental health liaison service.

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Elective Hub High Flow List- Gynae (2025)

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Type of publication:

Service improvement case study

Author(s):

*Martyn Underwood

Citation:

SaTH Improvement Hub, July 2025

SMART Aim:

To increase utilisation on an all day theatre list on the 16th of July 2025. Sub aim: To increase number of cases on an all day theatre list by 1 on the 16th of July 2025.

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Educating for Accuracy: Improving ENT Abbreviation Recognition (2025)

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Type of publication:

Service improvement case study

Author(s):

*Dr. Saarah Talha; *Dr. Karola Meunier; *Dr. Ayesha Khan; *Dr. Emma Richards; *Mr. Salil Sood

Citation:

SaTH Improvement Hub, July 2025

Aims:

To evaluate the understanding of commonly used clinical abbreviations among the multi-disciplinary
team. To assess the effectiveness of a structured educational intervention in improving abbreviation recognition and overall communication within the clinical team.

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Heparin-Induced Thrombocytopenia Following Tinzaparin Administration: A Case Report (2025)

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Type of publication:

Journal article

Author(s):

*Khallaf, Laila; *Katarki, Praveenkumar; *Ahmad, Nawaid; *Govindagowda, Thimmegowda.

Citation:

Cureus. 17(9):e93248, 2025 Sep.

Abstract:

Heparin-induced thrombocytopenia (HIT), a severe immune-mediated reaction, presents a significant diagnostic challenge, particularly with atypical symptoms like syncope or when induced by low-molecular-weight heparin (LMWH). This report describes the case of a 77-year-old male who developed severe thrombocytopenia following tinzaparin administration for bridging therapy after an elective endovascular aneurysm repair (EVAR). The patient presented to the emergency department with syncope, an uncommon manifestation of HIT. Initial investigations revealed isolated thrombocytopenia, and a high clinical suspicion based on a 4Ts score of 6 prompted the immediate discontinuation of tinzaparin and initiation of fondaparinux. The diagnosis was subsequently confirmed by a positive HIT antibody screening test. The patient's platelet counts improved in a few days, and he was successfully transitioned to warfarin without complications. This case highlights the critical importance of maintaining a high index of suspicion for HIT in any patient exposed to Heparin products, including LMWH, who develops thrombocytopenia, even when the clinical presentation is atypical. Early recognition and prompt management with alternative anticoagulants are essential to prevent life-threatening thromboembolic complications.

DOI: 10.7759/cureus.93248

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Comparative Diagnostic Accuracy of Clinical Assessment, Computed Tomography (CT), and Magnetic Resonance Imaging With Magnetic Resonance Cholangiopancreatography (MRI/MRCP) in Evaluating Common Bile Duct Stones (2025)

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Type of publication:

Journal article

Author(s):

*Al-Dulaimi, Mina; *Ibraheem, Mustafa; *Abdulkareem, Mustafa; Al-Dujaili, Aaisha; Abdulkareem, Ameer.

Citation:

Cureus. 17(10):e94572, 2025 Oct.

Abstract:

PURPOSE: To determine the most effective method for diagnosing common bile duct (CBD) stones, this research retrospectively compares the diagnostic accuracy of initial clinical evaluation, computed tomography (CT), and magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRI/MRCP). The goal is to identify the optimal non-invasive strategy to guide patient management and prevent unnecessary invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP). An accurate diagnosis of choledocholithiasis is essential for proper patient care.

MATERIALS AND METHODS: This single-center, retrospective analysis involved 691 adult patients who were under evaluation for suspected choledocholithiasis. The effectiveness of clinical assessment, multidetector CT, and MRI/MRCP was measured against definitive diagnoses obtained from surgical or procedural findings. For each diagnostic method, the study calculated sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC).

RESULTS: CBD stones were present in 311 of the 691 patients, a prevalence of 45%. MRI/MRCP was the most effective diagnostic tool, with a sensitivity of 92.7%, a specificity of 91.9%, and an accuracy of 92.3%. In comparison, CT scans yielded a sensitivity of 73.2%, a specificity of 82.9%, and an accuracy of 78.3%. Clinical assessment resulted in a sensitivity of 71.1%, a specificity of 87.1%, and an accuracy of 80%. The AUC for MRI/MRCP (0.95) was markedly higher than that for both CT (0.83; p<0.001) and clinical assessment (0.81; p<0.001). There was no significant difference in the diagnostic performance between CT and clinical assessment (p=0.45).

CONCLUSION: For the non-invasive identification of CBD stones, MRI/MRCP provides superior diagnostic accuracy compared to both CT and clinical evaluation. It is recommended as the top imaging choice for patients with suspected choledocholithiasis.

DOI: 10.7759/cureus.94572

Link to full-text [open access - no password required]