Background/Objective: Despite surgery being the primary curative treatment for cancer, patients with compromised preoperative physical, nutritional, and psychological status are often at a higher risk for complications. While various screening tools exist to assess physical, nutritional, and psychological status, there is currently no standardised self-reporting tool, or established cut-off points for comprehensive risk assessment. This study aims to develop, validate, and implement an online self-reporting preoperative screening tool that identifies modifiable risk factors in cancer surgery patients. Methods: This mixed-methods study consists of three distinct stages: (1) Development—(i) a scoping review to identify available physical, nutritional, and psychological screening tools; (ii) a Delphi study to gain consensus on the use of available screening tools; and (iii) a development of the online screening tool to determine patients at high risk of postoperative complications. (2) Testing—a prospective cohort study determining the correlation between at-risk patients and postoperative complications. (3) Implementation—the formulation of an implementation policy document considering feasibility. Conclusions: The timely identification of high-risk patients, based on their preoperative physical, nutritional, and psychological statuses, would enable referral to targeted interventions. The implementation of a preoperative online screening tool would streamline this identification process while minimising unwarranted variation in preoperative treatment optimisation. This systematic approach would not only support high-risk patients but also allow for more efficient provision of surgery to low-risk patients through effective risk stratification.

Background: Early detection and response to influenza and COVID-19 outbreaks in aged care facilities (ACFs) are critical to minimizing health impacts. The Sydney Local Health District (SLHD) Public Health Unit (PHU) has developed and implemented a novel web-based app with integrated functions for online line listings, detection algorithms, and automatic notifications to responders, to assist ACFs in outbreak response. The goal of the Influenza Outbreak Communication, Advice and Reporting (FluCARE) app is to reduce time delays to notifications, which we hope will reduce the spread, duration, and health impacts of an influenza or COVID-19 outbreak, as well as ease workload burdens on ACF staff. Objective: The specific aims of the study were to (1) evaluate the acceptability and user satisfaction of the implementation and use of FluCARE in helping ACFs recognize, notify, and manage influenza and COVID-19 outbreaks in their facility; (2) identify the safety of FluCARE and any potential adverse outcomes of using the app; and (3) identify any perceived barriers or facilitators to the implementation and use of FluCARE from the ACF user perspective. Methods: The FluCARE app was piloted from September 2019 to December 2020 in the SLHD. Associated implementation included promotion and engagement, user training, and operational policies. Participating ACF staff were invited to complete a posttraining survey. Staff were also invited to complete a postpilot evaluation survey that included the user Mobile Application Rating Scale (uMARS) measuring app acceptance, utility, and barriers and facilitators to use. An issues log was also prospectively maintained to assess safety. Survey data were analyzed descriptively or via content analysis where appropriate. Results: Surveys were completed by 31 consenting users from 27 ACFs. FluCARE was rated 3.91 of 5 overall on the uMARS. Of the 31 users, 25 (80%) would definitely use FluCARE for future outbreaks, and all users agreed that the app was useful for identifying influenza and COVID-19 outbreaks at their facilities. There were no reported critical issues with incorrect or missed outbreak detection. User training, particularly online training modules, and technical support were identified as key facilitators to FluCARE use. Conclusions: FluCARE is an acceptable, useful, and safe app to assist ACF staff with early detection and response to influenza and COVID-19 outbreaks. This study supports feasibility for ongoing implementation and efficacy evaluation, followed by scale-up into other health districts in New South Wales.