Ministry of Health Library

Health Improvement and Innovation Digest

Issue 180 - 6 December 2018

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@moh.govt.nz.

Article access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Quality Improvement (New Zealand)

A survey of the impact of patient adverse events and near misses on anaesthetists in Australia and New Zealand
Published in Anaesthesia and Intensive Care, the purpose of this research was to survey members of the Australian and New Zealand College of Anaesthetists around their experiences of adverse patient safety events and near misses, including their use of incident reporting systems and the organisational support available.

Co-designing nudges: Phase two of raising the bar on the national adult inpatient experience survey
Raising the Bar on the National Patient Experience Survey responds to the Adult National Inpatient Experience Survey results by investigating the lower scoring areas of the survey and recommending interventions to improve these results. Phase two involves co-designing low-cost interventions, referred to as 'nudges' to improve patient experience in these areas. Using insights from behavioural science, this new report details how Nelson-Marlborough, Northland and Waikato district health boards worked with Ogilvy and the Health Quality & Safety Commission to develop interventions to improve the inpatient experience.

Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews
Health inequity is a global issue, which occurs across and within countries, and is the greatest barrier to worldwide health and the development of the human race.  The purpose of this research, published in the Journal of Clinical Nursing, was to explore the impact of culture on health, healthcare provision and its contribution towards health inequity experienced by some marginalised communities.

Quality Improvement (International)

Quality Improvement Methodologies: Principles and Applications in the Pediatric Emergency Department
Published in Pediatric Clinics of North America, this article reviews the history of quality improvement in health care, describes Lean principles in detail, and provides illustrative examples of applications of Lean and quality improvement methodologies in the pediatric emergency department.

The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action
Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study, published in the American Journal of Infection Control, was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques.

Cardiovascular Disease and Diabetes (New Zealand)

Māori: living and dying with cardiovascular disease in Aotearoa New Zealand
This article, published in Current Opinion in Supportive and Palliative Care, provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Māori New Zealanders. High Māori CVD risk factors will contribute to a sharp increase in older Māori deaths which has implications for health and palliative care service provision.

Cardiovascular Disease and Diabetes (International)

Impact of Peer Support on Acute Care Visits and Hospitalizations for Individuals With Diabetes and Depressive Symptoms: A Cluster-Randomized Controlled Trial
Comorbid depression is associated with increased health care utilization and cost. Published in Diabetes Care, this study examined the effects of peer support on acute care (AC) and hospital utilization in individuals with diabetes with or without depressive symptoms.

Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model): A systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme
People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. The authors of this study, published in BMC Health Services Research, undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control.

Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease
Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega‐3 PUFA and plant oils in omega‐6 PUFA. Evidence suggests that increasing PUFA‐rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear. This Cochrane Review assessed effects of increasing total PUFA intake on cardiovascular disease and all‐cause mortality, lipids and adiposity in adults.

Primary Health Care (New Zealand)

Framework for examining the spatial equity and sustainability of general practitioner services
Published in the Australian Journal of Rural Health, the purpose of this study was to propose a framework for examining both the spatial equity and sustainability of GP services.

Primary Mental Health (New Zealand)

Substance misuse stories among Pacific peoples in New Zealand
This paper, published in Kōtuitui: New Zealand Journal of Social Sciences Online, examines the oral stories of Pacific people attending addiction treatment services in Auckland, New Zealand who were participating in a larger study exploring the validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).

Primary Mental Health (International)

The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis
Psychological interventions are labour-intensive and expensive, but e-health interventions may support them in primary care. In this study, published in the Journal of Affective Disorders, the authors systematically reviewed the effectiveness and cost-effectiveness of e-health interventions for depressive and anxiety symptoms and disorders in primary care.

Effects of electronic psychiatric consultations on primary care provider perceptions of mental health care: Survey results from a randomized evaluation
Primary care is the main point-of-entry for identifying and treating mental health problems. This research, published in Healthcare, examines the effect of a new model of supporting primary care providers (PCPs) treating mental health disorders, the electronic consultation (eConsults), a standard process for communication between PCPs and psychiatrists through an electronic health records system.

Better Help for Smokers to Quit (International)

A Meta-Analysis of Brief Tobacco Interventions for Use in Integrated Primary Care
The integration of behavioural health services in primary care settings presents an opportunity to enhance the delivery of tobacco cessation interventions in the primary care setting, but guidance on evidence-based treatments for tobacco use disorder that fits the brief format of integrated primary care (IPC) is limited. This meta-analysis, published in Nicotine & Tobacco Research, summarizes the outcomes of brief behavioural interventions targeting tobacco use that can be delivered in IPC settings.

Childhood Obesity (New Zealand)

Children's healthy and unhealthy beverage availability, purchase and consumption: A wearable camera study
Children's sugar-sweetened beverages (SSBs) consumption presents significant risks for obesity, type 2 diabetes and dental health. But there is a lack of objective data on beverages in children's overall environments. Published in Appetite, this study aimed to determine the nature and extent of children's beverage availability, purchase and consumption, throughout their day, using wearable cameras for data collection.

Childhood Obesity (International)

Lifestyle weight management programmes for children: A systematic review using Qualitative Comparative Analysis to identify critical pathways to effectiveness
Published in Preventive Medicine, this study aimed to identify critical features of successful lifestyle weight management interventions for overweight children (0–11years). Eleven qualitative UK-based studies examining children's, parents' and providers' perspectives and experiences of programmes were synthesised to identify components felt to be critical.

Good practice criteria for childhood obesity prevention in kindergartens and schools—elaboration, content and use
In accordance with the policy actions that address childhood overweight and obesity at European level and as a contribution to the EU Action Plan on Childhood Obesity 2014–20, a Joint Action on Nutrition and Physical Activity (JANPA) was established. As part of JANPA work package 6, an evaluation framework to identify good practices, targeting childhood obesity prevention in kindergartens and schools, was developed. Published in the European Journal of Public Health, this article describes the Work Package 6 of good practice criteria and its development, compares it to other frameworks and discusses its potential for future use.

Key Ministry of Health publications

Addressing the Challenges of Young Māori Women Who Smoke: A developmental evaluation of the phase two demonstration project
Smoking is the single leading preventable cause of early death in New Zealand and Māori smoking is significantly higher than smoking in the general population.  To address the problem the Ministry is taking a closer look at how to address the problem of smoking among young Māori women. To build on the insights from phase one, a phase two project - Addressing the Challenge of Young Māori Women who Smoke: A co-design demonstration project – was initiated. The project tested a collaborative programme of prototyping and evaluation. Its aim was to determine if, and how, smoking cessation services can better reach and enable young Māori women to reduce harm, stop smoking and remain smokefree.

Guidance for Best Practice Management in the National Bowel Screening Programme: Consultation document
As part of ongoing quality improvement, the National Bowel Screening Programme (NBSP) has developed draft clinical guidelines for the health sector entitled Best Practice Management in the National Bowel Screening Programme. The guidelines will provide guidance to practitioners involved in the Bowel Screening pathway, supporting clinical decision making and providing advice to participants. The NBSP is consulting on these draft guidelines with the clinical groups and professional bodies, using the Ministry of Health’s online consultation tool. A final version of the guidelines will be published following consideration of the consultation feedback.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.