Ministry of Health Library

Health Improvement and Innovation Digest

Issue 179 - 22 November 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 (International)

Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial)
The Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial was a stepped-wedge cluster randomised trial of a quality improvement (QI) programme to improve 90-day survival for patients undergoing emergency abdominal surgery in 93 hospitals in the UK National Health Service. The aim of this process evaluation, published in Implementation Science, was to describe how the EPOCH intervention was planned, delivered and received, at both cluster and local hospital levels.

Hospital Productivity (New Zealand)

Evaluation of Patients at Risk of Hospital Readmission (PARR) and LACE risk score for New Zealand context
Identification and prediction of patients who are at risk of hospital readmission is a critical step towards the reduction of the potential avoidable costs for healthcare organisations. This research, published in Studies in Health Technology and Informatics, focused on the evaluation of LACE Index for Readmission - Length of stay (days), Acute (emergent) admission, Charlson Comorbidity Index and number of ED visits within six months (LACE) and Patients At Risk of Hospital Readmission (PARR) using New Zealand hospital admissions.

Hospital Productivity (International)

Hospital-to-home interventions, use, and satisfaction: a meta-analysis    
Hospital-to-home transitions are critical opportunities to promote patient safety and high-quality care. However, such transitions are often fraught with difficulties associated with increased health care use and poor patient satisfaction. In this review, published in Pediatrics, the authors determined which pediatric hospital discharge interventions affect subsequent health care use or parental satisfaction compared with usual care.

Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach 
This study, published in BMC Health Services Research, aimed to demonstrate that long waiting times and wait lists are not necessarily associated with increasing demand or changes in resources. The authors report how substantial reductions in waiting times/wait lists across a range of specialties was obtained by improvements of basic problems identified through value-stream mapping and unsophisticated analyses.

Shorter Waits for Cancer Treatment (International)

The case for patient navigation in lung cancer screening in vulnerable populations: a systematic review
The authors of this study, published in Population Health Management, conducted a systematic review of published cancer screening studies to identify quality metrics used in patient navigation programs, as well as to recommend standardized metrics to define excellence in lung cancer navigation.

Cardiovascular Disease and Diabetes (International)

Evidence-based diabetes care for older people with Type 2 diabetes: a critical review
Older people with diabetes can represent some of the more complex and difficult challenges facing the clinician working in different settings. This review, published in Diabetic Medicine, sought to explore what evidence there is to guide clinicians in a comprehensive scheme of treatment for older adults, often in a high-risk clinical state, in terms of glucose lowering, blood pressure and lipid management, frailty care and lifestyle interventions.

Primary Health Care (New Zealand)

Introducing a checking technician allows pharmacists to spend more time on patient-focused activities
The objective of this study, published in Research in Social and Administrative Pharmacy, was to investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities.

Understanding the utilization of primary health care services by Indigenous men: a systematic review
This review, published in BMC Public Health, aimed to better understand the utilization of primary health care services by Indigenous men and assess the effectiveness of strategies implemented to improve utilization, by surveying peer-reviewed publications and grey literature from Australia, New Zealand, Canada and America.

Primary Health Care (International)

Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults: The D-PRESCRIBE randomized clinical trial 
High rates of inappropriate prescribing persist among older adults in many outpatient settings, increasing the risk of adverse drug events and drug-related hospitalizations. The objective of this study, published in JAMA, was to compare the effectiveness of a consumer-targeted, pharmacist-led educational intervention vs usual care on discontinuation of inappropriate medication among community-dwelling older adults.

Primary Mental Health (International)

Interventions to increase depression treatment initiation in primary care patients: a systematic review
Nearly 50% of depressed primary care patients referred to mental health services do not initiate mental health treatment. The most promising interventions for increasing depression treatment initiation in primary care settings remain unclear. The authors of this study, published in the Journal of General Internal Medicine, performed a systematic search to identify interventions designed to increase depression treatment initiation.

Unhealthy alcohol use in adolescents and adults: screening and behavioral counseling interventions. US Preventive Services Task Force Recommendation Statement   
The US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the effectiveness of screening to reduce unhealthy alcohol use, to update the USPSTF’s 2013 recommendation on screening for unhealthy alcohol use in primary care settings.

Better Help for smokers to Quit (International)

Integrating smoking cessation care in alcohol and other drug treatment settings using an organisational change intervention: a systematic review
Organizational change interventions involve systems and cultural change within health-care services to make smoking cessation care delivery part of usual treatment. This study, published in Addiction, examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation-related outcomes

Contingency management versus psychotherapy for prenatal smoking cessation: a meta-analysis of randomized controlled trials 
Prenatal smoking is the leading preventable cause of poor obstetric outcomes, yet treatment options are limited. The objective of this study, published in Womens Health Issues, was to compare the effect sizes of two intensive interventions for prenatal smoking cessation: contingency management (i.e., financial incentives for abstinence) and psychotherapy.

Weight Management (New Zealand)

Using codesign to develop a culturally tailored, behavior change mHealth intervention for indigenous and other priority communities: a case study in New Zealand 
The obesity rate in New Zealand is one of the highest worldwide, with highest rates among Maori and Pasifika. Codesign was used to develop a culturally tailored, behavior change mHealth intervention for Maori and Pasifika in New Zealand. The purpose of this article, published in Translational Behavioral Medicine, was to provide an overview of the codesign methods and processes and describe how these were used to inform and build a theory-driven approach to the selection of behavioral determinants and change techniques.

Key Ministry of Health publications

Achieving equity in health outcomes: highlights of selected papers
This paper traces the beginnings of health equity and the philosophical and ethical foundations that sit behind it. It looks at a selection of the international and local literature to help understand definitions of equity. It considers how framing and thinking about the concept of equity and approaches to addressing equity have evolved, and how progress to address equity can be measured.

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.