Ministry of Health Library

Health Improvement and Innovation Digest

Issue 170 - 21 June 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)

Paediatric team handover: a time to learn?
Paediatric team handovers provide medical professionals and students with the opportunity to exchange clinically relevant information about patients.  This study, published in the New Zealand Medical Journal, explored the extent to which learning opportunities existed and were utilised within paediatric team handovers in New Zealand secondary hospitals.

Quality Improvement (International)

Using lean methodology to optimize time to antibiotic administration in patients with sepsis
Published in the American Journal of Health System Pharmacy, this quasi-experimental study was conducted at an 802-bed institution using lean methodology to assess the inpatient pharmacy workflow for dispensing antibiotics to adult patients.

Shorter Waits for Cancer Treatment (International)

Reducing Wait Time for Lung Cancer Diagnosis and Treatment: Impact of a Multidisciplinary, Centralized Referral Program
A multidisciplinary, centralized referral program was established at our institution in 2014 to reduce delays in lung cancer diagnosis and treatment following diagnostic imaging observed with the traditional, primary care provider–led referral process. Published in the Canadian Association of Radiologists Journal, the main objectives of this retrospective cohort study were to determine if referral to a Thoracic Triage Panel (TTP): 1) expedites lung cancer diagnosis and treatment initiation; and 2) leads to more appropriate specialist consultation.

Shorter Stays In Emergency Departments (International)

Comparing the Effect of Throughput and Output Factors on Emergency Department Crowding: A Retrospective Observational Cohort Study
This study, published in the Annals of Emergency Medicine, compares how throughput and output factors affect emergency department (ED) median waiting room time.

Cardiovascular Disease and Diabetes (International)

Effectiveness of interventions involving nurses in secondary stroke prevention: A systematic review and meta-analysis
Among members of the health care team, nurses play a large role in actively engaging stroke survivors in secondary stroke prevention programs. Published in the European Journal of Cardiovascular Nursing, this systematic review and meta-analysis examines the effectiveness of interventions in which nurses have a primary role on modification of risk factors among stroke survivors.

Primary Health Care (New Zealand)

Core components of the rural nurse specialist role in New Zealand
New Zealand has a rural population with unique healthcare needs. Traditionally, rural health care has been provided by medical general practitioners (GPs); however, as the number of GPs declines, the rural nurse specialist (RNS) role has emerged. The RNS is a registered nurse with advanced nursing skills that enable independent, autonomous practice within rural areas. The health needs of each rural community are specific to that area and the RNS role has been developed according to local healthcare needs. The purpose of this research, published in Rural and Remote Health, was to provide a description of the RNS role in New Zealand.

Doctors and pharmacists provision and opinions of medicines information leaflets in New Zealand
Providing verbal medicines information to patients may be insufficient. Providing medicine information leaflets could support verbal information, however New Zealand health professionals’ opinions or use of leaflets is unknown. Published in the International Journal of Clinical Pharmacy, this research sought to examine self-reported provision and health professionals’ views about medicine information leaflets and to determine their support for tailoring patient leaflets.

Primary Health Care (International)

Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? An evaluation of reach, effectiveness and cost-effectiveness using a ‘trial within a cohort’
Innovative ways of delivering care are needed to improve outcomes for older people with multimorbidity. Health coaching involves ‘a regular series of phone calls between patient and health professional to provide support and encouragement to promote healthy behaviours’. This intervention is promising, but evidence is insufficient to support a wider role in multimorbidity care. Published in BMC Medicine, the authors evaluated health coaching in older people with multimorbidity.

Primary Mental Health (International)

Coordinating Mental and Physical Health Care in Rural Australia: An Integrated Model for Primary Care Settings
The ‘GP Clinic’ provides primary health care to people using community mental health services in a small town in Australia. This article, published in the International Journal of Integrated Care, examines the factors that have driven successful integration in this rural location.

Increased Immunisation (International)

Interventions to increase influenza vaccination rates of those 60 years and older in the community
The effectiveness of interventions to increase influenza vaccination uptake in people aged 60 years and older varies by country and participant characteristics. This Cochrane Review updates versions published in 2010 and 2014. The object of the review was to assess access, provider, system, and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community.

Better Health for Smokers to Quit (New Zealand)

An Exploration of Smoking-to-Vaping Transition Attempts Using a “Smart” Electronic Nicotine Delivery System
Electronic nicotine delivery systems (ENDS) are used to aid smoking cessation attempts; however, many smokers continue to smoke while using an ENDS (dual use). Although uncertainty remains regarding whether specific ENDS patterns hinder or support successful smoking cessation, recent advances in “smart” technology allow passive and active recording of behaviors in real time, enabling more detailed insights into how smoking and vaping patterns may coevolve. Published in Nicotine & Tobacco Research, this article describes patterns of ENDS initiation, and subsequent use, including any changes in cigarette consumption, among daily smokers using a “smart” ENDS (S-ENDS) to quit smoking.

Better Help for Smokers to Quit (International)

Nicotine replacement therapy versus control for smoking cessation
Nicotine replacement therapy (NRT) aims to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence.  This Cochrane Review sought to determine the effectiveness and safety of nicotine replacement therapy (NRT), including gum, transdermal patch, intranasal spray and inhaled and oral preparations, for achieving long-term smoking cessation, compared to placebo or 'no NRT' interventions.

Weight Management (New Zealand)

Combined diet and physical activity is better than diet or physical activity alone at improving health outcomes for patients in New Zealand’s primary care intervention
A dearth of knowledge exists regarding how multiple health behavior changes made within an exercise prescription programme can improve health parameters.  Published in BMC Public Health, this study aimed to analyse the impact of changing diet and increasing exercise on health improvements among exercise prescription patients.

Childhood Obesity (New Zealand)

Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial
Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper, published in Nutrients, was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7-24 months of age.

Childhood Obesity (International)

Parental Translation into Practice of Healthy Eating and Active Play Messages and the Impact on Childhood Obesity: A Mixed Methods Study
Childhood obesity is a significant health issue worldwide. Modifiable risk factors in early childhood relate to child healthy eating and active play, and are influenced by parents. Published in Nutrients, the aim of the study was two-fold. Firstly, to determine the weight status of children aged between birth and 3.5 years in a rural and remote area of Australia. Secondly, to explore the relationship between child weight status and translation of advice on healthy eating and active play provided to parents by local, nurse-led, Maternal Child Health (MCH) services.

The longitudinal relationship between community programmes and policies to prevent childhood obesity and BMI in children: the Healthy Communities Study
Although a national epidemic of childhood obesity is apparent, how community‐based programmes and policies (CPPs) affect this outcome is not well understood. This study, published in Pediatric Obesity, examined the longitudinal relationship between the intensity of CPPs in 130 communities over 10 years and body mass index (BMI) of resident children. The authors also examined whether these relationships differ by key family or community characteristics.

Effects of multidisciplinary interventions on weight loss and health outcomes in children and adolescents with morbid obesity
Morbid obesity is the fastest growing subcategory of childhood obesity, associated with an increased health risk that persists into adulthood. There is an urgent need to develop multifaceted interventions that target initial and long‐term lifestyle changes. Published in Obesity Reviews, this review investigates the effects of multidisciplinary interventions on weight loss and health outcomes in children and adolescents with morbid obesity. The influence of age, gender and family participation on health outcomes and intensive treatment alternatives are explored.

Key Ministry of Health Publications

Social, Emotional and Behavioural Difficulties in New Zealand Children: New Zealand Health Survey
Based on the Strengths and Difficulties Questionnaire (SDQ), this Ministry of Health publication explores the prevalence of social, emotional and behavioural difficulties in New Zealand children aged 3–14 years. Data come from the New Zealand Health Survey child developmental health and wellbeing module, which was in the field in 2012/13, 2014/15 and 2015/16. The publication reports on differences in the prevalence and nature of the difficulties experienced by children across age, sex, ethnicity and neighbourhood deprivation.

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.