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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 128 - 6 October 2016

Welcome to the fortnightly Health Improvement and Innovation Digest (HIID). 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.  You can use this link to subscribe to Grey Matter.

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)

Checklists, briefings and debriefings: an evidence summary
This Health and Quality Safety Commission publication provides evidence for the use of checklists, briefings and debriefings, providing an overview of research and studies undertaken in various hospitals.


Hospital Productivity (New Zealand)

Equity of publicly-funded hip and knee joint replacement surgery in New Zealand: Results from a national observational study
This study, published in the New Zealand Medical Journal, examines equity in the provision of publicly-funded hip and knee total joint replacement (TJR) surgery in New Zealand between 2006 and 2013 to:  investigate national rates by demographic characteristics; describe changes in national rates over time; and compare rates of provision between District Health Boards (DHBs).


Shorter Waits for Cancer Treatment (International)

Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening
Whether patient navigation improves outcomes for patients with comorbidities is unknown. The aims of this study, published in Cancer, were to determine the effect of comorbidities on the time to diagnostic resolution after an abnormal cancer screening test and to examine whether patient navigation improves the timeliness and likelihood of diagnostic resolution for patients with comorbidities in comparison with no navigation.


Shorter Stays In Emergency Departments (International)

Primary contact physiotherapy services reduce waiting and treatment times for patients presenting with musculoskeletal conditions in Australian emergency departments: an observational study
This study, published in the Journal of Physiotherapy, aims to investigate whether primary contact physiotherapists reduce waiting and treatment times and facilitate faster discharge in Australian emergency departments.

Primary triage nurses do not divert patients away from the emergency department at times of high in-hospital bed occupancy - a retrospective cohort study
Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study, published in BMC Emergency Medicine, is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage.


Primary Health Care (New Zealand)

The rural medical generalist workforce: The Royal New Zealand College of General Practitioners’ 2014 workforce survey results
Previous surveys have revealed a New Zealand rural medical generalist workforce that is mainly male, older and dependent on international medical graduates (IMGs). The aims of this study, published in the Journal of Primary Health Care, were to provide a snapshot of the New Zealand rural medical generalist workforce in 2014 and to make comparisons with the urban medical generalist workforce.

Rural women’s perspectives of maternity services in the Midland Region of New Zealand
Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. The aim of this study, published in the Journal of Primary Health Care, was to understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services.

Risk stratification of New Zealand general practice patients for emergency admissions in the next year: adapting the PEONY model for use in New Zealand
Patient-centred case management programmes in general practice are needed for patients at high risk for emergency admissions to hospital. The aim of this study, published in the Journal of Primary Health Care, was to adapt and assess the Predicting Emergency Admissions Over the Next Year (PEONY) model for use in New Zealand to provide risk stratification of general practice patients aged greater or equal to 40 years for emergency hospital admissions in the next year.

Measuring care alignment in general practice consultations for people with long-term conditions: an exploratory study
Chronic care Model (CCM) aims to make the care of people with long term conditions (LTC) planned, proactive and patient-centred. The patient assessment of chronic care (PACIC) and our recently developed modified PACIC (MPACIC) allow patient and provider views to be compared. The aim of this study, published in the Journal of Primary Health Care, was to explore the use of measures of care provision and receipt in primary care long-term conditions management and to assess congruity between patient and provider views of support.


Primary Health Care (International)

Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review
Looking at what makes General Practitioners (GPs) happy in their profession, may be important in increasing the GP workforce in the future. This literature review, published in BMC Family Practice, explored how the satisfaction of GPs had been studied.

The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study
The pressure in out-of-hours primary care is high due to an increasing demand for care and rising health-care costs. During the daytime, substituting general practitioners (GPs) with nurse practitioners (NPs) shows positive results to contribute to these challenges. However, there is a lack of knowledge about the impact during out-of-hours. The current study, published in BMC Family Practice, aims to provide an insight into the impact of substitution on resource use, production and direct health-care costs during out-of-hours.

Developing interprofessional care plans in chronic care: a scoping review
The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study, published in BMC Family Practice, aims to get an overview of the scientific literature on developing interprofessional shared care plans.


Primary Mental Health (International)

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners' perceptions
Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. This study, published in the British Journal of General Practice, aimed to ascertain primary care practitioners' perceptions of the barriers that prevent effective management of child and adolescent mental health problems.

Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression
The objective of this study, published in BMJ Open, was to examine the efficacy of psychological and psychosocial interventions for reductions in repeated self-harm.


Increased Immunisation (International)

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study
This study, published in BMJ Open, evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services.


Better Help for smokers to Quit (New Zealand)

Parental smoking during pregnancy: findings from the Growing Up in New Zealand cohort
This paper, published in the New Zealand Medical Journal, looked at factors that may contribute to women who continued to smoke during pregnancy and also the exposure to second-hand smoke.


Better Help for smokers to Quit (International)

Electronic cigarettes for smoking cessation
Electronic cigarettes (ECs) are electronic devices that heat a liquid into an aerosol for inhalation. The liquid usually comprises propylene glycol and glycerol, with or without nicotine and flavours, and stored in disposable or refillable cartridges or a reservoir. Since ECs appeared on the market in 2006 there has been a steady growth in sales. Smokers report using ECs to reduce risks of smoking, but some healthcare organizations, tobacco control advocacy groups and policy makers have been reluctant to encourage smokers to switch to ECs, citing lack of evidence of efficacy and safety. Smokers, healthcare providers and regulators are interested to know if these devices can help smokers quit and if they are safe to use for this purpose. This Cochrane Review evaluates the safety and effect of using ECs to help people who smoke achieve long-term smoking abstinence.


Weight Management (International)

Brief Primary Care Obesity Interventions: A Meta-analysis
Although practice guidelines suggest that primary care providers working with children and adolescents incorporate BMI surveillance and counseling into routine practice, the evidence base for this practice is unclear. The objective of this study, published in Pediatrics, wast o determine the effect of brief, primary care interventions for pediatric weight management on BMI.


Childhood Obesity (New Zealand)

Prevalence of comorbidities in obese New Zealand children and adolescents at enrolment in a community-based obesity programme
The aim of this study, published in Journal of Paediatrics and Child Health, was to describe the characteristics at enrolment of children and adolescents referred to an obesity programme and to determine how the prevalence of comorbidities differed in Indigenous versus non-Indigenous children.


Oral Health (International)

Community-based population-level interventions for promoting child oral health
Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions The objective of this Cochrane Review was to determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age.


Māori Innovation

Ngā Reanga o ngā Tapuhi: Generations of Māori nurses
The aim of this study, published in AlterNative, was to explore the experiences of Māori nurses and student nurses in Aotearoa New Zealand who combine culturally specific customary obligations in all areas of whānau (family), hapū (kinship group) and iwi (wider kinship group) life (in particular, caregiving responsibilities) with working or studying.


Key Ministry of Health Publications

National Healthy Food and Drink Policy
It is important that our health care system shows leadership in providing healthier food and drink environments because many of the diseases that result in people needing hospital care are associated with what we eat and drink. This Policy aims to demonstrate commitment to the health and wellbeing of staff, visitors and the general public by providing healthy food and drink options, consistent with the Eating and Activity Guidelines.

Pathways to child health, development and wellbeing: Optimal environments for orchids and dandelions. An overview of the evidence
This review discusses the findings of a rapid review of some of the latest evidence on the pathways to optimal health and wellbeing for children from birth to age 14 years, through the developmental periods of infancy, early and middle childhood and early adolescence.


Ministry of Health - Manatū Hauora
Level 2, 1-3 The Terrace
Wellington, 6011
New Zealand

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