Ministry of Health Library

Health Improvement and Innovation Digest

Issue 185 - 28 February 2019

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)

Impact of a smartphone app on prescriber adherence to antibiotic guidelines in adult patients with community acquired pneumonia or urinary tract infections
The objectives of this study, published in PloS ONE, was to determine whether providing the Auckland City Hospital (ACH) antibiotic guidelines in a mobile phone app increased guideline adherence by prescribers caring for inpatients with community acquired pneumonia (CAP) or urinary tract infections (UTIs).

Improving quality of clinical coding of post-partum haemorrhage: the process and its effects on reported incidence rates in a New Zealand hospital maternity service
Postpartum haemorrhage (PPH) is considered the leading cause of maternal mortality worldwide and remains one of the major causes of pregnancy-related death and morbidity in the Western world. Published in the New Zealand Medical Journal, the aim of this study was to investigate and improve the accuracy of its reporting of post-partum haemorrhage (PPH), to understand its true incidence.

Childhood cancer registration in New Zealand: a registry collaboration to assess and improve data quality
New Zealand has two national registries covering child cancer - the New Zealand Cancer Registry (NZCR) and the New Zealand Children’s Cancer Registry (NZCCR). The aim of this study, published in Cancer Epidemiology, was to evaluate the completeness and accuracy of child cancer registration in New Zealand.

Overcoming barriers to cervical screening among Pacific women: a narrative review
Despite organized cervical screening in New Zealand, Pacific women still face significant health disparities in regard to cervical cancer incidence and mortality and access to colposcopy services. This narrative review, published in Health Equity, explored the barriers and facilitators for Pacific women accessing the cervical screening pathway.

Disability Sector Quality Improvement (International)

An evaluation of mainstream type 2 diabetes educational programmes in relation to the needs of people with intellectual disabilities: a systematic review of the literature
Risk reduction and self-management programs for type 2 diabetes (T2D) are commonplace. However, little is known about their appropriateness for people with intellectual disabilities (ID). This review, published in the Journal of Applied Research in Intellectual Disabilities, evaluates successful components and theoretical basis of interventions and preventions in relation to the needs of people with ID with or at risk of T2D.

A systematic review of obesity interventions targeting anthropometric changes in youth with intellectual disabilities
Due to the increased prevalence of obesity and disparity experienced by youth with intellectual disabilities, efforts to synthesize existing knowledge of interventions to attenuate obesity within this marginalized population is imperative. The purpose of this investigation, published in the Journal of Intellectual Disabilities, was to systematically analyze interventions targeting anthropometric changes in youth with intellectual disabilities.

Hospital Productivity (New Zealand)

Electronic whiteboards improve the acute surgical patient admission process
Electronic whiteboards have largely replaced the use of traditional whiteboards in many hospital departments. They are used to electronically record and display a variety of patient information to streamline the admission process and the quality of handover between relevant staff. This study, published in the New Zealand Medical Journal, assessed the impact of such a system upon the patient admission process in a busy general surgery department.

Hospital Productivity (International)

Inpatient flow management: a systematic review
To ensure continuous care delivery, solving flow problems must not be limited to one unit, but should be extended to other departments - a prerequisite for solving flow problems in the entire hospital. The purpose of this paper, published in the International Journal of Health Care Quality Assurance, is to look at the information available in system-wide patient flow management studies, which were also systematically evaluated to demonstrate which interventions improve inpatient flow.

Shorter Stays In Emergency Departments (International)

Evaluating the first older people’s emergency department
The Older People’s Emergency Department (OPED) at the Norfolk and Norwich University Hospital (NNUH) is the first service of its kind in the UK. OPED provides patients aged 80 and over with Comprehensive Geriatric Assessment (CGA) within two hours of arrival. This study, published in Age and Ageing, aimed to explore the effect of rapid, routine use of CGA in a specialised OPED on patient and operational outcomes.

Cardiovascular Disease and Diabetes (New Zealand)

Health literacy in action: kaupapa Māori evaluation of a cardiovascular disease medications health literacy intervention.
The healthcare system is complex and challenging to virtually everyone but more so to those who are marginalised, impoverished, and isolated - all factors that exacerbate health literacy barriers. This article, published in AlterNative: An International Journal of Indigenous Peoples, reports on an analysis of qualitative data collected for a kaupapa Māori evaluation of a Cardiovascular Disease Medications Health Literacy Intervention.

Trends in cardiovascular management of people with diabetes by primary healthcare nurses in Auckland, New Zealand
Practice nurses are undertaking an increasing proportion of diabetes consultations. This study, published in Diabetic Medicine, aimed to re-examine current work practices and evaluate time trends in the cardiovascular management of people with diabetes consulted by primary healthcare nurses in New Zealand.

Cardiovascular Disease and Diabetes (International)

Decision aids for people with Type 2 diabetes mellitus: an effectiveness rapid review and meta-analysis
The authors of this study, published in Diabetic Medicine, performed a rapid review and meta-analysis of randomized controlled trials (RCTs) evaluating patient decision aids (PtDAs) for people with Type 2 diabetes mellitus.

Primary Health Care (International)

The impact of a GP-led community paediatric allergy clinic: a service evaluation
London's Whittington Hospital created a GP with Special Interest (GPwSI) community paediatric allergy clinic, running alongside pre-existing hospital clinics, to address local unmet needs, aiming to provide equity for patients, improve patient experience and decrease secondary care burden. This study published in Clinical & Experimental Allergy, sought to establish whether improvements have occurred within the service by introducing a GPwSI-led community paediatric allergy clinic alongside providing GP education and referral pathways.

Primary Mental Health (New Zealand)

A web-based alcohol risk communication tool: summary of the development process
The aim of this study, published by the Health Promotion Agency, was to develop a prototype for a web-based tool for use by health professionals in primary care to communicate alcohol harm risk with their patients and to engage with them regarding ways this risk could be reduced.

Effective care for Māori with bipolar disorder: a qualitative study
Published in the International Journal of Mental Health Nursing, this qualitative study combining individual interviews and focus groups was conducted with the aim to explore mental health clinicians’ and Māori mental health workers’ perspectives of effective treatment for Māori with bipolar disorder.

Primary Mental Health (International)

Is care really shared? A systematic review of collaborative care (shared care) interventions for adult cancer patients with depression
Collaborative care involves active engagement of primary care and hospital physicians in shared care of patients beyond usual discharge summaries. The aim of this systematic review, published in BMC Health Services Research, was to identify components, delivery and roles and responsibilities within collaborative interventions for depression in the context of cancer.

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 labor-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.

Better Help for smokers to Quit (International)

A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum
There is no routine support to prevent postpartum smoking relapse, due to lack of effective interventions. Previous reviews have identified behaviour change techniques (BCTs) within pregnancy cessation trials to specify which components might be incorporated into more effective interventions, but no reviews have identified BCTs for prevention of smoking relapse postpartum. This study, published in Addictive Behaviors, reviewed BCTs and potential delivery modes, to inform future interventions.

Relapse prevention interventions for smoking cessation
Treatments used to help people avoid relapse usually focus on teaching the skills to cope with temptations to smoke, but can also involve extending the length of the treatment that helped them to quit, or giving additional treatment, like follow-up calls, leaflets, or stop-smoking medicine. Published in the Cochrane Database of Systematic Reviews, the authors of this study set out to see if these types of approaches can be helpful, either for people who quit on their own or with the help of treatment, or for those who quit because they were pregnant or in hospital.

Weight Management (New Zealand)

Rugby Fans in Training New Zealand (RUFIT-NZ): a pilot randomized controlled trial of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand
This randomized controlled pilot study, published in BMC Public Health, aimed to determine potential effect and the feasibility of a healthy lifestyle intervention designed specifically for the needs of men conducted through professional rugby in NZ.

Childhood Obesity (International)

Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis
Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. This study, published in PLoS Medicine, aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact.

Oral Health (International)

The role of dental practitioners in addressing overweight and obesity among children: a scoping review of current interventions and strategies
Dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children. This review, published in Obesity Research & Clinical Practice, aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting.

Māori Innovation

Te Ara Waiora a Tāne: a kaupapa Māori mental-health assessment and intervention planning approach
This paper, published in Australasian Psychiatry, aimed to describe a Māori approach to assessment and intervention planning using the Māori creation narrative Te Ara a Tāne (The Journey of Tāne) and to outline an evaluation one year after the model was implemented.

Huarahi Oranga: an introduction to Māori concepts informing a Māori healing and psychiatry partnership
The aim of this article, published in Australasian Psychiatry, was to give an overview of Māori concepts informing a collaboration between a Māori healer and a psychiatrist.

Key Ministry of Health Publications

Evaluation of the Mobility Action Programme (MAP): Cycle 1 Final Report
The Mobility Action Programme (MAP) is an early intervention programme for people with musculoskeletal conditions. Seventeen pilots have been located with all twenty District Health Boards (DHBs) of New Zealand to deliver evidence informed, community based and multidisciplinary care. The Ministry commissioned Allen + Clarke to evaluate the effectiveness and impact of the MAP, and to provide an evidence base that identifies the models and approaches that achieve the programme’s intended outcomes. This report is the first stage to be released and covers the period from January 2016 when services commenced through to May 2018. 

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.