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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 223 - 3 December 2020

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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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.

Health Equity (New Zealand)

Equally Well - Some Key Facts
This publication from Te Pou displays some key facts about life expectancy, co-existing issues, medication, and substance use for people experiencing mental health and addiction issues.

Observations by and Conversations with Health Workers and Hospital Personnel Involved in Transferring Māori Patients and Whānau to Waikato Hospital in Aotearoa New Zealand
The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. In this paper, published in the International Journal of Environmental Research and Public Health, hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base.


Quality Improvement (New Zealand)

Factors associated with overall satisfaction with care at the end‐of‐life: Caregiver voices in New Zealand
In New Zealand, as in other industrialised societies, an ageing population has led to an increased need for palliative care services. In this study, published in Health and Social Care in the Community, a cross‐sectional postal survey of bereaved carers was conducted in order to describe both bereaved carer experience of existing services in the last 3 months of life, and to identify factors associated with overall satisfaction with care.

Kōrero mai site case studies
Between July 2017 and June 2018, the Health Quality & Safety Commission (HQSC) worked with Ko Awatea’s Dr Lynne Maher and the four Kōrero mai lead sites to co-design patient, family and whānau escalation of care processes. HQSC asked the sites to develop case studies about their co-design approach and what worked for their consumers and hospitals.


Quality Improvement (International)

Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study, published in the International Journal of Environmental Research and Public Health, was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways.


Shorter Waits in Emergency Departments (International)

Effect of hospital interventions to improve patient flow on emergency department clinical quality indicators
The Royal College of Emergency Medicine highlights poor flow through hospitals as a major challenge to improving emergency department flow. This study, published in the Emergency Medicine Journal, describes the effect of several hospital-wide flow interventions on Yeovil District Hospital’s emergency department flow.


Cardiovascular Disease and Diabetes (New Zealand)

Diabetic ketoacidosis admissions at Middlemore Hospital: observational study of cause and patient demographics
The aim of this study, published in the New Zealand Medical Journal, was to analyse data on diabetic ketoacidosis (DKA) admissions to better understand characteristics of those presenting with DKA and identify high-risk groups.

Ethnic inequities in screening for diabetes in pregnancy in New Zealand—adherence to national guidelines
The aim of this study, published in the New Zealand Medical Journal, was to assess adherence to the 2014 Ministry of Health (MoH) screening guidelines for diabetes in pregnancy (DiP) by Māori and non-Māori in the Waikato region.


Cardiovascular Disease and Diabetes (International)

Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis
Patient activation has been recognised as a reliable driver of self-management decision-making. This systematic review and meta-analysis, published in the Australian Journal of Primary Health, examines existing evidence on whether embedding patient activation within Type 2 diabetes mellitus (T2DM) self-management programs can improve patient outcomes.

Implementation of Telerehabilitation Interventions for the Self-Management of Cardiovascular Disease: Systematic Review
This systematic review, published in JMIR Mhealth Uhealth, aimed to synthesise research evaluating the effectiveness of implementing cardiac telerehabilitation interventions at scale in routine clinical practice, including factors underlying successful implementation processes, and experimental research evaluating implementation-related outcomes.


Primary Health Care (New Zealand)

Primary care improvement case study: South City Health: Managing child eczema
This case study, published by the Health Quality & Safety Commission, explores South City Health's primary care improvement project for child eczema.

 


Primary Health Care (International)

The Importance of Taking a Patient-Centered, Community-Based Approach to Preventing and Managing Frailty: A Public Health Perspective
Across the world, life expectancy is increasing. However, the years of life gained do not always correspond to healthy life years, potentially leading to an increase in frailty. Given the extent of population aging, the association between frailty and age and the impact of frailty on adverse outcomes for older people, frailty is increasingly being recognized to be a significant public health concern. The purpose of this paper, published in Frontiers in Public Health, is to offer an overview of the concept of frailty for a public health audience in order to raise awareness of the multidimensional aspects of frailty and on how these should be addressed using an integrated and holistic approach to care.

Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme
Loneliness is considered a global public health issue because of its detrimental impact on physical and mental health but little is known about which interventions can reduce loneliness. One potential intervention is social prescribing, where a link worker helps service‐users to access appropriate support such as community activities and social groups. Some qualitative studies have identified that social prescribing may help to reduce service‐users’ loneliness. Given this, the British Red Cross (a third sector organisation) developed and delivered a national social prescribing service in the United Kingdom to support people who were experiencing, or at risk of, loneliness. Service‐users could receive up to 12 weeks of support from a link worker. This mixed methods study, published in Health and Social Care in the Community, was conducted to understand the impact of the support on loneliness, and to identify the facilitators and barriers to service delivery.

Integrated health and social care in the community: A critical integrative review of the experiences and well‐being needs of service users and their families
A need for people‐centred health and social support systems is acknowledged as a global priority. Most nations face challenges in providing safe, effective, timely, affordable, coordinated care around the needs and preferences of people who access integrated health and social care (IHSC) services. Much of the current research in the field focuses on describing and evaluating specific models for delivering IHSC. Fewer studies focus on person‐centred experiences, needs and preferences of people who use these services. However, current international guidance for integrated care sets a precedence of person‐centred integrated care that meets the health and well‐being needs of people who access IHSC services. This review, published in Health and Social Care in the Community, aims to better understand the experiences and health and well‐being needs of people who use IHSC services in a community setting.


Primary Mental Health (International)

Cognitive behavioural therapy for anxiety disorders in children and adolescents
Previous Cochrane Reviews have shown that cognitive behavioural therapy (CBT) is effective in treating childhood anxiety disorders. However, questions remain regarding the following: up‐to‐date evidence of the relative efficacy and acceptability of CBT compared to waiting lists/no treatment, treatment as usual, attention controls, and alternative treatments; benefits across a range of outcomes; longer‐term effects; outcomes for different delivery formats; and amongst children with autism spectrum disorders (ASD) and children with intellectual impairments. The objective of this Cochrane Review was to examine the effect of CBT for childhood anxiety disorders, in comparison with waitlist/no treatment, treatment as usual (TAU), attention control, alternative treatment, and medication.


Weight Management (New Zealand)

The impact of voluntary front-of-pack nutrition labelling on packaged food reformulation: A difference-in-differences analysis of the Australasian Health Star Rating scheme
Front-of-pack nutrition labelling (FoPL) of packaged foods can promote healthier diets. Australia and New Zealand (NZ) adopted the voluntary Health Star Rating (HSR) scheme in 2014. This paper, published in PLOS Medicine, studied the impact of voluntary adoption of HSR on food reformulation relative to unlabeled foods and examined differential impacts for more-versus-less healthy foods.

The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review, published in the International Journal of Environmental Research and Public Health, is to synthesise information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries.


Oral Health (International)

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents
Most of the detected increment in dental caries among children above the age of six years and adolescents is confined to occlusal surfaces of posterior permanent molars. Dental sealants and fluoride varnishes are much used to prevent caries. As the effectiveness of both interventions in controlling caries as compared with no intervention has been demonstrated previously, this Cochrane Review aimed to evaluate their relative effectiveness.


Key Ministry of Health Publications

Annual Update of Key Results 2019/20: New Zealand Health Survey
The Annual Data Explorer provides a snapshot of the health of New Zealanders through the publication of key indicators on health behaviours, health status and access to health care for both adults and children.

Fetal and Infant Deaths web tool
This web tool presents a summary of fetal and infant deaths, with a focus on deaths and stillbirths registered in 2017.


District Health Board Initiative

Innovative dental schemes delivering dramatic results and bringing healthy smiles back to Eastern Bay students
Dental pain isn't just a health issue for young Eastern Bay students, says one high school principal, it affects their education and their futures. Addressing that issue is just one of the motivating factors behind some innovative dental health schemes launched at schools across the region. The school has worked closely with the Bay of Plenty District Health Board (BOPDHB) to address issues with access to dental care and address the disparity in health outcomes.


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.

Ministry of Health - Manatū Hauora
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