Ministry of Health Library
Health Improvement and Innovation Digest
Issue 197 - 15 August 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@health.govt.nz.
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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.
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Quality Improvement (New Zealand)
A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity
This report, by the Health Quality & Safety Commission, highlights a number of areas where change is needed in the health system. The report is divided into three chapters. The first analyses inequity between how Māori and non-Māori access and receive health services, and the effects on equity of improvement activities in our system. The second chapter asks why these inequities exist, and the third chapter addresses opportunities for improvement.
Severe maternal morbidity due to obstetric haemorrhage: Potential preventability
Haemorrhage in pregnancy may be life‐threatening to woman and infant. The impact of severe obstetric haemorrhage can be reduced by detecting high‐risk women, implementing guidelines and treatment plans, early detection of hypovolaemia, and timely appropriate treatment. This study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, aims to describe cases of severe maternal morbidity caused by obstetric haemorrhage in New Zealand and investigate the potential preventability of these cases.
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Shorter Stays In Emergency Departments (International)
Strengths and weaknesses of the acute care systems in the United Kingdom and the Netherlands: what can we learn from each other?
Despite the similarities in the UK’s and Dutch health care systems, such as universal health coverage, there are differences in the number of patients presenting at the Emergency Departments and the burden of crowding between these countries. Given the similarities in funding, this BMC Emergency Medicine paper explores the similarities and differences in the organisational structure of acute care in the UK and the Netherlands.
How does clinical space utilisation impact patient flow?
Long waiting times in accident and emergency (A&E) departments remain one of the largest barriers to the timely assessment of critically unwell patients. In order to reduce the burden on A&Es, some trusts have introduced ambulatory care areas (ACAs) which provide acute assessment for general practitioner referrals. However, ACAs are often based on already busy acute medical wards and the availability of clinical space for clerking patients means that these patients often face long waiting times too. A cheap and sustainable method to reducing waiting times is to evaluate current space utilisation with the view to making use of underutilised workspace. The aim of this quality improvement project, published in BMJ Open Quality, was to improve accessibility to pre-existing clinical spaces, and in doing so, reduce waiting times in acute admissions.
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Cardiovascular Disease and Diabetes (New Zealand)
Understandings of disease among Pacific peoples with diabetes and end‐stage renal disease in New Zealand
Compared with New Zealand Europeans, Pacific peoples in New Zealand develop type 2 diabetes at a higher rate and a younger age, and have 3.8 times higher incidence of end‐stage renal disease (ESRD). The objective of this study, published in Health Expectations, was to investigate contextual factors that shape understandings of disease for Pacific peoples with diabetes and ESRD.
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Primary Health Care (International)
Vitamin D supplementation for women during pregnancy
Vitamin D supplementation during pregnancy may be needed to protect against adverse pregnancy outcomes. The objective of this Cochrane Review was to examine whether vitamin D supplementation alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes.
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Better Help for smokers to Quit (International)
Motivational interviewing for smoking cessation
Motivational Interviewing (MI) is a directive patient‐centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help people to a make a successful attempt to stop smoking. The objective of this Cochrane Review was to evaluate the efficacy of MI for smoking cessation compared with no treatment, in addition to another form of smoking cessation treatment, and compared with other types of smoking cessation treatment.
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Weight Management (New Zealand)
The effect of food price changes on consumer purchases: a randomised experiment
Most evidence on health-related food taxes and subsidies relies on observational data and effects on single nutrients or foods instead of total diet. The aim of this study, published in The Lancet Public Health, was to measure the effect of randomly assigned food price variations on consumer purchasing, where sets of prices emulated commonly discussed food tax and subsidy policies, including a subsidy on fruit and vegetables, a sweetened beverage tax, and taxes on foods according to sugar, sodium, and saturated fat content.
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Childhood Obesity (International)
Interventions for preventing obesity in children
Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well‐being. The international evidence base for strategies to prevent obesity is very large and is accumulating rapidly. The objective of this Cochrane Review was to determine the effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children.
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Health Equity (New Zealand)
Subsequent injuries experienced by Maori: results from a 24-month prospective study in New Zealand.
Māori, the indigenous population of New Zealand, experience a disproportionate burden of injury compared to non-Māori. Injury burden can be exacerbated by subsequent injuries (injuries that occur after, but not necessarily because of, an earlier or 'sentinel' injury). Despite obligations under New Zealand's Treaty of Waitangi, it appears no published studies have investigated subsequent injuries among Māori. This study, published in the New Zealand Medical Journal, aims to describe subsequent injuries experienced by Māori and reported to New Zealand's no-fault injury Accident Compensation Corporation (ACC), and determine: the number and timing of subsequent injury (SI) claims reported to ACC in 24 months following a sentinel injury; the proportions experiencing ≥1 SI; and the nature of SIs.
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Key Ministry of Health Publications
Achieving Equity in Health Outcomes – Summary of a discovery process
This report provides a brief summary of phase one of the Achieving Equity Work Programme: The Discovery Phase. The aim of the discovery phase was to identify where practical and coordinated effort could be undertaken to achieve a measurable shift in health equity in the next three to five years.
Sustainability and the Health Sector
This publication aims to support and encourage the health sector to take an active role in incorporating sustainability practices and reducing carbon emissions. It highlights the wide-ranging benefits of sustainability and provides ideas of how health facilities in New Zealand can reduce their environmental footprints and contribute to the transition to a sustainable, low-emissions world. It also acknowledges that a multi-agency approach is required to effect change, and signals that the Ministry of Health intends to continue to work with District Health Boards and other agencies to create a knowledge base of evidence and expertise to facilitate sustainable thinking throughout the health sector.
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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.
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