Ministry of Health Library

Health Improvement and Innovation Digest

Issue 141 - 27 April 2017

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.

You can forward this newsletter to others who may be interested in receiving it. They can register and subscribe here. You can also access other recent issues of the digest here.

If you have any queries, please email us at library@moh.govt.nz.

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)

Treatment Injury Information: Supporting Patient Safety Report
ACC have released national figures about claims for treatment injuries (cases where patients are unintentionally harmed during medical treatment) in New Zealand public hospitals. The report is part of a sector-wide programme to support improvements in patient safety, reduce patient harm and reduce treatment injuries.

Quality Improvement (International)

Does a quality improvement campaign accelerate take-up of new evidence? A ten-state cluster-randomized controlled trial of the Institute for Health Improvement’s Project JOINTS
A decade ago, the Institute for Healthcare Improvement pioneered a quality improvement (QI) campaign, leveraging organizational and personal social networks to disseminate new practices. There have been few rigorous studies of the QI campaign approach. Project JOINTS (Joining Organizations IN Tackling SSIs) engaged a network of state-based organizations and professionals in a 6-month QI campaign promoting adherence to three new evidence-based practices known to reduce the risk of infection after joint replacement. This study, published in Implementation Science, measured adherence to the evidence-based practices before and after the campaign.

Shorter Stays In Emergency Departments (New Zealand)

Time to cranial computerised tomography for acute traumatic brain injury in paediatric patients: Effect of the shorter stays in emergency departments target in New Zealand
Timely access to computerised tomography (CT) for acute traumatic brain injuries (TBIs) facilitates rapid diagnosis and surgical intervention. In 2009, New Zealand introduced a mandatory target for emergency department (ED) stay such that 95% of patients should leave ED within 6 h of arrival. This study, published in the Journal of Paediatrics and Child Health, investigated whether this target influenced the timeliness of cranial CT scanning in children who presented to ED with acute TBI.

Shorter Stays In Emergency Departments (International)

Effects of a hospital-wide intervention on emergency department crowding and quality: A prospective study
The objective of this study, published in Emergency Medicine Australasia, was to determine the impact of a management-supported, multimodal, hospital-wide intervention on ED crowding and quality measures.

Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions
The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. The objective of this study, published in Quality Management in Health Care, was to evaluate a Lean-based initiative to reduce ED LOS for medicine admissions.

Overcrowding in emergency departments: A review of strategies to decrease future challenges
Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study, published in Journal of Research in Medical Sciences, was to present strategies that have proven to reduce delay and overcrowding in EDs.

More Heart and Diabetes Checks (New Zealand)

Developing a synthetic national population to investigate the impact of different cardiovascular disease risk management strategies: A derivation and validation study
Many national cardiovascular disease (CVD) risk factor management guidelines now recommend that drug treatment decisions should be informed primarily by patients' multi-variable predicted risk of CVD, rather than on the basis of single risk factor thresholds. This study, published in PLoS One, aimed to investigate the potential impact of treatment guidelines based on CVD risk thresholds at a national level. The authors also aimed to create a synthetic population, representing the joint CVD risk factor distributions of the adult New Zealand population.

Primary Health Care (New Zealand)

Multimorbidity, clinical decision making and health care delivery in New Zealand Primary care: a qualitative study
Multimorbidity is a major issue for primary care. This study, published in BMC Family Practice, aimed to explore primary care professionals’ accounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery.

Health, functional ability and life satisfaction among older people 65 years and over: A cross sectional study
Satisfaction with life is a subjective and complex interplay of an older persons' perspective on their life achievements. Satisfaction with life, alongside health and functional ability are major contributors to successful ageing. This study, published in Contemporary Nurse, explored the impact of increasing age on older people's perceptions of their health, functional ability and life satisfaction.

Primary Health Care (International)

Social prescribing: less rhetoric and more reality. A systematic review of the evidence
Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service. This systematic review, published in BMJ Open, assesses the evidence for their effectiveness.

Clinical and cost effectiveness of nurse-led self-management interventions for patients with COPD in primary care: A systematic review
Chronic obstructive pulmonary disease is increasing in prevalence and constitutes a major cause of morbidity and mortality globally. As well as contributing to a significant decline in health status in many patients, this condition creates a considerable burden on healthcare providers. Self-management interventions are frequently implemented in community settings to limit the impact of chronic obstructive pulmonary disease on everyday life of individuals and to manage pressure on health systems. Nurses are the most likely professional group to provide self-management support. This systematic review, published in International Journal of Nursing Studies, aims to evaluate the clinical and cost effectiveness of nurse-led self-management for patients with chronic obstructive pulmonary disease in primary care.

Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care
There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study, published in PLoS One, was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up.

Primary Mental Health (New Zealand)

Effectiveness of Primary Health Care Services in Addressing Mental Health Needs of Minority Refugee Population in New Zealand
Many people are displaced from their country of origin and become refugees, mostly due to armed conflicts, political violence and human rights abuse. Refugees have complex mental, physical, and social health problems related to their traumatic background and the experiences they have endured during their refugee journey. The aim of this qualitative exploratory study, published in Issues in Mental Health Nursing, was to examine the effectiveness of primary health care services in addressing mental health needs of Bhutanese refugee women resettled in New Zealand.

Dietary behaviours and the mental well-being of New Zealand adolescents
The aim of this study, published in Journal of Paediatrics and Child Health, was to examine the associations between diet and mental health indicators in adolescents.

Farm suicides in New Zealand, 2007-2015: A review of coroners' records
Economic recessions and severe weather events are often associated with increased suicide rates. The Global Dairy Crisis 2015/2016 led to an economic downturn in the New Zealand dairy farming industry and, coupled with droughts in some regions and floods in others, raised fears about increased suicide rates among farmers. However, little was known about suicides in the farming sector. This study, published in the Australian and New Zealand Journal of Psychiatry, reviews characteristics of recent farm-related suicides in New Zealand and assesses the extent to which financial stresses contributed to the deaths.

Primary Mental Health (International)

Comprehensive Screening for Suicide Risk in Primary Care
Suicide is a major public health problem and a complex clinical challenge. Assessment and early identification could be enhanced with screening tools that look beyond depression. The purpose of this study, published in the American Journal of Preventive Medicine, was to identify profiles of risk behaviours and social stress associated with suicidal ideation and behaviour using the Behavioral Health Screen.

Outcomes of Integrated Behavioral Health with Primary Care
Integrating behavioural health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study, published in the Journal of the American Board of Family Medicine, was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care.

Increased Immunisation (New Zealand)

Global importation and population risk factors for measles in New Zealand: a case study for highly immunized populations
As endemic measles is eliminated through immunization, countries must determine the risk factors for the importation of measles into highly immunized populations to target control measures. Despite eliminating endemic measles, New Zealand suffers from outbreaks after introductions from abroad, enabling the authors to use it as a model for measles introduction risk. The authors of this study, published in Epidemiology and Infection, used a generalized linear model to analyse risk factors for 1137 measles cases from 2007 to June 2014. They also provided estimates of national immunity levels, and modelled measles importation risk.

Better Help for smokers to Quit (New Zealand)

Smoking in Pregnancy Among Indigenous Women in High-Income Countries: A Narrative Review
Pregnant women in socioeconomically disadvantaged circumstances, such as Indigenous women, have a high prevalence of smoking. Tobacco smoking is the most significant reversible risk factor for the health of Indigenous pregnant women and their babies. The authors of this study, published in Nicotine and Tobacco Research, conducted a narrative review of the literature on smoking among Indigenous pregnant women in the United States, Canada, New Zealand, and Australia.

Weight Management (New Zealand)

Associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders: an analysis of data from the 2008/09 New Zealand Adult Nutrition Survey
The purpose of this study, published in European Journal of Nutrition, was to investigate associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders.

Childhood Obesity (International)

Overweight and Obesity in Children under 5 Years: Surveillance Opportunities and Challenges for the WHO European Region
Many children who have overweight or obesity before puberty can develop obesity in early adulthood, which is associated with increased morbidity and mortality. The preschool years (ages 0–5) represents a point of opportunity for children to be active, develop healthy eating habits, and maintain healthy growth. Surveillance of childhood overweight and obesity in this age group can help inform future policies and interventions. This study, published in Frontiers in Public Health, aimed to review and report available prevalence data in WHO European Region Member States and determine how many countries can accurately report on rates of overweight and obesity in children under 5 years.

A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries
Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review, published in Journal for Specialists in Pediatric Nursing, was to provide a synthesis of current evidence on influences on PA and sedentary behaviours of preschool-age children in high-income countries.

Key Ministry of Health Publications

A Strategy to Prevent Suicide in New Zealand: Draft for public consultation
Every year over 500 people die by suicide in New Zealand. This has a devastating impact on the lives of the people involved and impacts all of us in some way. The New Zealand Suicide Prevention Strategy 2006–2016, which has guided suicide prevention activity in New Zealand since 2006, has come to an end. ‘A Strategy to Prevent Suicide in New Zealand: Draft for public consultation’ outlines a framework for how we can work together to reduce suicidal behaviour in New Zealand. It also identifies a set of priority areas for action. Consultation is open until 11 pm, Monday 12 June 2017.

Te Ara Whakapiri: Principles and guidance for the last days of life
This publication outlines the essential components and considerations required to promote quality care at the end of life for all adults in New Zealand. It also provides examples of useful approaches and tools that will serve as aids for the development of national and/or local resources as part of implementation.