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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 218 - 24 September 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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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)

Improving trauma care for critically bleeding patients: A history, evidence summary and proposed quality improvement approach
This document by Health Quality & Safety Commission is an early output from the critical haemorrhage project. It presents the history of managing critical haemorrhage in New Zealand, an evidence summary that justifies the proposed next steps and a description of the intended critical haemorrhage project approach.

Webinar recording: Let's discuss pressure injuries
The inaugural ‘Let’s discuss pressure injuries’ webinar was held on 12 August 2020. Facilitated by Dr Leona Dann, specialist patient safety at the Health Quality & Safety Commission, this was an opportunity to hear about healing long-term pressure ulcers.


Quality Improvement (International)

Patient safety culture in primary and home care services
Safety culture is still a poorly studied subject in primary care and home care, although these settings are considered gateways to access to healthcare. This study, published in BMC Family Practice, aims to evaluate safety culture in primary and home care settings.


Cancer Services (International)

The Victorian Lung Cancer Service Redesign Project: Impacts of a Quality
This article, published in Internal Medicine Journal, discusses the effect of an improvement collaborative on timeliness and management in lung cancer. This initiative targeted Quality Improvement (QI) in lung cancer management, engaging a Quality Improvement collaborative using service redesign methodologies in five Victorian hospitals.


Shorter Waits in Emergency Departments (International)

Paramedic streaming upon arrival in emergency department: A prospective study
The role of paramedics in hospital triage or streaming models has not been adequately explored and is potentially a missed opportunity for enhanced patient flow. The aim of the present study, published in Emergency Medicine Australasia, was to assess the concordance between a streaming decision by paramedics with the decision by nurses after arrival to the ED.


Better Help for Smokers to Quit (New Zealand)

Associations of history of mental illness with smoking and vaping among university students aged 18–24 years in New Zealand: Results of a 2018 national cross-sectional survey
Data on associations of history of mental illness (HMI) with smoking and vaping in New Zealand (NZ) are lacking. This study, published in Addictive Behaviors, examines these associations in university students aged 18–24 years.

Patterns of Use of Vaping Products among Smokers: Findings from the 2016–2018 International Tobacco Control (ITC) New Zealand Surveys
Alternative nicotine products like e-cigarettes could help achieve an end to the epidemic of ill health and death caused by smoking. However, in-depth information about their use is often limited. This study, published in the International Journal of Environmental Research and Public Health, investigated patterns of use of e-cigarettes and attitudes and beliefs among smokers and ex-smokers in New Zealand (NZ), a country with an ‘endgame’ goal for smoked tobacco.


Better Help for smokers to Quit (International)

Smartphone health apps for tobacco Cessation: A systematic review
Given the low retention and lack of persistent support by traditional tobacco cessation programs, evidence-based smartphone app-supported interventions can be an important tobacco control component. The objective of this systematic review, published in Addictive Behaviors, was to identify and evaluate the types of studies that use smartphone apps for interventions in tobacco cessation.


Weight Management (International)

Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review
Real-time video communication technology allows virtual face-to-face interactions between the provider and the user, and can be used to modify risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. No systematic reviews have examined the effectiveness of individual real-time video counseling for addressing each of the risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. This systematic review, published in the Journal of Medical and Internet Research, aims to examine the effectiveness of individually delivered real-time video counseling on risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity.


Childhood Obesity (International)

The training and support needs of 22 programme directors of community-based childhood obesity interventions based on the EPODE approach: an online survey across programmes in 18 countries
Tackling childhood obesity is complex and requires a community-based approach implemented in multiple environments. It is known from literature that knowledgeable and skilled professionals are essential to implement such an approach successfully. The aim of the present study, published in BMC Health Services Research, was to assess the need for training and support among a global network of programme directors implementing a Community-Based Childhood Obesity Intervention (CBCOI) based on the EPODE approach, in order to assist them in optimising the implementation process.

Dietetic management of obesity and severe obesity in children and adolescents: A scoping review of guidelines
This scoping review, published in Obesity Reviews, describes current guidelines for the dietary management of pediatric obesity and severe obesity.

Family-based nutrition interventions for obesity prevention among school-aged children: a systematic review
Effective evidence-informed family-based nutrition interventions for childhood obesity management are needed. The objective of this systematic review, published in Translational Behavioral Medicine, was to assess the number and quality of published randomised controlled trials incorporating family-based nutrition interventions for childhood obesity management and to identify intervention attributes used in successful interventions.


Disability Services (International)

Developing person‐centred care competencies for the healthcare workforce to support family caregivers: Caregiver centred care
Family caregivers (FCGs) are an integral part of the healthcare system. Researchers have proposed training to enhance the competencies of health providers to work effectively with FCGs. The objectives in this paper, published in Health and Social Care in the Community, are fourfold: a brief review of stakeholder engagement that led to the development of the competencies the health workforce needs to support FCGs, a description of the process used to name the competency domains, a report on the Modified Delphi process used to validate the domain indicators, and a description of the competency framework.

Environmental and behavioural interventions for reducing physical activity limitation and preventing falls in older people with visual impairment
Impairment of vision is associated with a decrease in activities of daily living. Avoidance of physical activity in older adults with visual impairment can lead to functional decline and is an important risk factor for falls. The rate of falls and fractures is higher in older people with visual impairment than in age‐matched visually normal older people. Possible interventions to reduce activity restriction and prevent falls include environmental and behavioral interventions. This Cochrane Review aimed to assess the effectiveness and safety of environmental and behavioral interventions in reducing physical activity limitation, preventing falls and improving quality of life amongst visually impaired older people.


Key Ministry of Health Publications

Second Round of Consultation on Requirements for Third-party Service Providers
The codes of practice included in this consultation were published under the Radiation Safety Act 2016 (the Act) with requirements for managing entities to use an external service that is either approved by the Director for Radiation Safety or maintains laboratory accreditation under ISO/IEC 17025, or internal capability validated by a qualified expert for individual dosimetry monitoring and leak testing. This Guide sets out general considerations for a regulatory body when establishing its regulatory framework around management system for service providers. In this consultation, ORS invites your feedback on the most appropriate approach to achieve reliability and uniformity of monitoring and testing outcomes. The closing date for submissions is 12.00 pm, Saturday 31 October 2020.

Health Sector Response to the 2019 Measles Outbreaks
This report was commissioned by the Ministry in early 2020 to consider the health system's response to the measles outbreaks, and was conducted by Dr Gerard Sonder and Dr Suitafa Debbie Ryan.  The review was tasked with reflecting on how the system responded, and continues to respond, to the outbreak, and to identify opportunities to strengthen future responses, and identifying what went well and what could be improved to help manage future disease outbreaks.

Influenza vaccine supply chain report
This report was commissioned by the Ministry in May 2020 to examine the supply and distribution of influenza vaccines and identify improvements for the 2021 influenza season and beyond. It was produced by PricewaterhouseCoopers (PWC), and highlights ten areas of focus grouped into the following themes of authorising and political environment, the strategic goals of the programme, and the organisation and system capabilities.


District Health Board Initiative

Harti Hauora provides more support for Māori community in Southland
Helping tamariki Māori avoid hospital admissions for respiratory infections by supporting the health of their whānau is the aim of a new collaborative healthcare service at Southland Hospital. Harti Hauora is a Kaupapa Māori centred programme improving connections with health care and other family support service. Awarua Whānau Services, WellSouth Primary Health Network and Southern DHB have worked together to introduce the programme for Māori whose tamariki are admitted to hospital with respiratory infections.


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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