Ministry of Health Library

Health Improvement and Innovation Digest

Issue 176 - 11 October 2018

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)

Evaluating fundamentals of care: the development of a unit-level quality measurement and improvement programme
Feedback from patients, families, whanau, staff and audit data in 2014 indicated variability in the delivery of fundamental aspects of care such as monitoring, nutrition, pain management and environmental cleanliness at a New Zealand District Health Board. This project, published in the Journal of Clinical Nursing, aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care.

Trends in outpatient prescription medicine use in New Zealand children 2010–2015: a national population-based study
Research examining trends in the outpatient prescription medicine use of New Zealand children is limited. The objective of this retrospective cohort study, published in Pediatric Drugs, was to provide an overview of prescription medicine use in New Zealand children and assess changing patterns in use from 2010 to 2015.

Quality Improvement (International)

Using learning communities to support adoption of health care innovations
Diffusion of innovations can be a slow process, posing a major challenge to quality improvement in health care. Learning communities can provide a rich, collaborative environment that supports the adoption of health care innovations and motivates organizational change. Published in the Joint Commission Journal on Quality and Patient Safety, this study evaluated the effectiveness of communities of learning supported by the Agency for Healthcare Research and Quality (AHRQ) Health Care Innovations Exchange over 2014-2016.

Hospital staffing and health care-associated infections: a systematic review of the literature
Previous literature has linked the level and types of staffing of health facilities to the risk of acquiring a health care-associated infection (HAI). Investigating this relationship is challenging because of the lack of rigorous study designs and the use of varying definitions and measures of both staffing and HAIs. The objective of this systematic review, published in the Joint Commission Journal on Quality and Patient Safety, was to understand and synthesize the most recent research on the relationship of hospital staffing and HAI risk.

Hospital Productivity (International)

Use of Lean and related transformational performance improvement systems in hospitals in the United States: results from a national survey
The health care system in the United States is costly with high variance in quality. There is growing interest in transformational performance improvement initiatives, such as the Lean management system, to eliminate waste and inefficiency and improve quality of care for patients. This study, published in the Joint Commission Journal on Quality and Patient Safety, surveyed short-term acute general medical/surgical and pediatric hospitals in the United States on their use of Lean or related Lean plus Six Sigma or Robust Process Improvement approaches.

Shorter Stays In Emergency Departments (International)

Interventions to improve patient flow in emergency departments: an umbrella review
Patient flow and crowding are two major issues in ED service improvement. A substantial amount of literature exists on the interventions to improve patient flow and crowding, making it difficult for policymakers, managers and clinicians to be familiar with all the available literature and identify which interventions are supported by the evidence. This umbrella review, published in the Emergency Medicine Journal, provides a comprehensive analysis of the evidence from existing quantitative systematic reviews on the interventions that improve patient flow in EDs.

Why do ‘fast track’ patients stay more than four hours in the emergency department? An investigation of factors that predict length of stay
Low-acuity 'fast track' patients represent a large portion of Australian EDs' workload and must be managed efficiently to meet the National Emergency Access Target. This study, published in Emergency Medicine Australasia, determined the relative importance and estimated marginal effects of patient and system-related variables in predicting ED fast track patients who stayed longer than 4 hours in the ED.

Cardiovascular Disease and Diabetes (New Zealand)

The influence of pharmacist-led adherence support on glycaemic control in people with type 2 diabetes
Adherence to treatment is important to achieve target outcomes, particularly for those with type 2 diabetes. Pharmacists are well placed to enhance adherence, however evidence of the impact on clinical outcomes is not well known. The objective of this study, published in the International Journal of Clinical Pharmacy, was to determine the impact of an adherence support service on adherence scores and subsequent clinical biomarkers (HbA1c). The study focused on community pharmacies providing a Medicines Use Review (MUR) Service in a New Zealand locality.

Incidence and outcomes of out-of-hospital cardiac arrest: A New Zealand perspective
The objective of this study, published in Emergency Medicine Australasia, was to describe the incidence of and outcomes from out-of-hospital cardiac arrest (OHCA) in the New Zealand population served by the St John Ambulance Service.

Primary Health Care (International)

How does it feel to be a problem? Patients' experiences of self-management support in New Zealand and Canada
People with long-term conditions often feel they are a problem, a burden to themselves, their family and friends. Providers struggle to support patients to self-manage. The Practical Reviews in Self-Management Support (PRISMS) taxonomy lists what provider actions might support patient self-management. The objective of this study, published in Health Expectations, was to offer providers advice on how to support patient self-management.

Does patient self-management education of primary care professionals improve patient outcomes: a systematic review
The primary aim of this systematic review, published in BMC Family Practice, was to examine the effectiveness of educational interventions for primary care professionals that are designed to improve their support for patient self-management of chronic conditions and improve patient outcomes.

Primary Mental Health (New Zealand)

Promoting youth mental health via text-messages: a New Zealand feasibility study
A growing body of research has documented the positive effects of gratitude programs on participants' mental health and well-being. For children and adolescents, these programs typically rely on school-based group designs tied with a health curriculum, whereas innovative technology-based programs are relatively understudied. This experiment, published in Applied Psychology: Health and Well being, investigated the feasibility and efficacy of a gratitude text-messaging program for promoting adolescent mental health relative to a positive reflective control condition.

Ngā Whakāwhitinga (standing at the crossroads): how Māori understand what Western psychiatry calls "schizophrenia"
This project, published in Transcultural Psychiatry, explored how Māori understand experiences commonly labelled "schizophrenic" or "psychotic". Kaupapa Māori Theory and Personal Construct Theory guided the research within a qualitative methodology.

Primary Mental Health (International)

Use of technology for care coordination initiatives for patients with mental health issues: a systematic literature review
This systematic literature review, published in Neuropsychiatric Disease & Treatment, investigates the use of technology for the coordination and management of mental health care with an emphasis on outcomes.

Better Help for Smokers to Quit (International)

Mental health service user and staff perspectives on tobacco addiction and smoking cessation: a meta-synthesis of published qualitative studies
There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. This study, published in Journal of Psychiatric & Mental Health Nursing, provides a meta-synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice.

Childhood Obesity (New Zealand)

Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand
Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. This study, published in the Australian & New Zealand Journal of Public Health, used a novel solution-focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non-obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13-17) living in socioeconomically deprived neighbourhoods.

Childhood Obesity (International)

Interventions to prevent global childhood overweight and obesity: a systematic review
In view of the prevalence, health consequences, and costs of childhood obesity, there has been substantial interest in identifying effective interventions to prevent excess weight gain in young people. This systematic review, published in The Lancet Diabetes & Endocrinology, expands on previous reviews of obesity prevention interventions by including recent studies (until May 23, 2017) from all parts of the world.

Technology-based counseling in the management of weight and lifestyles of obese or overweight children and adolescents: a descriptive systematic literature review
The number of overweight and obese children and adolescents has increased worldwide. Obese children and adolescents need counseling interventions, including technology-based methods, to help them manage their weight by changing their lifestyles. The objective of this study, published in Informatics for Health & Social Care, was to describe technology-based counseling interventions in supporting obese or overweight children and adolescents to change their weight/lifestyle.

Effectiveness of school-based physical activity and nutrition interventions with direct parental involvement on children's BMI and energy balance-related behaviors - a systematic review
The aims of this systematic review, published in PLoS ONE, were to study the effectiveness of primary school-based physical activity, sedentary behavior and nutrition interventions with direct parental involvement on children's BMI or BMI z-score, physical activity, sedentary behavior and nutrition behavior and categorize intervention components into targeted socio-cognitive determinants and environmental types using the Environmental Research framework for weight Gain prevention (EnRG).

Key Ministry of Health Publications

New Zealand Antimicrobial Resistance Action Plan: year one progress report
This report informs the wider health sector and relevant stakeholders’ what work has been completed and progress achieved in the first year of the Antimicrobial action plan towards the five objectives of the Action Plan.

Surgical mesh registry: cost benefit analysis
This report provides an analysis of the number and cost of mesh surgery, the cost of the burden of disease, the costs and benefits of clinical registries generally, and an estimated benefit-cost ratio for a surgical mesh registry in New Zealand.

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.