Issue 178 - 8 November 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.

Aged residential care quality improvement programme charter
This document sets out the Health Quality & Safety Commission's work through the aged residential care quality improvement programme. It gives an overview of how the Commission will work in aged residential care, and has been informed by sector engagement and what they have identified as being important to them. The Commission is partnering with the sector, establishing long-term relationships and a quality improvement network to support a strong culture of continuous quality improvement. The ultimate aim is to improve residents’ experience of care, resilience and quality of life.

Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies
Identifying characteristics associated with struggling healthcare organisations may help inform improvement. The authors of this study, published in BMJ Quality & Safety, systematically reviewed the literature to: (1) identify organisational factors associated with struggling healthcare organisations and (2) summarise these factors into actionable domains.

Inpatient flow management: a systematic review
In hospitals, several patient flows compete for access to shared resources. Failure to manage these flows result in one or more disruptions within a hospital system. The purpose of this paper, published in the International Journal of Health Care Quality Assurance, is to look at the information available in system-wide patient flow management studies, which were also systematically evaluated to demonstrate which interventions improve inpatient flow.,

Successful hospital readmission reduction initiatives: top five strategies to consider implementing today    
This comparative study, published in the Journal of Hospital Administration, conducted a systematic review to identify the most effective interventions to reduce unplanned 30-day readmissions to hospital.

Prostate cancer diagnostic pathway: Is a one-stop cognitive MRI targeted biopsy service a realistic goal in everyday practice? A pilot cohort in a tertiary referral centre in the UK
The purpose of this study, published in BMJ Open, was to evaluate the feasibility of a novel multiparametric MRI (mpMRI) and cognitive fusion transperineal targeted biopsy (MRTB) led prostate cancer (PCa) diagnostic service with regard to cancer detection and reducing time to diagnosis and treatment.

Should I be more concerned about patient care or the four-hour target?
Evidence suggests that patients are spending longer in UK EDs and it is possible that those who remain longer than four hours could have worse outcomes. This article, published in Emergency Nurse, identifies the effects of prolonged ED length of stay through a systematic literature review of data published since implementation of the four-hour target to measure the relationship between breaching the target and morbidity and mortality.

Cardiovascular disease risk prediction equations in 400 000 primary care patients in New Zealand: a derivation and validation study
Most cardiovascular disease risk prediction equations in use today were derived from cohorts established last century and with participants at higher risk but less socioeconomically and ethnically diverse than patients they are now applied to. For this study, published in The Lancet, the authors recruited a nationally representative cohort in New Zealand to develop equations relevant to patients in contemporary primary care and compared the performance of these new equations to equations that are recommended in the USA

Preventing cardiovascular disease in New Zealand: making better use of statins but also tobacco control, changing the food supply and other strategies
There is new evidence from a very large systematic review and meta-analysis (Navarese et al 2018), that using statins for reducing levels of low-density lipoprotein cholesterol reduces the risk of premature death. In this viewpoint article, published in the New Zealand Medical Journal, the authors consider the implications of this new evidence for New Zealand but also examine how the use of statins may be improved for primary prevention of cardiovascular disease (CVD) in this country.

A national public health programme on gambling policy development in New Zealand: insights from a process evaluation
In New Zealand, a public health programme on gambling policy development is part of a national gambling harm reduction and prevention strategy mandated by the Gambling Act 2003. Funded by the Ministry of Health, the programme directs workplace/organisational gambling policies, non-gambling fundraising policies, and local council policies on electronic gaming machines (EGMs). The authors of this study, published in Harm Reduction Journal, carried out a process evaluation of this programme to identify practical information (e.g. advocacy approaches; challenges and ameliorating strategies) that can be used by programme planners and implementers to reinforce programme effectiveness and serve to guide similar policy-focused public health initiatives elsewhere.

Guidelines for adolescent depression in primary care (GLAD-PC): part I. Practice preparation, identification, assessment, and initial management
The objective of this study, published in Pediatrics, was to update clinical practice guidelines to assist primary care (PC) clinicians in the management of adolescent depression. This part of the updated guidelines is used to address practice preparation, identification, assessment, and initial management of adolescent depression in PC settings.

Guidelines for adolescent depression in primary care (GLAD-PC): part II. Treatment and ongoing management
The objective of this study, published in Pediatrics, was to update clinical practice guidelines to assist primary care (PC) in the screening and assessment of depression. In this second part of the updated guidelines, the authors address treatment and ongoing management of adolescent depression in the PC setting.

Nurse-delivered interventions for mental health in primary care: a systematic review of randomized controlled trials
Many people experiencing mental health issues have established relationships with primary care providers, including general practice nurses (GPNs). The objective of this study, published in Family Practice, was to synthesize the evidence about nurse-delivered interventions in primary care for adults with mental illness.

Which eHealth interventions are most effective for smoking cessation? A systematic review
The purpose of this study, published in Patient Preference and Adherence, was to synthesize evidence of the effects and potential effect modifiers of different electronic health (eHealth) interventions to help people quit smoking.

Nutritional interventions or exposures in infants and children aged up to 3 years and their effects on subsequent risk of overweight, obesity and body fat: a systematic review of systematic reviews
This study, performed as part of the international EarlyNutrition research project and published in Obesity Reviews, provides a systematic review of systematic reviews on the effects of nutritional interventions or exposures in children (up to 3 years of age) on the subsequent risk of obesity, overweight and adiposity.

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States
Socioeconomic inequalities are associated with oral health status, either subjectively (self-rated oral health) or objectively (clinically-diagnosed dental diseases). The aim of this study, published in BMC Oral Health, was to compare the magnitude of socioeconomic inequality in oral health and dental disease among adults in Australia, Canada, New Zealand and the United States (US).

Ministry of Health Output Plan 2018/19
This output plan is a performance agreement between the Minister of Health (the Minister) and the Director-General of Health, and includes the work programme for the Associate Ministers of Health. It covers the financial year ending 30 June 2019. The plan is designed to demonstrate that New Zealanders will have access to strongly and strategically provided public health services which are well funded by the Government and that will deliver high-quality 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.