Ministry of Health Library

Health Improvement and Innovation Digest

Issue 216 - 27 August 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.

If you no longer wish to receive this newsletter, you can unsubscribe here.

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@health.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.

Māori Innovation

Kia whakatōmuri te haere whakamua: engaging Māori rural communities in health and social service care
Research on collaboration between health and social service organisations and professions often views collaboration from the narrow perspective of being between practitioners from different professions at a set point in time. This is often also focused on issues of efficacy and does not address the role of identity, values, and practices, or “culture” within collaboration, an important aspect when engaging with indigenous populations. This study, published in AlterNative, presents a Kaupapa Māori qualitative case study in a small rural community, which highlights how western culture has permeated within and across a health care system.

Health Equity (New Zealand)

A qualitative study of the role of Samoan Church ministers in health literacy messages and health promotion in Auckland, New Zealand
Health promotion and health literacy activities within church congregations are not a new concept; however, this has not yet been widely researched in New Zealand. This paper, published in the Australian and New Zealand Journal of Public Health, explores the views of Samoan Methodist Church ministers about health‐related issues and their role in health promotion and health literacy in their churches.

Quality Improvement (International)

Mobile technologies to support healthcare provider to healthcare provider communication and management of care
The widespread use of mobile technologies can potentially expand the use of telemedicine approaches to facilitate communication between healthcare providers, this might increase access to specialist advice and improve patient health outcomes. The objective of this Cochrane Review was to assess the effects of mobile technologies versus usual care for supporting communication and consultations between healthcare providers on healthcare providers' performance, acceptability and satisfaction, healthcare use, patient health outcomes, acceptability and satisfaction, costs, and technical difficulties.

Improving Patients’ Medication Adherence and Outcomes in Nonhospital Settings Through eHealth: Systematic Review of Randomized Controlled Trials
Electronic health (eHealth) refers to the use of information and communication technologies for health. It plays an increasingly important role in patients’ medication management. The objective of this review, published in the Journal of Medical Internet Research, was to assess evidence on whether eHealth for patients’ medication management can improve drug adherence and health outcomes in nonhospital settings and which eHealth functions are commonly used and are effective in improving drug adherence.

Hospital Productivity (International)

Routine Health Information System (RHIS) improvements for strengthened health system management
A well‐functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. The objective of this Cochrane Review was to assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes.

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review
Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review, published in the International Journal of Environmental Research and Public Health, was to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve.

Cancer Services (New Zealand)

Evidence of inequitable use of chemotherapy in New Zealand colorectal cancer patients
The aim of this study, published in the New Zealand Medical Journal, was to explore variations in the use of and timeliness of chemotherapy in patients diagnosed with colorectal cancer in New Zealand.

Cancer Services (International)

Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review
It is not clear whether clinical practice guidelines and consensus statements are adequately promoting shared decision making. The objective of this systematic review, published in Health Expectations, was to evaluate the recommendations about shared decision making  in clinical practice guidelines and consensus statements concerning breast cancer treatment.

Shorter Waits in Emergency Departments (New Zealand)

Evaluating the implementation and outcomes of a sepsis pathway in the emergency department
Early recognition and timely management, including prompt administration of antibiotics, has been fundamental in improving the mortality related to sepsis. This study, published in the New Zealand Medical Journal, aimed to examine the effect of the Sepsis Pathway Programme, a set of guidelines for sepsis, on the recognition, early investigation and management of septic patients in the emergency department.

Cardiovascular Disease and Diabetes (New Zealand)

Primary care improvement case study: The Hutt Union and Community Health Service diabetes improvement project
As part of HQSC's Whakakotahi – primary care improvement programme, the Hutt Union and Community Health Service undertook an ambitious project to reduce average blood glucose levels, as measured by HbA1c, in its low-decile and largely Pacific and Māori community.

Cardiovascular Disease and Diabetes (International)

Reduction in saturated fat intake for cardiovascular disease
Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. The objective of this Cochrane Review was to assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials.

Primary Health Care (International)

Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: a before-and-after study
Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study, published in BMC Family Practice, aimed to evaluate the outcomes of a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on the activation levels of patients with one or more chronic diseases in general practices across Northern Sydney, Australia.

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Increasing rates of preventable sexually transmitted infections (STIs) in the US pose substantial burdens to health and well-being. The objective of this report and review, published in JAMA, was to update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of behavioral counseling interventions for preventing STIs.

Interventions for escalation of therapy for acute exacerbations of asthma in children: an overview of Cochrane Reviews
Asthma is an illness that commonly affects adults and children, and it serves as a common reason for children to attend emergency departments. An asthma exacerbation is characterised by acute or subacute worsening of shortness of breath, cough, wheezing, and chest tightness and may be triggered by viral respiratory infection, poor compliance with usual medication, a change in the weather, or exposure to allergens or irritants. The objective of this overview was to summarise Cochrane Reviews with or without meta‐analyses of randomised controlled trials on the efficacy and safety of second‐line treatment for children with acute exacerbations of asthma.

Primary Mental Health (New Zealand)

What can primary care services do to help First Nations people with unhealthy alcohol use? A systematic review: Australia, New Zealand, USA and Canada
First Nations peoples of Australia, New Zealand, the United States of America (USA) and Canada are more likely to be non-drinkers than other people in these countries. However, those who do drink may be at greater risk of alcohol-related harms (at a population level) due to the ongoing impacts from colonisation and associated oppression. Addressing unhealthy drinking (drinking above recommended limits including alcohol use disorders) in primary care settings is one important way to increase accessibility of treatment. This systematic review, published in Addiction Science & Clinical Practice, identifies peer-reviewed studies of alcohol treatments delivered in primary care or other non-residential settings for First Nations peoples of Australia, New Zealand, USA and Canada.

Primary Mental Health (International)

Depression screening in adults by pharmacists in the community: a systematic review
Improving the identification of depression in adults in primary care can produce clinical and economic benefits. Community Pharmacists may play a role in screening for depression. The objective of this paper, published in the International Journal of Pharmacy Practice, was to systematically review and evaluate the evidence for the feasibility, impact and cost‐effectiveness of community pharmacists screening adults for depression.

Lessons learned from service design of a trial of a digital mental health service: Informing implementation in primary care clinics
Implementing a digital mental health service in primary care requires integration into clinic workflow. However, without adequate attention to service design, including designing referral pathways to identify and engage patients, implementation will fail. This article, published in Translational Behavioral Medicine, reports results from the authors efforts designing referral pathways for a randomized clinical trial evaluating a digital service for depression and anxiety delivered through primary care clinics.

Weight Management (International)

Effectiveness of Lifestyle Interventions for Prevention of Harmful Weight Gain among Adolescents from Ethnic Minorities: A Systematic Review
The escalating obesity among adolescents is of major concern, especially among those from an ethnic minority background. The adolescent period offers a key opportunity for the implementation of positive lifestyle behaviours as children transition to adulthood. The objective of this review, published in the International Journal of Environmental Research and Public Health, was to examine the effectiveness of lifestyle interventions for adolescents and their impact in ethnic and racial minorities for the prevention of overweight and obesity.

Oral Health (New Zealand)

Oral Health Among Older Adults With Complex Needs Living in the Community and in Aged Residential Care Facilities within New Zealand
The objective of this study, published in the Journal of the American Medical Directors Association, was to describe the oral health status and dental service use of older adults with complex needs living within the community and aged residential care (ARC) facility settings, and to determine associations between dental service utilization and sociodemographic variables.

Oral Health (International)

Health promotion interventions to improve oral health of adolescents: A systematic review and meta‐analysis
The objective of this study, published in Community Dentistry and Oral Epidemiology, was to evaluate the effectiveness of health promotion interventions on oral health knowledge, behaviour and status of healthy adolescents.

Disability Services (New Zealand)

How is life going for the disability community? (Fourth Survey)
This report provides a brief overview of some of the key findings from the fourth online survey on 'How life is going for the disability community' carried out by the Office for Disability Issues.  The purpose of the suite of surveys was to understand the issues associated with the COVID-19 pandemic being experienced by disabled people and their family/whānau. The surveys also collected information from service providers and others in the disability sector (such as community advocates).

District Health Board Initiatives

Asian flu vaccination programme reaching more people in our community
Community Flu Fighters programme has this year reached over 900 people from the Chinese, Indian, Korean and Cambodian communities as well as other groups. The collaboration between CM Health’s Asian Health team, Unichem Pakuranga, Auckland Chinese Medical Association (ACMA) and local organisations delivered free flu vaccination clinics in locations close to where the communities live and socialise.

Wellbeing Navigators ready to help returning New Zealanders
Returning New Zealanders accommodated in Rotorua are being given extra help with any challenges they may face with Wellbeing Navigators stationed at each of the hotels.

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.