Issue 235 - 24 June 2021

Welcome to the fortnightly Health Improvement and Innovation Digest. The Digest has links to key evidence of interest, with access to new content arranged by topic.

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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)

Guidelines for working with Asian patients and their families
This document from the Health Quality & Safety Commission contain information and guidance for clinicians to increase cultural awareness, sensitivity, knowledge and skills when working with Asian patients and their families. 

Quality Improvement (International)

Early postnatal discharge from hospital for healthy mothers and term infants
Length of postnatal hospital stay has declined dramatically in the past 50 years. There is ongoing controversy about whether staying less time in hospital is harmful or beneficial. The objective of this Cochrane Review was to assess the effects of a policy of early postnatal discharge from hospital for healthy mothers and term infants in terms of important maternal, infant and paternal health and related outcomes. 

Hospital Productivity (International)

Targeted rehabilitation may improve patient flow and outcomes: development and implementation of a novel Proactive Rehabilitation Screening (PReS) service
Rehabilitation programmes can be delivered to patients receiving acute care (‘in-reach rehabilitation’) and/or those who have completed acute care but experience ongoing functional impairments (‘subacute rehabilitation’). Access to these programmes depends on a rehabilitation assessment, but there are concerns that referrals for this assessment are often triggered too late in the acute care journey. This article, published in BMJ Open Quality, describes a Proactive Rehabilitation Screening (PReS) process designed to systematically screen patients during an acute hospital admission, and identify early those who are likely to require specialist rehabilitation assessment and intervention. 

Cancer Services (International)

Improving access to cancer information and supportive care services: A systematic review of mechanisms applied to link people with cancer to psychosocial supportive care services
Previous research has described the low uptake of psychosocial support services in people living with cancer. While characteristics of individuals using services have been examined, mechanisms applied to link individuals to support services are less frequently considered. This review, published in Psycho-Oncology, aims to identify the mechanisms used to link people with cancer to support services and assess their impact.

Emergency Department Services (International)

Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review
The objective of this study, published in BMJ Open, was to conduct a scoping review to identify and summarise the existing literature on interventions involving primary healthcare professionals to manage emergency department (ED) overcrowding.

Primary Health Care (New Zealand)

Advance care planning communication skills manual
This document from the Health Quality & Safety Commission is a manual for all health professionals involved in having advance care planning conversations. 

Advance care planning training manual
This manual from the Health Quality & Safety Commission provides an in-depth view of advance care planning and how it can be incorporated into health care.

Primary Health Care (International)

A Systematic Review of the Effect of Telepharmacy Services in the Community Pharmacy Setting on Care Quality and Patient Safety
While community pharmacy-based telepharmacy services can expand medication access for underserved communities, the safety and quality of these services is uncertain. This systematic review, published in the Journal of Health Care for the Poor and Underserved, was conducted in August 2020 exploring the effect of community pharmacy-based telepharmacy services on patient safety and care quality.

Increasing the completion rate of the advance directives in primary care setting – a randomized controlled trial
The completion rate of Advance Directives (ADs) has been low. This study, published in BMC Family Practice, aims to examine the effectiveness of two interventions active counseling sessions coupled with passive patient education pamphlets, and patient education pamphlets alone, compared with control group (usual care), in increasing the completion rates of ADs in the primary care setting.

Primary Mental Health (International)

Saving Lives: A Systematic Review on the Efficacy of Theory-Informed Suicide Prevention Programs
Suicide is a global epidemic. This review, published in the Community Mental Health Journal, assessed the scope and effectiveness of suicide prevention programs.

Smoking Cessation (New Zealand)

Difference between perceived and actual daily smoking prevalence among New Zealand adults
Individuals’ social norms, beliefs and attitudes towards a behaviour predict their intentions and behaviours. Several studies have found that smoking behaviour is greatly influenced by individuals’ perceptions of social norms about smoking. There is substantial evidence that the perceived smoking prevalence rate is a strong predictor for actual smoking behaviour among young people. There is, however, a shortage of literature on perceived daily smoking prevalence among adults, and how this relates to smoking behaviour. This brief report, by the Health Promotion Agency, examines the difference between perceived and actual daily smoking prevalence by socio-demographic groups and smoking status using a nationally representative sample of New Zealanders aged 15 years and over.

The Potential Effectiveness of COVID-Related Smoking Cessation Messages in Three Countries
Health authorities are advising smokers to quit to reduce their COVID-related risk. The types of messages that may be effective in alerting smokers to this risk and encouraging a quit attempt are unknown. The aim of this study, published in Nicotine & Tobacco Research, was to test a series of messages to identify potentially effective communication approaches in Australia, New Zealand, and the United Kingdom.

Weight Management (New Zealand)

Participants’ and caregivers’ experiences of a multidisciplinary programme for healthy lifestyle change in Aotearoa/New Zealand: a qualitative, focus group study
Child and adolescent obesity continues to be a major health issue internationally. This study, published in BMJ Open, aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change.

Cross-National Outcomes of a Digital Weight Loss Intervention in the United States, Canada, United Kingdom and Ireland, and Australia and New Zealand: A Retrospective Analysis
Mobile health (mHealth) interventions are ubiquitous and effective treatment options for obesity. There is a widespread assumption that the mHealth interventions will be equally effective in other locations. This retrospective study, published in Frontiers in Public Health, assesses weight loss and engagement with an mHealth behaviour change weight loss intervention developed in the United States (US) in four English-speaking regions: the US, Australia and New Zealand (AU/NZ), Canada (CA), and the United Kingdom and Ireland (UK/IE).

Weight Management (International)

Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review
Childhood is a window of opportunity for the prevention of the obesity pandemic. Since “the first 1000 days of life” is a period in which healthy eating habits must be acquired, it should be the target for preventive strategies. Baby-led weaning (BLW) is an emergent way of weaning that could influence children’s health. The nutrition committees of the main pediatric societies affirm there is not enough evidence to support which is the best method of weaning. The aim of this review, published in Nutrients, was to determinate the influence of BLW on the infant’s weight gain compared to the traditional spoon-feeding, and to assess if it could decrease the risk of obesity in children.

Oral Health (International)

Visual or visual‐tactile examination to detect and inform the diagnosis of enamel caries
The detection and diagnosis of caries at the initial (non‐cavitated) and moderate (enamel) levels of severity is fundamental to achieving and maintaining good oral health and prevention of oral diseases. The objective of this Cochrane Review was to determine the diagnostic accuracy of different visual classification systems for the detection and diagnosis of non‐cavitated coronal dental caries for different purposes (detection and diagnosis) and in different populations (children or adults).

Key Ministry of Health Publications

Ministry of Health Stakeholder engagement: Long-term pathway to mental wellbeing
Aotearoa’s approach to supporting people with mental health and addiction needs is undergoing transformation, driven by He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction, published in 2018. He Ara Oranga acknowledged that the system provided a solid foundation to build on, and that New Zealand’s mental health and addiction system has valuable strengths, including a skilled and committed workforce. However, the assessment of the system outlined unmet needs, growing inequities and long-term, systemic barriers. The engagement sought specific feedback on the mental wellbeing framework published within Kia Kaha, Kia Maia, Kia Ora Aotearoa.

Annual Report on Drinking-water Quality 2019-2020
The Annual Report on Drinking-water Quality 2019-20 describes drinking-water quality for all registered networked drinking-water supplies that served populations of more than 100 people from 1 July 2019 to 30 June 2020.

Death, Funerals, Burials and Cremation: A Review of the Burial and Cremation Act 1964 and Related Legislation: Summary of submissions 2021
A summary of public submissions in response to the Consultation Document released in November 2019, including findings for policy development for the Ministry of Health and areas for future policy work. 

District Health Board Initiative

Peer Support - a journey of partnership and relationship building
Peer Support Specialists across a number of organisations in Counties Manukau have been working together to raise the profile of Peer Support services in their region.

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.