Issue 249 - 31 March 2022

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.

Health Equity (New Zealand)

Indigenous health equity in health register ascertainment and data quality: a narrative review
Health registers play an important role in monitoring distribution of disease and quality of care; however, benefit is limited if ascertainment (i.e., the process of finding and recruiting people on to a register) and data quality (i.e., the accuracy, completeness, reliability, relevance, and timeliness of data) are poor. Indigenous peoples experience significant health inequities globally, yet health data for, and about, Indigenous peoples is often of poor quality. This narrative review, published in the International Journal for Equity in Health, aimed to identify perceived barriers for the ascertainment of Indigenous peoples on health registers, and collate strategies identified and used by health registers to support comprehensive ascertainment and high-quality data for Indigenous peoples. 

Using vignettes about racism from health practice in Aotearoa to generate anti‐racism interventions
Racism is a key modifiable determinant of health that contributes to health inequities in Aotearoa and elsewhere. Experiences of racism occur within the health sector for workers, patients and their whānau (extended family) every day. This paper, published in Health & Social Care in the Community, uses stories of racism from nurses – reworked into vignettes – to examine the dynamics of racism to generate possible micro, meso and macro anti-racism interventions.

Health Equity (International)

Inequities in Health Care Services Caused by the Adoption of Digital Health Technologies: Scoping Review
Digital health technologies (ie, the integration of digital technology and health information) aim to increase the efficiency of health care delivery; they are rapidly adapting to health care contexts to provide improved medical services for citizens. However, contrary to expectations, their rapid adoption appears to have led to health inequities, with differences in health conditions or inequality in the distribution of health care resources among different populations. This scoping review, published in Journal of Medical Internet Research, aims to identify and describe the inequities of health care services brought about by the adoption of digital health technologies.

Quality Improvement (New Zealand)

Toolkit released to help DHBs learn from mental health and addiction sector adverse events
The Health Quality & Safety Commission has released a toolkit for triaging, reviewing and learning from adverse events in mental health and addiction services.

Humanizing harm: Using a restorative approach to heal and learn from adverse events
Healthcare is not without risk. Despite two decades of policy focus and improvement efforts, the global incidence of harm remains stubbornly persistent, with estimates suggesting that 10% of hospital patients are affected by adverse events. This viewpoint, published in Health Expectations, explores how current investigative responses can compound the harm for all those affected—patients, families, health professionals and organizations—by neglecting to appreciate and respond to the human impacts.

Quality Improvement (International)

Sustaining interventions in care homes initiated by quality improvement projects: a qualitative study
Inadequate and varied quality of care in care homes has led to a proliferation of quality improvement (QI) projects. This study, published in BMJ Quality & Safety, examined the sustainability of interventions initiated by such projects.

Hospital Productivity (International)

Key Indicators Affecting Hospital Efficiency: A Systematic Review
Measuring hospital efficiency is a systematic process to optimising performance and resource allocation. This systematic review, published in Frontiers in Public Health, investigated the key input, process, and output indicators that are commonly used in measuring the technical efficiency of the hospital to promote the accuracy of the results.

Emergency Department Services (International)

The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety - A realist evaluation
Primary care streaming was implemented in UK Emergency Departments (EDs) to manage an increasing demand for urgent care. This article, published in International Emergency Nursing, aimed to explore its effectiveness in EDs with different primary care models and identify contexts and mechanisms that influenced outcomes.

Cardiovascular Disease and Diabetes (New Zealand)

Adherence to Clinical Practice Guideline Recommendations in Women with Gestational Diabetes and Associations with Maternal and Infant Health-A Cohort Study
Gestational diabetes mellitus (GDM) is managed by dietary advice, but limited evidence exists about the impact of adherence on health. This study, published in Nutrients, assessed whether adherence to the New Zealand Ministry of Health dietary recommendations is associated with maternal and infant health in women with GDM.

Cardiovascular Disease and Diabetes (International)

Brief lifestyle interventions for prediabetes in primary care: a service evaluation
The increasing number of cases of prediabetes in the UK is concerning, particularly in Wales where there is no standard programme of support. The aim of the current service evaluation, published in BMC Primary Care, was to examine the effectiveness of brief lifestyle interventions on glucose tolerance in people at risk of developing type 2 diabetes.

Primary Health Care (International)

Maximising the health impacts of free advice services in the UK: A mixed methods systematic review
After a decade of austerity spending cuts and welfare reform, the COVID-19 pandemic has posed further challenges to the finances, health and wellbeing of working-age, low-income people. While advice services have been widely seen (and funded) as an income maximisation intervention, their health and well-being impact is less clear. Previous systematic reviews investigating the link between advice services and health outcomes have found a weak evidence base and cover the period up until 2010. This mixed methods review, published in Health & Social Care in the Community, examined up to date evidence to help understand the health impacts of free and independent welfare rights advice services.

How Are Non-Medical Settlement Service Organizations Supporting Access to Healthcare and Mental Health Services for Immigrants: A Scoping Review
Following resettlement in high-income countries, many immigrants and refugees experience barriers to accessing primary healthcare. Local non-medical settlement organizations, such as the Local Immigration Partnerships in Canada, that support immigrant integration, may also support access to mental health and healthcare services for immigrant populations. This scoping review, published in the International Journal of Environmental Research and Public Health, aims to identify, and map the types and characteristics of approaches and interventions that immigrant settlement organizations undertake to support access to primary healthcare for clients.

Primary Mental Health (New Zealand)

Predictors of Suicide Ideation and Attempt Planning in a Large Sample of New Zealand Help-Seekers
Suicide is a major public health concern worldwide. The present study, published in Frontiers in Psychiatry, explores the risk factors for suicide ideation and suicide attempt planning by analysing anonymized data collected by a New Zealand telephone helpline.

Primary Mental Health (International)

Nurse-led task-shifting strategies to substitute for mental health specialists in primary care: A systematic review
This review, published in the International Journal of Nursing Practice, aimed to synthesize evidence comparing task-shifting interventions led by general practice nurses and mental health specialists in improving mental health outcomes of adults in primary care.

Weight Management (International)

Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting
The prevalence of childhood obesity is increasing worldwide with long-term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects. Evaluation of interventions could provide more practically relevant information when considered in the context of the setting in which the intervention was delivered. This systematic review, published in Maternal & Child Nutrition, has evaluated diet and physical activity interventions aimed at reducing obesity in children, from birth to 5 years old, by intervention setting.

Oral Health (International)

Building an understanding of Indigenous Health Workers’ role in oral health: A qualitative systematic review
Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review, published in Community Dentistry and Oral Epidemiology, aimed to build an understanding of IHW insights on oral health.

Key Ministry of Health Publications

Designated Auditing Agency Handbook
This handbook gives the Ministry of Health's requirements of designated auditing agencies (DAAs) for auditing and audit reporting for the certification of health care services under the Health and Disability Services (Safety) Act 2001. The handbook also gives providers of health care services a guide to specific requirements for various types of audits.

Ministry of Health Consultations & Events

Review of Radiation Safety Fees and Regulations
The Review of Radiation Safety Fees and Regulations sets out proposals to amend the Radiation Safety Regulations 2016 (the Regulations), including significant increases to application fees for radiation safety authorisations, minor amendments to existing exemptions and setting out the fees payable in a simple format. This consultation is designed to provide sufficient information and time for people who are affected by the Regulations to make an informed contribution to proposals to amend the Regulations. The closing date for submissions is 12pm, Friday 29 April, 2022.

District Health Board Initiative

Balanced diet key to learning success
The tamariki receive a healthy morning tea and lunch thanks to the Government’s healthy school lunches programme, supported by Hawke’s Bay DHB, Sport Hawke’s Bay and the Ministry of Education. Principal Matariki Perepe-Perana said staff had noticed a huge difference in the children’s health since introducing the Ka Ora Ka Ako healthy school lunches programme.

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.