Issue 269 - 2 February 2023

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)

Three steps to meeting health literacy needs
The new guide for health care professionals, published by the Health Quality and Safety Commission, provides a process to follow with every person in every health care discussion.

Cultural safety involves new professional roles: a rapid review of interventions in Australia, the United States, Canada and New Zealand
Cultural safety is a decolonizing and transformative approach to health care aimed at achieving health care that recognizes, respects and nurtures the needs, rights and identities of Indigenous peoples. Such a transformation requires new or radically reimagined professional roles. Based on a rapid review design, this synthesis, published in AlterNative, aimed to identify fundamental characteristics of cultural safety interventions that involved the creation or transformation of professional roles.

Health Equity (International)

Racial Health Equity and Social Needs Interventions: A Review of a Scoping Review
Social needs interventions aim to improve health outcomes and mitigate inequities by addressing health-related social needs, such as lack of transportation or food insecurity. However, it is not clear whether these studies are reducing racial or ethnic inequities. The objective of this review, published in JAMA Network Open, was to understand how studies of interventions addressing social needs among multiracial or multiethnic populations conceptualize and analyse differential intervention outcomes by race or ethnicity.

Nothing about us without us: A co‐production strategy for communities, researchers and stakeholders to identify ways of improving health and reducing inequalities
Co-production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co-production and how to operationalize it. This paper, published in Health Expectations, describes the development of a co-production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK.

Cancer Services (International)

Web-Based Asynchronous Tool to Facilitate Communication Between Primary Care Providers and Cancer Specialists: Pragmatic Randomized Controlled Trial
Cancer poses a significant global health burden. With advances in screening and treatment, there are now a growing number of cancer survivors with complex needs, requiring the involvement of multiple health care providers. Previous studies have identified problems related to communication and care coordination between primary care providers (PCPs) and cancer specialists. This study, published in the Journal of Medical Internet Research, aimed to examine whether a web- and text-based asynchronous system (eOncoNote) could facilitate communication between PCPs and cancer specialists (oncologists and oncology nurses) to improve patient-reported continuity of care among patients receiving treatment or posttreatment survivorship care.

Emergency Department Services (International)

Hospital Capacity Command Centers: A Benchmarking Survey on an Emerging Mechanism to Manage Patient Flow
Delayed hospital and emergency department (ED) patient throughput, which occurs when demand for inpatient care exceeds hospital capacity, is a critical threat to safety, quality, and hospital financial performance. In response, many hospitals are deploying capacity command centers (CCCs), which co-locate key workgroups and aggregate real-time data to proactively manage patient flow. Only a narrow body of peer-reviewed articles have characterized CCCs to date. To equip health system leaders with initial insights into this emerging intervention, this study, published in the Joint Commission Journal on Quality and Patient Safety, sought to survey US health systems to benchmark CCC motivations, design, and key performance indicators.

Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis
Pharmacists have an increasing role as part of the emergency department (ED) team. However, the impact of ED-based pharmacy interventions on the quality use of medicines has not been well characterised. This systematic review, published in Emergency Medicine Journal, aimed to synthesise evidence from studies examining the impact of interventions provided by pharmacists on the quality use of medicines in adults presenting to ED. 

Cardiovascular Disease and Diabetes (International)

Altered dietary salt intake for preventing diabetic kidney disease and its progression
There is strong evidence that our current consumption of salt is a major factor in the development of increased blood pressure (BP) and that a reduction in our salt intake lowers BP, whether BP levels are normal or raised initially. Effective control of BP in people with diabetes lowers the risk of strokes, heart attacks and heart failure and slows the progression of chronic kidney disease (CKD) in people with diabetes. The objective of this Cochrane Review was to evaluate the effect of altered salt intake on BP and markers of cardiovascular disease and of CKD in people with diabetes.

Nurse-led telehealth intervention effectiveness on reducing hypertension: a systematic review
Hypertension is a public health concern for many countries. The World Health Organization has established a global objective to reduce the prevalence of non-communicable diseases, including hypertension, which is associated with cardiovascular disease. Remote nursing interventions can potentially lessen the burden on the healthcare system and promote a healthier population. This systematic review, published in BMC Nursing, aims to synthesise available evidence on the effectiveness of nursing-led telehealth interventions in reducing blood pressure in hypertensive patients.

Effectiveness of Diabetes Case Conferencing Program on Diabetes Management
Diabetes case conferencing is where an endocrinologist visits a general practitioner (GP) to advise on the care of patients with diabetes. Past case conferencing studies have reported improved diabetes management and clinical outcomes in primary care. This study, published in the International Journal of Integrated Care, investigated the effectiveness of a diabetes case conferencing program in South Western Sydney, Australia.

Primary Health Care (New Zealand)

Use of healthcare resources and family planning methods 12 months after birth in women of South Auckland: The Healthy Mums and Babies (HUMBA) randomised trial
The aim of this randomised trial, published in The New Zealand Medical Journal, was to report the utilisation of healthcare and family planning methods by participants in the Healthy Mums and Babies (HUMBA) trial at 12 months postpartum.

Experience of telehealth for receipt of primary health care: an online survey of young people in a geographic region of Aotearoa New Zealand
Telehealth became more widely used when the global COVID-19 pandemic restricted access to in-person consultations for primary care during periods of 'lockdown'. In 2021 (August-September), 15-to 25-year-olds in the Wellington region of Aotearoa New Zealand were invited to participate in an online survey that aimed to find out about telehealth experiences, perceived advantages and disadvantages, and willingness to use it for receipt of primary care. The results of this survey were published in the Australian Journal of Primary Health.

Primary Health Care (International)

“We're on the ground, we know what needs to be done”: Exploring the role of Aboriginal Health Workers in primary health care
Aboriginal Health Workers (AHWs) are core providers of primary health care (PHC) for First Nations peoples in Australia. However, the national AHW workforce is aging and in short supply. There is a poor understanding of the factors contributing to this attrition from the perspectives of AHWs themselves. This study, published in Frontiers in Public Health, aimed to systematically explore the current functioning and sustainability of AHWs in NSW PHC by amplifying AHW voices.

Effectiveness of nurse‐led multidisciplinary interventions in primary health care: A systematic review and meta‐analysis
This review, published in the International Journal of Nursing Practice, aimed to synthesise the available evidence on the effectiveness of nurse-led multidisciplinary interventions in primary health care.

Primary care team and its association with quality of care for people with multimorbidity: a systematic review
Multimorbidity is posing an enormous burden to health systems, especially for primary healthcare system. While primary care teams (PCTs) are believed to have potentials to improve quality of primary health care (PHC), less is known about their impact on the quality of care for people with multimorbidity. This review, published in BMC Primary Care, assessed the characteristics of PCTs and their impact on the quality of care for people with multimorbidity and the mechanisms. 

Primary Mental Health (New Zealand)

Nōku te Ao: Sovereignty of the Māori Mind
The purpose of this report, published by the Health Promotion Agency, is to present a Māori world view of factors that contribute to discrimination of people who have experienced — or continue to experience — mental distress.

Enhancing an online cognitive behavioural therapy intervention for depression: Harnessing the feedback of sexual and gender minority youth to help improve SPARX
SPARX is an online cognitive behavioural therapy self-help intervention for adolescent depression provided in serious game format. Since 2014, it has been freely available in Aotearoa New Zealand (NZ) due to funding from the NZ government. This article, published in Australasian Psychiatry, explores how feedback from sexual and gender minority youth (SGMY) was used to refine and update SPARX.

Primary Mental Health (International)

Effectiveness of Social Inclusion Interventions for Anxiety and Depression among Adolescents: A Systematic Review
Adolescents who are socially excluded are at increased risk of mental health problems such as depression and anxiety. Promoting social inclusion could be an effective strategy for preventing and treating adolescent depression and anxiety. This systematic review of intervention studies, published in the International Journal of Environmental Research and Public Health, aimed to prevent or treat adolescent depression and/or anxiety by promoting social inclusion.

Smoking Cessation (International)

Helping smokers with diabetes quit: A scoping review of the interventions utilised, and the challenges and barriers to smoking cessation
Tobacco smoking is recognised as a priority in diabetes management, yet many individuals with diabetes continue to smoke beyond diagnosis. This paper, published in Primary Care Diabetes, identifies the most promising smoking cessation strategies by reviewing the literature reporting interventions carried out amongst this study population, and the challenges and barriers to smoking cessation.

Key Ministry of Health Publications

Commissioning for Pae Ora Healthy Futures 2022
The Commissioning for Pae Ora Healthy Futures 2022 framework is a Te Tiriti o Waitangi-grounded consolidation of evidence on how commissioning can be used to improve health equity and outcomes and bring the whānau ora vision into the health system. 

Health Sector Initiative

New junior doctors enjoy cultural experience
The first day on the job for Te Whatu Ora Lakes junior doctors was different to what you might expect. The 15 new junior doctors experienced a noho at Te Kuirau Marae in Ohinemutu, Rotorua. They also had a hikoi around Ohinemutu, as well as whakawhanaungatanga and kōrero about Te Arawa history and working with Māori whānau within the hospitals. 

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.