Issue 271 - 2 March 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.

Māori Innovation

A tohu (sign) to open our eyes to the realities of Indigenous Māori registered nurses: A qualitative study
The aim of this study, published in the Journal of Advanced Nursing, was to Identify the experiences of Māori nurses and priorities for a Māori model of relational care working with Māori patients and their whānau (extended family network) in acute hospital services.

Health Equity (New Zealand)

Reimagining eating disorder spaces: a qualitative study exploring Māori experiences of accessing treatment for eating disorders in Aotearoa New Zealand
Health, illness, and the body are conceptualized within the cultural context of a society. The values and belief systems of a society, including media portrayals, shape how health and illness present. Traditionally, Western portrayals of eating disorders have been prioritized over and above Indigenous realities. This paper, published in the Journal of Eating Disorders, explores the lived experiences of Māori with eating disorders and their whānau (family/support system) to identify the enablers and barriers to accessing specialist services for eating disorders in New Zealand.

Children and young people's participation in decision-making within healthcare organisations in New Zealand: An integrative review
There is a paucity of literature on children and young people's participation in decision-making within healthcare organisations in New Zealand. This integrative review, published in the Journal of Child Health Care, examined child self-reported peer-reviewed manuscripts and published guidelines, policy, reviews, expert opinion and legislation to explore how New Zealand children and young people participate in discussions and decision-making processes within healthcare settings and what are barriers and benefits to such participation.

Towards a mother-centred maternal health promotion
A transformative approach to maternal health promotion should be mother-centred, context-driven and grounded in lived experiences. Health promotion can achieve this by drawing on its disciplinary roots to extend and reorient maternal health promotion towards an approach of non-stigmatizing and equitable health promotion that has mothers' well-being at the centre, particularly giving credit to marginalized, 'non-normative' maternities. This article, published in Health Promotion International, draws on data from 18 workshops conducted across Aotearoa New Zealand.

Quality Improvement (International)

The relationship between job stress and patient safety culture among nurses: a systematic review
Work stress is one of the leading causes of physical and mental problems among nurses and can affect patient safety. Nurses experiencing stress are more prone to make errors, which has consequences for the safety culture. This study, published in BMC Nursing, aimed to describe the findings of studies that examined the relationship between job stress and patient safety culture among nurses.

Emergency Department Services (International)

Effects of process changes on emergency department crowding in a changing world: an interrupted time-series analysis
During a 6-year period, several process changes were introduced at the emergency department (ED) to decrease crowding, such as the implementation of a general practitioner cooperative (GPC) and additional medical staff during peak hours. This study, published in the International Journal of Emergency Medicine, assessed the effects of these process changes on three crowding measures: patients’ length of stay (LOS), the modified National ED OverCrowding Score (mNEDOCS), and exit block while taking into account changing external circumstances, such as the COVID-19 pandemic and centralisation of acute care.

Reducing “Left without being seen” in a community emergency department: A rapid-cycle change project
Left without being seen (LWBS) is a challenge faced by EDs across the United States (US) and has become more prevalent since the COVID-19 pandemic. This study, published in the Journal of Nursing Education and Practice, attempted to reduce the left without being seen rate by implementing a multiple rapid-cycle Plan-Do-Check-Act (PDCA) change interventions in triage and throughout the ED.

Cardiovascular Disease and Diabetes (International)

Delivering diabetes shared medical appointments in primary care: early and mid-program adaptations and implications for successful implementation
Self-management is essential for good outcomes in type 2 diabetes and patients often benefit from self-management education. Shared medical appointments (SMAs) can increase self-efficacy for self management but are difficult for some primary care practices to implement. This study, published in BMC Primary Care, explores how practices adapt processes and delivery of SMAs for patients with type 2 diabetes and may provide helpful strategies for other practices interested in implementing SMAs.

A Systematic Review of Behavioral Interventions on Children at Risk for Diabetes
The aim of this systematic review, published in the American Journal of Preventive Medicine, was to examine the impact of behavioral-based interventions on cardiometabolic outcomes among children at risk for diabetes.

Primary Health Care (New Zealand)

Counting what counts: a systematic scoping review of instruments used in primary healthcare services to measure the wellbeing of Indigenous children and youth
Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review, published in BMC Primary Care, assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth.

Primary Mental Health (New Zealand)

Depression literacy in older Chinese people in New Zealand
Older Chinese people in New Zealand underutilise mental health services. Lack of recognition of mental health issues and awareness of available treatment is a potential barrier to accessing care. This study, published in Australasian Psychiatry, investigated depression literacy in older Chinese people.

Primary Mental Health (International)

Interventions to improve the detection of depression in primary healthcare: systematic review
Several studies have been conducted on the effect of interventions on the detection of depression in primary healthcare (PHC). Systematic reviews have also been done on the effectiveness of separate interventions. However, systematic reviews are not done on the comparative effectiveness of several interventions. This study, published in Systematic Reviews, aimed at synthesising the global evidence on the effectiveness of interventions to improve the detection of depression in PHC.

Increased Immunisation (New Zealand)

Informing women about maternal vaccination in Aotearoa New Zealand: Is it effective?
Aotearoa/New Zealand (NZ) follows a government-funded national midwifery continuity of care model for maternity care during pregnancy. It is recommended by health authorities in NZ that women are immunised against influenza, pertussis and COVID-19 during pregnancy. The aim of this research, published in Midwifery, was to investigate how Māori and Pacific women find out about vaccination during pregnancy, if the information given to them suited their needs, and how the delivery of information to Māori and Pacific women could be improved.

Weight Management (New Zealand)

The Value of Recreational Physical Activity in Aotearoa New Zealand: A Scoping Review of Evidence and Implications for Social Value Measurement
Internationally, there is rising interest in measuring the value of sport and physical activity to society. A critical step in valuing the sector is first establishing the relationship between engagement in sport and physical activity and the societal outcomes that ensue. This paper, published in the International Journal of Environmental Research and Public Health, summarises the findings of a literature review carried out as part of a larger study on the Social Return on Investment (SROI) of recreational physical activity in Aotearoa New Zealand. The review aimed to synthesise existing evidence on the relationship between recreational physical activity and wellbeing outcomes for all New Zealanders, including tangata whenua.

Weight Management (International)

Internet of things-Enabled technologies as an intervention for childhood obesity: A systematic review
Childhood obesity is one of the most serious public health challenges of the 21st century, with consequences lasting into adulthood. Internet of Things (IoT)-enabled devices have been studied and deployed for monitoring and tracking diet and physical activity of children and adolescents as well as a means of providing remote, ongoing support to children and their families. This review, published in PLOS Digital Health, aimed to identify and understand current advances in the feasibility, system designs, and effectiveness of IoT-enabled devices to support weight management in children.

Key Ministry of Health Publications

Australia and New Zealand Summit on the Value of Allied Health Care
This publication provides insights into the discussions and presentations at the Australia and New Zealand Summit on the Value of Allied Health held online in August 2022.

Ministry of Health Consultations & Events

Hauora Māori Strategy Consultation
As part of the next stage of the health reforms, the Ministry are developing a range of strategies to help guide our health system to achieve pae ora, healthy futures. One of those strategies is the Hauora Māori Strategy which will set the direction of the new health system for improving Māori health and wellbeing. Manatū Hauora and Te Aka Whai Ora are developing the interim Hauora Māori Strategy as part of a suite of health strategies within the Pae Ora (Healthy Futures) Act. These strategies will set the strategic direction for the health system. They’ll also guide health entities like Te Whatu Ora and Te Aka Whai Ora in their future planning, investments and priorities. This consultation closes on the 15th March 2023.

Health Sector Initiative

Wounds Clinic makes a difference at Tauranga Hospital
The Plastic Surgery Wound Clinic has been established at Tauranga Hospital. In this clinic, patients are able to receive post-reconstructive surgery care or care for complex wounds at the hospital, with input from the doctors as needed. They can then be linked with the district nurses once appropriate. The clinic has improved communication between the hospital and community.

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.