Issue 280 - 20 July 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)

Well-being and cultural identity for Māori: Knowledge of iwi (tribal) affiliations does not strongly relate to health and social service outcomes
Research indicates that experiences in health and social services vary depending on identity. For Indigenous groups, identity and affiliation is complex. This paper, published in Social Science & Medicine, explores ethnicity and knowledge of tribal (iwi) affiliations for Māori and links this to health and social service outcomes in administrative data, the national Census, and Māori social survey data.

Whānau experiences of supporting a hospitalised family member away from their home base
In Aotearoa New Zealand, accessing the required level of hospital care can mean a patient is transferred away from their home base. Being transferred away from familiar surroundings inequitably impacts on people who live in rural areas, including Māori. During such transfers, whānau (family) of Māori patients who travel to support their unwell family member are also away from wider support systems. This paper, published in Kōtuitui, presents the findings of 17 semi-structured interviews with 19 whānau from across the Central North Island region. Whānau discuss their experiences of being away from home and of providing support to their hospitalised whānau member.

Incidence and outcomes of critical illness in indigenous peoples: a systematic review and meta-analysis
Indigenous Peoples experience health inequities and racism across the continuum of health services. This systematic review and meta-analysis, published in Critical Care, examined the incidence and outcomes of critical illness among Indigenous Peoples.

Public Health (New Zealand)

Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes: A Systematic Review and Meta-Analysis
Smoking causes considerable noncommunicable diseases, perinatal morbidity, and mortality. The objective of this review, published in JAMA Network Open, was to investigate the associations of population-level tobacco-control policies with health outcomes.

Cohort profile: Ngā Kawekawe o Mate Korona | Impacts of COVID-19 in Aotearoa - a prospective, national cohort study of people with COVID-19 in New Zealand
The COVID-19 pandemic has had significant health, social and economic impacts around the world. The authors of this study, published in BMJ Open, established a national, population-based longitudinal cohort to investigate the immediate and longer-term physical, psychological and economic impacts of COVID-19 on affected people in Aotearoa New Zealand (Aotearoa), with the resulting evidence to assist in designing appropriate health and well-being services for people with COVID-19.

Quality Improvement (New Zealand)

Principles for engaging consumers and whānau in mental health and addiction adverse event reviews
This information, published by the Health Quality & Safety Commission, is provided for mental health and addiction (MHA) services. It is intended to guide adverse event review facilitators on the principles of engaging with consumers and their whānau affected by an adverse event.

Consumer research: Safer prescribing and dispensing of medicines
Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) is working alongside other agencies to support safer prescribing and dispensing of medicines.

Emergency Department Services (International)

Acute assessment services for patient flow assistance in hospital emergency departments
Emergency departments (EDs) are facing serious and significant issues in the delivery of effective and efficient care to patients. Acute assessment services have been implemented at many hospitals internationally to assist in maintaining patient flow for identified groups of patients attending the ED. Identifying the risks and benefits, and optimal configurations of these services may be beneficial to those wishing to utilise an acute assessment service to improve patient flow. The objectives of this Cochrane Review was to assess the effects of acute assessment services on patient flow following attendance at a hospital ED.

Improving Safety and Quality With an Emergency Department Overcrowding Plan
The objective of the project, published in the Journal of Emergency Nursing, was to use an interdisciplinary team to strengthen and revise the emergency department overcrowding plan to reduce the patient wait times, length of stay, and the left-without-being-seen rates.

Primary Health Care (New Zealand)

Ethnic group differences in patient satisfaction with GP services: findings from the New Zealand Attitudes and Values Study
The objective of this study, published in the New Zealand Medical Journal, was to identify key predictors of general practitioner (GP) satisfaction and increase insight into the mechanisms behind ethnic health inequities in New Zealand.

Building positive respectful midwifery relationships: An analysis of women's experiences of continuity of midwifery care in Aotearoa New Zealand
The aim of this article, published in Women and Birth, was to explore women's experiences of continuity of midwifery care in Aotearoa NZ, whether they support the expectations within the Standards of Midwifery Practice and identify the characteristics of care that may contribute to positive or negative experiences of care.

Whānau Māori and Pacific peoples' knowledge, perceptions, expectations and solutions regarding antibiotic treatment of upper respiratory tract infections: a qualitative study
The rate of community antibiotic use is high in Aotearoa New Zealand (NZ) when compared to other nations, and in NZ, as in most other nations, antibiotics are very commonly prescribed for self-limiting upper respiratory tract infections (URTIs). Resources that build knowledge, perceptions and understanding can potentially reduce unnecessary antibiotic consumption. To inform the content of educational resources, the authors of this study, published in BMC Infectious Diseases, conducted an in-depth qualitative study with 47 participants via 6 focus groups of the knowledge, attitudes, and expectations of whānau Māori and Pacific peoples about antibiotics and URTIs.

Primary Health Care (International)

Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence
Primary healthcare (PHC) integration has been promoted globally as a tool for health sector reform and universal health coverage (UHC), especially in low‐resource settings. However, for a range of reasons, implementation and impact remain variable. PHC integration, at its simplest, can be considered a way of delivering PHC services together that sometimes have been delivered as a series of separate or 'vertical' health programmes. Healthcare workers are known to shape the success of implementing reform interventions. Understanding healthcare worker perceptions and experiences of PHC integration can therefore provide insights into the role healthcare workers play in shaping implementation efforts and the impact of PHC integration. The objective of this Cochrane Review was to map the qualitative literature on healthcare workers' perceptions and experiences of PHC integration to characterise the evidence base, with a view to better inform future syntheses on the topic.

Increased Immunisation (New Zealand)

"She vaccinated my baby and that's all…" Immunisation decision-making and experiences among refugee mothers resettled in Aotearoa New Zealand
To prevent disease outbreaks, refugee children must be age-appropriately immunised. This qualitative study, published in BMC Public Health, gained an in-depth understanding of refugee mothers' vaccine decision-making and experiences accessing immunisation services for their children post-resettlement in Aotearoa New Zealand.

Weight Management (New Zealand)

Integration of exercise prescription into medical provision as a treatment for non-communicable diseases: A scoping review
The purpose of this scoping review, published in Frontiers in Public Health, is to stimulate interest and to raise awareness, among researchers, healthcare practitioners, and policymakers regarding the current scientific literature related to exercise prescription for non-communicable diseases.

Tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults accessing care: a scoping review
Health care providers have reported low knowledge, skill, and confidence for discussing movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), which may be improved with the use of tools to guide movement behaviour discussions in their practice. The aim of this review, published in BMC Primary Care, was to report and appraise tools for movement behaviour discussions between health care providers and adults 18 + years in a primary care context within Canada or analogous countries.

Key Ministry of Health Publications

Pae Ora - Healthy Futures for all New Zealanders
The Pae Ora - Healthy Futures Strategies set the direction for a system that is equitable, accessible, cohesive and people-centred. The six strategies are: The New Zealand Health Strategy, Pae Tū: Hauora Māori Strategy, Te Mana Ola: The Pacific Health Strategy, The Health of Disabled People Strategy, The Rural Health Strategy, and The Women’s Health Strategy. These strategies set a long-term vision that cover the many factors that influence people’s health and wellbeing, including the role of health services. They show a future where people can live well and achieve good health, where families are empowered to be healthy, and where our communities and environments support good health.

Pae Ora Health Strategies: Summary of feedback from engagement 
This report summarises the major themes from engagement undertaken to inform the development of the Pae Ora health strategies. 

Health and Independence Report 2022 
This publication provides an overview of the state of public health in Aotearoa New Zealand for the 2022 calendar year and presents the latest data on measures of health, causes of health loss, and determinants of health.

Registrar (assisted dying) Annual Report – June 2023
The Registrar (assisted dying) Annual Report to the Minister of Health covers the period from 1 April 2022 to 31 March 2023 and is the first full year report published since the Act came into force.

Health Workforce Strategic Framework
This strategic framework is designed to guide health system settings and ensure Aotearoa New Zealand has a sustainable, representative and responsive health workforce that can meet the future needs of people and whānau.

Health Sector Initiative

Diabetes monitoring device pilot successful
A pilot of a continuous monitoring device for Māori living with diabetes in Taranaki significantly reduced their blood glucose levels and gave them tino rangatiratanga (self-determination) over their hauora (health), those involved in delivering the service say. A collaborative of providers, including Te Whatu Ora Taranaki, Pinnacle Midlands Health Network, Ngāruahine Iwi Health, Ngāti Ruanui and Tui Ora ran a six-month pilot of the Freestyle Libre Glucose Monitoring System in 2022, in which 40 patients had a device fitted in their arm.

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.