Issue 298 - 18 April 2024

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 Health NZ district 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 (International)

A Systemwide Strategy to Embed Equity into Patient Safety Event Analysis
There is a lack of framework to incorporate equity into event analysis. This quality improvement initiative, published by the Joint Commission Journal on Quality and Patient Safety, involved the development of equity tools that were introduced in a two-hour interactive, case-based training across 11 acute care facilities at the largest municipal healthcare system in the United States.

Nutrition & Physical Activity (New Zealand)

Feeding Indigenous Aotearoa better
How Aotearoa imagines our food futures – the role food plays in our lives, our cultures, our economy, our media representations, our marketing campaigns – will depend on the available vocabulary we have for thinking about food and its value to society. The diverse realities of Māori offer important perspectives on how we might imagine and participate in our nation’s food futures. This article, published in the Journal of the Royal Society of New Zealand, provides an overview of our recent Kaupapa Māori research project Kai Atua: food stories for hope and wellbeing which explains how food is part of an Indigenous woven universe made up of human communities, ngā Atua (deities), economic and social forces and the natural world.

Nutrition & Physical Activity (International)

Effectiveness of nutritional counseling with overweight pregnant women on child growth at 6 months: A randomized controlled trial
Studies that have investigated the effect of nutritional counselling during the prenatal period on the follow-up outcomes of children at 6 months have produced inconclusive results. The study, published in Nutrition, aimed to investigate the effect of nutritional counselling, based on the NOVA food classification, encouraging the consumption of fresh and minimally processed foods, with overweight adult pregnant women on infant growth at 6 months of age.

A scoping review of the role of policy in mitigating childhood obesity in underserved populations using the RE-AIM framework
Health policy may impact this epidemic which disproportionally affects underserved populations. The aim of this review, published in Worldviews on Evidence-Based Nursing, was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations.

Quality Improvement (New Zealand)

Zero seclusion: Safety and dignity for all – change package
The Zero seclusion change package, published by the Health Quality & Safety Commission, uses a set of globally recognised, evidence-based interventions aimed at improving the care of tāngata whaiora while moving towards achieving zero seclusion in mental health inpatient units.

Quality Improvement (International)

Lessons Learned from a National Hospital Antibiotic Stewardship Implementation Project
The goal of antibiotic stewardship programs (ASPs) is to ensure patients receive effective therapy while minimizing adverse events. To overcome barriers commonly faced in implementing successful ASPs, AHRQ established a multifaceted, nationwide Safety Program for Improving Antibiotic Use in 2018. This report, published in the Joint Commission Journal on Quality and Patient Safety, summarises the lessons learned from the implementation of this initiative based on structured interviews with ASP leaders.

Cancer Services (New Zealand)

Perspectives of potentially eligible Indigenous Māori on a lung cancer screening programme: a qualitative study
Lung cancer causes more deaths than any other cancer, globally and in Aotearoa New Zealand, where it disproportionately affects Māori. This study, published in The New Zealand Medical Journal, aimed to understand Māori perspectives on lung cancer screening in Aotearoa New Zealand to guide its equity-focused implementation, including identifying enablers and barriers.

Emergency Department Services (New Zealand)

The epidemiology of dying within 48 hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand
Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people. The objective of this study, published in Age and Ageing, was to estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere.

Changes in alcohol-related emergency department presentations—a comparison of three waves in 2013, 2017 and 2022
Emergency departments (EDs) around the world are increasingly overcrowded, which is associated with significant patient harm. Alcohol use is a known contributor to ED overcrowding. This study, published in The New Zealand Medical Journal, aimed to assess trends in the characteristics of alcohol-related ED presentations over time.

Emergency Department Services (International)

Improving Wait Times for Children with Caregivers with Limited English Proficiency in the Emergency Department
In our pediatric emergency department (ED), children triaged as low acuity who presented with Spanish-speaking caregivers with limited English proficiency (SSLEP) experienced disparately longer wait times than similarly triaged children with English-proficient caretakers. Although inequities in ED care based on language preference exist, little is known about effective interventions to eliminate the disparity. This quality improvement study, published in Pediatric Quality & Safety, aimed to eliminate the disparity in wait times and share effective interventions.

Cardiovascular Disease and Diabetes (New Zealand)

Intensive management from diagnosis improves HbA1c at 12 months post-diagnosis: results from a prospective cohort study in children with newly diagnosed type 1 diabetes
The aim of this study, published in The New Zealand Medical Journal, was to examine the impact of intensive management of type 1 diabetes (T1D) from diagnosis on HbA1c 12 months from diagnosis.

Association between direct transport to a cardiac arrest centre and survival following out-of-hospital cardiac arrest: A propensity-matched Aotearoa New Zealand study
Direct transport to a cardiac arrest centre following out-of-hospital cardiac arrest may be associated with higher survival. However, there is limited evidence available to support this within the New Zealand context. This study, published in Resuscitation Plus, used a propensity score-matched cohort to investigate whether direct transport to a cardiac arrest centre improved survival in New Zealand.

Cardiovascular Disease and Diabetes (International)

Mobile phone text messaging for medication adherence in secondary prevention of cardiovascular disease
Cardiovascular diseases (CVDs) are the leading cause of death globally, accounting for almost 18 million deaths annually. People with CVDs have a five times greater chance of suffering a recurrent cardiovascular event than people without known CVDs. Although drug interventions have been shown to be cost‐effective in reducing the risk of recurrent cardiovascular events, adherence to medication remains suboptimal. The objective of this Cochrane Review was to evaluate the benefits and harms of mobile phone text messaging for improving medication adherence in people with CVDs compared to usual care.

Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation
Depression and anxiety occur frequently (with reported prevalence rates of around 40%) in individuals with coronary heart disease (CHD), heart failure (HF) or atrial fibrillation (AF) and are associated with a poor prognosis, such as decreased health‐related quality of life (HRQoL), and increased morbidity and mortality. The objective of this Cochrane Review was to assess the effects of psychological interventions in adults who have a diagnosis of CHD, HF or AF, compared to no psychological intervention, on psychological and clinical outcomes.

Empowering patients in primary care: a qualitative exploration of the usability and utility of an online diabetes self-management tool
Despite the potential advantages of Internet-based diabetes self-management education, its adoption was not widespread among Singapore’s public primary care clinics (polyclinics). The aim of this study, published in BMC Primary Care, was to explore the perceived utility and usability of the educational tool in patients with suboptimally-controlled T2DM in a Singapore primary care setting.

Primary Health Care (International)

Common barriers and enablers to the use of non-drug interventions for managing common chronic conditions in primary care: an overview of reviews
Non-drug interventions are recommended for chronic condition prevention and management yet are underused in clinical practice. Understanding barriers and enablers to using non-drug interventions may help implement non-drug interventions in primary care. This article, published in BMC Primary Care, aimed to conduct an overview of reviews to identify and summarise common barriers and enablers for using non-drug interventions for common chronic conditions in primary care.

Health Sector Initiative

Northland Mobile Nurse-led Vascular Service a First in New Zealand
A New Zealand first, mobile nurse-led vascular service from Whangārei Hospital hit the road last month, offering a two-day clinic in Kaitaia. Established last year, the nurse-led service helped alleviate pressure on the visiting Consultant clinic which is only offered once a fortnight in Whangārei.

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.