Issue 299 - 2 May 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.

You can forward this newsletter to others who may be interested in receiving it. They can register and subscribe here. You can also access other recent issues of the digest here.

If you have any queries, please email us at library@health.govt.nz.

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.

Māori Innovation

Introducing 'Ngaruroro', a New Model for Understanding Māori Wellbeing
Indigenous peoples around the world are revitalising their ancestral beliefs, practices, and languages, including traditional understandings of health and wellbeing. In the Aotearoa (New Zealand) context, a number of ground-breaking Māori health- and wellbeing-related models have emerged, each with their own scope and applications. This study, published in the International Journal of Environmental Research and Public Health, aimed to explore and identify several key sources of wellbeing for Māori individuals.

Health Equity (New Zealand)

Five-Year Post-Housing Outcomes for a Housing First Cohort in Aotearoa, New Zealand
This paper, published in the International Journal on Homelessness, presents outcomes for a Housing First (HF) cohort in Aotearoa, New Zealand.

Health care delivery of kidney transplantation to indigenous Māori in Aotearoa New Zealand: A qualitative interview study with clinician stakeholders
Indigenous people experience higher rates of kidney failure than do non-Indigenous Peoples. However, compared to Indigenous patients, health care systems deliver kidney transplantation to non-Indigenous patients at a substantially higher rate and more frequently as the first treatment of kidney failure. Indigenous Māori patients in Aotearoa New Zealand report numerous barriers to kidney transplantation. This study, published in the Journal of Health Services Research & Policy, explored the perspectives of clinicians as stakeholders in the delivery of kidney transplantation.

Health Equity (International)

Telemedicine, e-Health, and Digital Health Equity: A Scoping Review
With the progressive digitization of people's lives and in the specific healthcare context, the issue of equity in the healthcare domain has extended to digital environments or e-environments, assuming the connotation of "Digital Health Equity" (DHE). Telemedicine and e-Health, which represent the two main e-environments in the healthcare context, have shown great potential in the promotion of health outcomes, but there can be unintended consequences related to the risk of inequalities. This paper, published in Clinical Practice and Epidemiology in Mental Health, aimed to review papers that have investigated the topic of Digital Health Equity in Telemedicine and e-Health.

Co-designing a Health Journey Mapping resource for culturally safe health care with and for First Nations people
Many healthcare professionals and services strive to improve cultural safety of care for Australia’s First Nations people. However, they work within established systems and structures that do not reliably meet diverse health care needs nor reflect culturally safe paradigms. Journey mapping approaches can improve understanding of patient/client healthcare priorities and care delivery challenges from healthcare professionals’ perspectives leading to improved responses that address discriminatory practices and institutional racism. This project, published in the Australian Journal of Primary Health, aimed to review accessibility and usability of the existing Managing Two Worlds Together (MTWT) patient journey mapping tools and resources, and develop new Health Journey Mapping (HJM) tools and resources.

Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review
The objective of this review, published in JBI Evidence Synthesis, was to describe how health service and delivery systems in high-income countries define and operationalise health equity. A secondary objective is to identify implementation strategies and indicators being used to integrate and measure health equity.

Nutrition & Physical Activity (New Zealand)

Changes in weight status of caregivers of children and adolescents enrolled in a community-based healthy lifestyle programme: Five-year follow-up
Whānau Pakari is a family-centred healthy lifestyle programme for children/adolescents with overweight/obesity in New Zealand. This secondary analysis, published in Obesity Research & Clinical Practice, assessed 5-year BMI changes in accompanying caregivers.

Quality Improvement (International)

Ensuring safe and equitable discharge: a quality improvement initiative for individuals with hypertensive disorders of pregnancy
The objective of this study, published in BMJ Quality & Safety, was to improve timely and equitable access to postpartum blood pressure (BP) monitoring in individuals with hypertensive disorders of pregnancy (HDP).

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact
The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. This review, published in BMC Health Services Research, sought to comprehensively grasp the conceptualisation and principles of CQI, explore existing models and tools, analyse barriers and facilitators, and investigate its overall impacts.

Hospital Productivity (New Zealand)

A longitudinal study examining the relationship between prioritization scores and changes in impact on life scores in elective surgery patients
Healthcare systems globally face the issue of resource constraints and need for prioritisation of elective surgery. Inclusive, explicit prioritisation tools are important in improving consistency and equity of access to surgery across health systems. The General Surgical Prioritisation Tool developed by New Zealand's Ministry of Health scores patients for elective non-cancer surgery based on surgeon's clinical judgement and patient derived Impact on Life (IoL) scores. This study, published in the ANZ Journal of Surgery, aims to measure the changes in patient derived IoL scores after common general surgical procedures to enable direct comparison and inform future prioritisation.

Cancer Services (New Zealand)

Do treatment patterns differ in those with early-onset colorectal cancer?
The incidence of early-onset colorectal cancer (EOCRC) is increasing. International guidelines state that treatment should not differ from that of older patients. Several studies have shown that patients under 50 years are receiving more aggressive treatment, without any survival benefit. This study, published in the Expert Review of Anticancer Therapy, aimed to determine if treatment for stages 2 and 3 EOCRC differs from those of late-onset colorectal cancer (LOCRC) patients.

Emergency Department Services (International)

Free-for-all: Does crowding impact outcomes because hospital emergency departments do not prioritise effectively?
Unexpected peaks in volumes of attendances at hospital emergency departments (EDs) have been found to affect waiting times, intensity of care and outcomes. This study, published in the Journal of Health Economics, explored whether these effects of ED crowding on patients are caused by poor clinical prioritisation or a quality-quantity trade-off generated by a binding capacity constraint.

Short waits, happy patients and expert care, moving basic musculoskeletal care from the emergency department to a physiotherapist-led diversion pathway
Patients with musculoskeletal conditions (MSKCs) are highly prevalent in ED. This project, published in Emergency Medicine Australasia, explores the impact of the pilot phase of a 'diversion pathway', which directed patients with MSKCs from the ED waiting room to an outpatient clinic led by advanced-scope physiotherapists.

Primary Health Care (New Zealand)

Intercontinental translatability of a peer-led GP education model from New Zealand to the United Kingdom: a pilot study
Pegasus Small Group education for General Practitioners (GPs) is a professional development programme that has been delivered in Canterbury, New Zealand for over 30 years. Peer developed content is delivered in small groups supporting interactive discussions informed by evidence and locally relevant data. This paper, published in BJGP Open, reports on an international collaboration between South Tyneside Clinical Commissioning Group (CCG) in the UK and Pegasus Health in Canterbury New Zealand and aimed to determine whether the Canterbury model of Small Group (SG) professional development for GPs was transferrable to the South Tyneside context.

Primary Mental Health (New Zealand)

Investigating the relationship between prenatal alcohol exposure and children's behavioural and emotional development: analysis of the Growing Up in New Zealand study
The aim of this study, published in Alcohol and Alcoholism, was to examine the relationship between prenatal alcohol exposure (PAE) and children's behavioural and emotional development in a large generalisable sample of women and their children in Aotearoa New Zealand.

Distinct profiles of mental health need and high need overall among New Zealand adolescents - Cluster analysis of population survey data
The objective of this study, published in The Australian and New Zealand Journal of Psychiatry, was to identify clinically meaningful groups of adolescents based on self-reported mental health and wellbeing data in a population sample of New Zealand secondary school students.

Smoking Cessation (International)

Risk and safety profile of electronic nicotine delivery systems (ENDS): an umbrella review to inform ENDS health communication strategies
This umbrella review, published in Tobacco Control, aims to summarise the evidence about electronic nicotine delivery systems’ (ENDS) risk and safety health profile to inform ENDS health communication strategies.

Key Ministry of Health Publications

Funding to Māori Health Providers 2018/19 to 2022/23
This publication summarises funding to Māori health providers by the Ministry of Health, Te Whatu Ora and Te Aka Whai Ora from 2018/19 to 2022/22. It follows on from our previous reports in 2017, 2021, 2022 and 2023.

Health Sector Initiative

Nelson Hospital welcomes new Patient at Risk team
Health New Zealand Nelson Marlborough recently introduced a new Patient at Risk (PAR) team who will play a pivotal role in providing patients and whānau with the best possible care.

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.