Issue 319 - 3 April 2025

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 (New Zealand)

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians
This research, published in the ANZ Journal of Surgery, investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration.

Health Equity (International)

Hospital-based interventions addressing social needs: A systematic narrative review
Healthcare settings worldwide are adopting screening and referral interventions to address patients’ social needs. Some interventions provide one-off lists of resources (‘light-touch’ interventions) while others employ Health Navigators to provide ongoing assistance and advocacy with community organisations (‘high-touch’ interventions). Understanding the manner in which these interventions are integrated in hospital settings, and their effects on medical and social outcomes, is limited. This systematic narrative review, published in the American Journal of Preventive Medicine, uses narrative synthesis to explore workflows for screening and referral interventions for social needs in hospital settings, and barriers and enablers to intervention success.

Do the effects of interventions aimed at the prevention of childhood obesity reduce inequities? A re-analysis of randomized trial data from two Cochrane reviews
Public health attempts to prevent obesity in children and young people should aim to minimize health inequalities. Two Cochrane reviews examining interventions aiming to prevent childhood obesity found that interventions promoting (only) physical activity have a small beneficial effect on BMI for people aged 5-18 years, as do interventions promoting physical activity alongside healthy eating for 5-11 year olds. This article, published in EClinicalMedicine, examined whether the effectiveness of the interventions included in these reviews differed according to eight factors associated with inequity: place, race/ethnicity, occupation, gender/sex, religion, education, socio-economic status, and social capital (the PROGRESS framework).

Mobilizing the Power of Lived/Living Experiences to Improve Health Outcomes for all
Health Equity Assessments (HEAs) are decision‐support frameworks or tools used to evaluate the equity impacts of policies, programmes and initiatives. However, HEAs are often conducted without meaningful engagement from the individuals and communities most affected by health inequities. This lack of social participation limits the relevance and effectiveness of HEAs, leaving systemic inequities unaddressed and opportunities for impactful change unrealized. This study, published in Health Expectations, explores involving people with diverse lived/living experiences when conducting and offering HEAs.

Quality Improvement (International)

Audit and feedback: effects on professional practice
The objective of this Cochrane Review was to assess the effects of Audit and feedback (A&F)  on the practice of healthcare professionals and to examine factors that may explain variation in the effectiveness of A&F.

Reporting feedback on healthcare outcomes to improve quality in care: a scoping review
Providing healthcare providers (HCPs) feedback on their practice patterns and achieved outcomes is a mild to moderately effective strategy for improving healthcare quality. Best practices for providing feedback have been proposed. However, it is unknown how these strategies are implemented in practice and what their real-world effectiveness is. This scoping review, published in Implementation Science, addresses this gap by examining the use and reported impact of feedback reporting practices in various clinical fields.

Emergency Department Services (New Zealand)

Indigenous Relational Practices as a Strategy to Transform Acute Hospital Settings: A Kaupapa Māori Grounded Theory Study
Relational practice is the basis for human connection and is linked to enhanced healthcare experiences and involvement with healthcare services. Although the nurse-patient relationship is typically built around behavioural communication skills, relational practice requires developing awareness, connectedness and responsiveness to others. The task-oriented ways of working have eroded these attributes. This study, published in Nursing Inquiry, explored how Indigenous values and practices can transform relational practice in a publicly funded acute hospital in Aotearoa, New Zealand. Kaupapa Māori (Māori philosophy and practice) and grounded theory were used to generate and analyse data from interviews with Māori staff and consumers.

Emergency Department Services (International)

Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis
A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study, published in BMJ Open, is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings.

Artificial intelligence-driven forecasting and shift optimization for pediatric emergency department crowding
This study, published in JAMIA Open, aimed to develop and evaluate an artificial intelligence (AI)-driven system for forecasting Pediatric Emergency Department (PED) overcrowding and optimising physician shift schedules using machine learning operations (MLOps).

Cardiovascular Disease and Diabetes (New Zealand)

Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study
Type 2 diabetes (T2D) is a significant health issue in New Zealand with a disproportionate effect for Māori. To address inequities and optimise care, Te Korowai Hauora o Hauraki, an Iwi Māori health provider, established the 'Piki te Ora service' to support its five rural clinics by providing culturally safe, multidisciplinary support for patients with T2D. This study, published in the Journal of Primary Health Care, aimed to undertake a service review, describing and evaluating the available clinical data, of the Piki te Ora service.

Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis
Rural Māori experience inequities in heart health outcomes compared to rural non-Māori and urban Māori. Access to health care is a significant contributor to these inequities. There is a wealth of literature that explores Māori access to health care; however, the voice of rural Māori within the literature is limited. Under Te Tiriti o Waitangi (The Treaty of Waitangi), Māori have legislative rights to access, engage, and participate in the health care system equitably. This study, published in the Journal of Primary Health Care, aimed to investigate the barriers and facilitators of accessing heart health care for rural Māori.

Primary Health Care (New Zealand)

Interprofessional communication between general dental practitioners and general medical practitioners: a qualitative study
Interprofessional communication between health care professionals is crucial to deliver quality health outcomes and enhance patients' quality of life. This study, published in the Journal of Primary Health Care, aimed to investigate the perspectives and contents of the interprofessional communication between general dental practitioners (GDPs) and general medical practitioners (GPs), and to explore the barriers and strategies that could bridge the gap between these health care professionals from their perspectives.

Primary Health Care (International)

Stakeholders’ perceptions and experiences of factors influencing the commissioning, delivery, and uptake of general health checks: a qualitative evidence synthesis
General health checks are integral to preventive services in many healthcare systems. They are offered, for example, through national programmes or commercial providers. Usually, general health checks consist of several screening tests to assess the overall health of clients who present without symptoms, aiming to reduce the population's morbidity and mortality. The objective of this Cochrane Review was to identify how stakeholders (i.e. healthcare managers or policymakers, healthcare providers, and clients) perceive and experience general health checks and experience influencing factors relevant to the commissioning, delivery, and uptake of general health checks.

Utility of advanced training skills among GPs: a systematic review
Advanced Skills Training (AST) is designed to provide GPs with an opportunity to enhance their clinical practice in a narrower speciality. This is valuable particularly for rural and remote communities that cannot justify narrower specialist services in the local community. ASTs require additional focused training, usually for 12 months, in a selected procedural or non-procedural skill such as anaesthetics, obstetrics, surgery, emergency medicine, paediatrics, adult internal medicine, mental health, Indigenous health or palliative care. Ideally, several practitioners with complementary AST experiences work together to provide a wider range of extended scope practice according to community need. However, experience so far suggests that this goal is not necessarily achieved. Thus, this systematic review, published in Rural and Remote Health, aimed to assess the value and fitness for purpose of AST and ensure that it is meeting the growing demand for coordinated care in rural communities.

Primary Mental Health (International)

Combined pharmacological and psychosocial interventions for alcohol use disorder
The objective of this Cochrane Review was to assess the effects of combined pharmacological and psychosocial interventions for the treatment of alcohol use disorder in adults.

Smoking Cessation (New Zealand)

Trends in smoking prevalence among 14–15-year-old adolescents before and after the emergence of vaping in New Zealand; an interrupted time series analysis of repeated cross-sectional data, 1999–2023
New Zealand experienced a prolonged period of minimal regulation on e-cigarettes until the passing of the 2020 Smokefree Environments and Regulated Products (Vaping) Amendment Act. This study, published in The Lancet Regional Health - Western Pacific, analyses the Action for Smokefree 2025 (ASH) Year 10 Snapshot Survey data from 1999 to 2023 to compare changes in smoking trends among 14–15-year-old students before and after the advent of vaping in New Zealand (around 2010).

Patterns and experiences of smoking, electronic cigarettes (vapes) and heated tobacco use among people who smoke or who recently quit
The aim of this study, published in The New Zealand Medical Journal, is to understand patterns and experiences of smoking and electronic cigarette use, as well as related attitudes and behaviours among adults in Aotearoa New Zealand who smoke or recently stopped smoking.

Ministry of Health Consultations & Events

Putting Patients First: Modernising health workforce regulation
The Government is inviting New Zealanders to share their views on health workforce regulation by 11.59 pm Wednesday 30 April. On 28 March 2025, the Ministry published a discussion document: Putting Patients First: Modernising health workforce regulation. This document asks about your views on: Patient-centred regulation: Faster wait times, better outcomes, and a system that truly puts patients first. Streamlined regulation: Using resources and administering the rules in the most cost-effective way possible, ensuring value for money for taxpayers and better outcomes for patients.

Health Sector Initiative

Upstander community mobilisation underway for Atu-Mai violence prevention programme
Le Va’s Atu-Mai Upstanders have begun their next wave of innovative community mobilisation activations, working to prevent sexual violence in different spaces including schools, community organisations, clubs and churches across Tāmaki Makaurau Auckland. Community leaders, trained through the Atu-Mai Upstander programme, are delivering workshops and hosting talanoa (conversations) in their communities to raise awareness for the prevention of sexual harm.

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.