Health Improvement and Innovation Digest - 27 September 2018

on 28 September

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Health Improvement and Innovation Digest

Issue 175 - 27 September 2018

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email

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.


Quality Improvement (New Zealand)

Do healthcare services behave as complex systems? Analysis of patterns of attendance and implications for service delivery
The science of complex systems has been proposed as a way of understanding health services and the demand for them, but there is little quantitative evidence to support this. The authors of this study, published in BMC Medicine, analysed patterns of healthcare use in different urgent care settings to see if they showed two characteristic statistical features of complex systems: heavy-tailed distributions (including the inverse power law) and generative burst patterns.

A survey of the impact of patient adverse events and near misses on anaesthetists in Australia and New Zealand
The authors of this study, published in Anaesthesia & Intensive Care, conducted a cross-sectional online survey of members of the Australian and New Zealand College of Anaesthetists to investigate their experiences of adverse patient safety events and near misses, including their use of incident reporting systems and the organisational support available.

A communication skills intervention to minimise patient perpetrated aggression for healthcare support workers in New Zealand: A cluster randomised controlled trial
Healthcare support workers face challenging situations in their day-to-day work but may have minimal training on how to deal with such incidents. Although staff training is often recommended as an essential part of any comprehensive approach for preventing and managing workplace violence, there is paucity of evidence on the content and effectiveness of such training. This study, published in Health & Social Care in the Community, aimed to evaluate the effect of an intervention (communication skills training) to reduce the experience of aggression for healthcare support workers.


Quality Improvement (International)

Interventions for preventing falls in older people in care facilities and hospitals
Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. The objective of this Cochrane Review was to assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals.

Can the public release of performance data in health care influence the behaviour of consumers, healthcare providers, and organisations
The aim of this Cochrane Review was to find out if publicly releasing information about the performance of healthcare providers (e.g. hospitals and individual professionals) has a measurable influence on changing the behaviour of consumers, providers, and purchasers of care. The authors also sought to determine whether this affected the performance of healthcare providers, patient outcomes, and staff morale.

Patient‐mediated interventions to improve professional practice
This Cochrane Review suggests that patients may change healthcare professionals’ practice though the following three strategies: 1) strategies where patients give healthcare professionals information about themselves; 2) strategies where patients are given healthcare information; and 3) strategies where patients take part in patient education. Patient decision aids may make little or no difference to healthcare professionals’ practice, however, the certainty is low, and these results should be interpreted carefully. We still need more research about the best ways in which patients can change professional practice and about the impact it has on patients’ health.


Hospital Productivity (International)

Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study
Unplanned hospital readmissions are a quality and safety indicator. In Australian, 8% to 11.1% of unplanned readmissions occur ≤1 day of acute care discharge. The aim of this study, published in BMC Health Services Research, was to explore the reasons for unplanned hospital readmissions ≤1 day of acute care discharge, and determine what proportion of such unplanned hospital readmissions were potentially preventable.


Shorter Stays In Emergency Departments (International)

Long length of stay at the emergency department is mostly caused by organisational factors outside the influence of the emergency department: A root cause analysis
Emergency department (ED) crowding is common and associated with increased costs and negative patient outcomes. The aim of this study, published in PLoS ONE, was to conduct an in-depth analysis to identify the root causes of an ED length of stay (ED-LOS) of more than six hours.


Cardiovascular Disease and Diabetes (New Zealand)

A Longitudinal Study of Interactions Between Health Professionals and People With Newly Diagnosed Diabetes
Published in The Annals of Family Medicine, this study sought to observe in detail the primary care interactions and communications of patients with newly diagnosed diabetes over time. In addition, they sought to identify key points in the process where miscommunication might occur.


Cardiovascular Disease and Diabetes (International)

Lifestyle Indices and Cardiovascular Disease Risk: A Meta-analysis
Several studies investigated lifestyle indices to account for interrelations between lifestyle behaviors and cardiovascular disease risk. So far, no systematic review has been conducted. Thus, the aim of this stdy, published in the American Journal of Preventive Medicine, was to summarize the evidence of associations between lifestyle indices and cardiovascular disease risk in observational prospective studies.


Primary Health Care (International)

Impact of preventive primary care on children’s unplanned hospital admissions: a population-based birth cohort study of UK children 2000–2013
Universal health coverage (UHC) aims to improve child health through preventive primary care and vaccine coverage. Yet, in many developed countries with UHC, unplanned and ambulatory care sensitive (ACS) hospital admissions in childhood continue to rise. The authors of this study, published in BMC Medicine, investigated the relation between preventive primary care and risk of unplanned and ACS admission in children in a high-income country with UHC.


Primary Mental Health (International)

Videoconferencing psychological therapy and anxiety: a systematic review
The growing worldwide prevalence of individuals with anxiety disorders has increased needs for mental health services. Due to limited number of mental health providers and community resources, especially in low-income countries, individuals often seek services from primary care settings. Through collaborative care models, services via telemedicine address the mental health provider shortage. While previous reviews show telemedicine effectively treats mental illness, a gap exists for reviews on videoconferencing psychological therapy for anxiety treatment. This systematic review, published in Family Practice, aimed to summarize videoconferencing psychological therapy for anxiety disorder treatment

Family physicians perceived role in perinatal mental health: an integrative review
Responding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family physicians are ideally placed to provide an effective response as it is recognised that they are responsible for organising care and supports for women and their families. This paper, published in BMC Family Practice, reports an integrative review undertaken to examine family physicians' perceived role in perinatal mental health care and concludes with recommendations for health policy, research and practice.


Better Help for smokers to Quit (International)

Maintaining abstinence from smoking after a period of enforced abstinence - systematic review, meta-analysis and analysis of behaviour change techniques with a focus on mental health
Smoking prevalence is doubled among people with mental health problems and reaches 80% in inpatient, substance misuse and prison settings, widening inequalities in morbidity and mortality. As more institutions become smoke-free but most smokers relapse immediately post-discharge, this study, published in Psychological Medicine, aimed to review interventions to maintain abstinence post-discharge.

Support for patients who have difficulty quitting smoking: a review
Smoking cessation plays a crucial role in reducing preventable morbidity and mortality. However, some smokers find smoking cessation difficult, despite receiving treatment. This includes heavy smokers with chronic obstructive pulmonary disease, smokers with a psychiatric disorder, and female and underage smokers. This review article, published in Internal Medicine, describes smoking cessation approaches for patients who find it difficult to quit smoking


Weight Management (International)

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults
The objective of this US Preventive Services Task Force Recommendation Statement, published in JAMA, was to update the USPSTF 2012 recommendation on screening for obesity in adults. The USPSTF reviewed the evidence on interventions (behavioral and pharmacotherapy) for weight loss or weight loss maintenance that can be provided in or referred from a primary care setting.


Childhood Obesity (New Zealand)

Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis
School food environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear. The objective of this study, published in PloS ONE, was to systematically review and quantify the impact of school food environment policies on dietary habits, adiposity, and metabolic risk in children.


Childhood Obesity (International)

Effect of educational interventions on health in childhood: A meta-analysis of randomized controlled trials
The purpose of this study, published in Medicine, was to summarize the evidences from randomized controlled trials (RCTs) investigating the effects of educational interventions in overweight/obesity childhood by using meta-analytic approach.


Oral Health (International)

Are educating and promoting interventions effective in oral health?: A systematic review
It is estimated that about 20%-25% of the world's population are suffering from periodontal diseases or severe gum diseases. This requires appropriate interventions. For the development of effective and evidence-based programmes tailored to the target group, the aim of this review, published in the International Journal of Dental Hygiene, was to survey to the effectiveness of oral health education and promotion interventions in the relevant groups of people.

Oral Health Education and Promotion Programmes: Meta-Analysis of 17-Year Intervention
Oral Health Education and Promotion Interventions (OHEPIs) focus on improving knowledge, to adopt favourable oral health behaviours that can enhance oral health and clinical oral health. However, no meta-analyses exist that evaluate the effectiveness of OHEPI programmes. The aim of this meta-analysis, published in the International Journal of Dental Hygiene, was to determine the effectiveness of oral health education and promotion programmes.


Key Ministry of Health Publications

Te Ao Auahatanga Hauora Māori: Māori Health Innovation Fund – Analysis of Te Kākano Seeding Innovation 2013-17
This publication showcases Te Ao Auahatanga Hauora Māori: Māori Health Innovation initiatives trailed between 2013 and 2017. It draws upon a broad range of individual innovation stories and illustrates themes of success across 22 initiatives and discusses alignment to the fund’s objectives, overall aim and priorities.


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.


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