Ministry of Health Library Health Improvement and Innovation Digest

on 29 April

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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 189 - 25 April 2019

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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Have you heard about Grey Matter?

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)

Using the Behaviour Change Wheel to explore potential strategies for minimising harms from non-recreational prescription medicine sharing
Non-recreational sharing of prescribed medicines can have positive outcomes under some circumstances, but can also result in negative health outcomes. This paper, published in Research in Social & Administrative Pharmacy, describes a theoretically underpinned and systematic approach to exploring potential interventions to reduce harm.


Quality Improvement (International)

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis
The majority of children receiving care in the emergency department (ED) are discharged home, making discharge communication a key component of quality emergency care. The aim of this study, publised in Systematic Reviews, was to examine how and why discharge communication works in a pediatric ED context and develop recommendations for practice, policy, and research.

Interventions to improve hand hygiene compliance in emergency departments: a systematic review
The emergency department (ED) is where hand hygiene problems are significant as the procedures in the ED are often high risk and invasive. The aim of this study, published in the Journal of Hospital Infection, was to investigate hand hygiene compliance (HHC) rate, factors affecting the HHC rate, and intervention strategies to improve HHC in EDs.

Implementation of Lean and Six Sigma principles in ophthalmology for improving quality of care and patient flow
In this review, published in Survey of Ophthalmology, the authors explain what "Lean" and Six Sigma are, and highlight their implementation in settings such as cataract surgery, laser capsulotomy, an ophthalmic emergency room, as well as its role as a powerful tool for improving clinic patient flow. They discuss basic principles of Lean management, review examples of implementing these principles in an ophthalmology practice, and lastly, offer physicians practical tools for identifying "wasteful" processes and ways to eliminate them.


Disability Sector Quality Improvement (International)

How to improve the quality of life of elderly people with intellectual disability: a systematic literature review of support strategies
The increased life expectancy of people with intellectual disability intensifies the need for age-specific support. Published in the Journal of Applied Research in Intellectual Disabilities, the authors conducted a review of studies  analysing links between support strategies and quality of life outcomes.


Shorter Stays In Emergency Departments (International)

The impact of general practitioners working in or alongside emergency departments: a rapid realist review
The aim of this study, published in BMJ Open, was to develop context-specific theories that explain how and why general practitioners working in or alongside emergency departments affect: patient flow; patient experience; patient safety and the wider healthcare system.

The impact of different liaison psychiatry models on the emergency department: a systematic review of the international evidence
This review, published in the Journal of Psychosomatic Research, aimed to evaluate the current evidence for what impact different Liaison Psychiatry (LP) services are having on Emergency Departments (ED).


Cardiovascular Disease and Diabetes (New Zealand)

What protects against pre-diabetes progressing to diabetes? Observational study of integrated health and social data
The aim of this study, published in Diabetes Research and Clinical Practice, was to examine the incidence of type 2 diabetes in people with newly diagnosed prediabetes and the factors that protect against this progression.


Primary Health Care (International)

Barriers and facilitators to the implementation of doctor‐nurse substitution strategies in primary care: a qualitative evidence synthesis
The objectives of this study, published in the Cochrane Database of Systematic Reviews, were (1) To identify factors influencing implementation of interventions to substitute doctors with nurses in primary care. (2) To explore how the synthesis findings related to, and helped to explain, the findings of the Cochrane intervention review of the effectiveness of substituting doctors with nurses. (3) To identify hypotheses for subgroup analyses for future updates of the Cochrane intervention review.

The effects of community pharmacy delivered public health interventions on population health and health inequalities:a review of reviews
Community pharmacies have great potential to deliver services aimed at promoting health and preventing disease, and are well placed in deprived communities. This review of reviews, published in Preventive Medicine, aimed to assess the effectiveness of community pharmacy-delivered public health services and assess how they impact on inequalities in health using PROGRESS-Plus characteristics.


Primary Mental Health (New Zealand)

Transitions through stages of alcohol use, use disorder and remission: findings from Te Rau Hinengaro, The New Zealand Mental Health Survey
To understand transitions from alcohol use to disorder, the authors of this study, published in Alcohol and Alcoholism, examined timing of transitions between stages of alcohol use and associations between transitions and socio-demographic factors.

Peer support use of Alcohol and Drug Outcome Measure (ADOM). Huarahi Oranga - a case study
Te Pou supported The Salvation Army to establish peer support staff using ADOM in their work. This non clinician/practitioner use of ADOM has been written up as a case study, highlighting the need for a clear implementation process that identifies enablers and barrier to implementation, as well as ongoing support and leadership. Te Pou is grateful for the opportunity to pilot this innovative use of ADOM, with this paper having implications nationally for the peer support workforce.


Primary Mental Health (International)

Depression in primary care: part 2-management
In this two part series, published in BMJ, the authors reviewed the evidence available to help to guide primary care providers and practices to recognize and manage depression. The first review outlined an approach to screening and diagnosing depression in primary care. This second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level.

Technology-based alcohol interventions in primary care: systematic review
The aim of this study, published in the Journal of Medical Internet Research, was to review recent literature on the use of technology to deliver, enhance, or support the implementation of alcohol-related interventions in primary care. The authors focused on addressing questions related to (1) categorization or target of the intervention, (2) descriptive characteristics and context of delivery, (3) reported efficacy, and (4) factors influencing efficacy.

The effectiveness of four empirically supported psychotherapies for primary care depression and anxiety: a systematic review and meta-analysis
The aim of this review, published in the Journal of Affective Disorders, is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care.


Better Help for smokers to Quit (International)

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, published in Internal Medicine, article describes smoking cessation approaches for patients who find it difficult to quit smoking.

Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation
The objective of this study, published in the Cochrane Database of Systematic Reviews, was to determine the effectiveness and safety of different forms, deliveries, doses, durations and schedules of NRT, for achieving long‐term smoking cessation, compared to one another.


Weight Management (International)

Mobile health applications in weight management: a systematic literature review
Weight management is an effective strategy for controlling chronic disease and maintaining physical health, and research on this topic has risen dramatically over the past four decades. This systematic literature review, published in the American Journal of Preventive Medicine, aimed to identify existing evidence on the efficacy of mobile health technology in facilitating weight management behaviors, such as healthy food consumption and physical activity.


Childhood Obesity (New Zealand)

Systemic barriers and equitable interventions to improve vegetable and fruit intake in children: interviews with national food system actors
Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand's children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The aim of this study, published in the International Journal of Environmental Research and Public Health, was to map the potential causal pathways explaining this decline and possible actions to reverse it.


Childhood Obesity (International)

How can health services strengthen support for children affected by overweight and obesity, and their families?
This paper, published in Public Health Research & Practice, argues that health services can use serial growth assessment to routinely identify and manage children who are above a healthy weight, just as they might routinely identify and manage hypertension in older patients. The authors highlight the evidence for the acceptability and effectiveness of family-focused clinical intervention for weight management in children. They also outline system-level changes that health services should consider to enable and support routine clinical identification and management of affected children and their families.


Oral Health (International)

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries
The objective of this study, published in the Cochrane Database of Systematic Reviews, was to evaluate the effectiveness of interdental cleaning devices used at home, in addition to toothbrushing, compared with toothbrushing alone, for preventing and controlling periodontal diseases, caries, and plaque. A secondary objective was to compare different interdental cleaning devices with each other.


Māori Innovation

Rangatahi Tu Rangatira: innovative health promotion in Aotearoa New Zealand
Rangatahi Tu Rangatira (R2R) is a national health promotion programme in Aotearoa New Zealand which aims to promote cultural and physical wellbeing for rangatahi (young people) and their whānau (family). Grounded in tikanga Māori, the programme focuses on total wellbeing, leadership and cultural awareness providing rangatahi opportunities to increase their participation in physical activity and cultural knowledge through ngā taonga tākaro (Māori ancestral games). This paper, published in Health Promotion international, focuses on an evaluation of this innovative health promotion programme focusing on the delivery of R2R by a local iwi provider in a rural area.

The role of Māori community gardens in health promotion: a land-based community development response by Tangata Whenua, people of their land
For Māori in Aotearoa New Zealand, land is not only an economic foundation but an anchor for tribal identity and a spiritual base. The forced alienation of Māori land since the 1800s, due to colonisation, has distanced communities from a direct relationship with their lands. There is little published research on Māori community gardens (māra) and their potential to reconnect Māori with ancestral lands. This study, published in Global Health Promotion, explores the motivations for developing māra and examines the role of māra in Māori health promotion.


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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