south central study day 1 st february 2011 debra thornton library & knowledge services manager...
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South Central Study Day1st February 2011
Debra Thornton Library & Knowledge Services ManagerBlackpool Teaching Hospitals Foundation Trust
Clinical Librarian Searches March 08 - May 09
05
1015
2025
3035
40
Successful clinical librarian service◦ Obs / Gyn MDT ◦ A&E Clinical Governance◦ Cardiac Clinical Governance◦ Practice Development Nurses
Requested by:
Intended use of the information:
Requested by:
Intended use of the information:
Requested by:
Intended use of the information:
Searches by staff group
Doctor35%
Nurse28%
Midwife6%
Manager17%
Doctor
Nurse
Midwife
Manager
AHP
GP
Student
Other
“Effective HRM practices can reduce mortality in hospitals”
“Like detergent, the word ‘librarian’ is an accurate description of function, but not a value proposition”
(Janice Lachance. Information Outlook 2009)
Board librarianManagement Information SpecialistManagement Information ConsultantBusiness Intelligence Librarian
We chose MANAGEMENT LIBRARIAN – and were very glad we did........
Develop leaders
Stimulate innovation
University Hospital
Empowerment
Continuous improvement
A LEARNING ORGANISATION
Aligned with Trust Objectives
Management Librarian
A ‘leap of faith’
What can the Service offer the Trust?
Management Librarian to work with management teams throughout the Trust
Ensure that decision making at the highest level is evidence based and supported by relevant knowledge and information
The service enables access to this knowledge store at the exact time it is required
The service is a personal service provided at the point of need – by telephone request, by e-mail or in person at meetings
Librarian attendance at Board and other meetings engenders a culture of evidence based decision making in a non-clinical setting
Provide high quality evidence of new developments and practices that have proven to show benefits in terms of improved quality services and financial gains.
Impact of The Service:
Trust Board of Directors
Executive Directors/Divisional Directors Meeting
Change Management Group Meeting
Associate Directors of Operations Meeting
Directorate Managers Meeting
Senior Management Meetings:
Impact of The Service:
Attendance at senior management meetings has resulted in information searches taking place on some of the following topics:
Recruitment of Nurses – Examples of best practice
Closing Wards to Improve Healthcare
Trusts publishing their own data to the public
Examples of best practice around the patient experience
Trusts publishing their own data to the public
Stories ‘are a way to teach, inspire, persuade, and share information’.
‘Patient stories can be effective as a tool for informing the service planning process’
Question: How can we share patient experiences with our staff?
Includes:
Chief Executive Associate Directors of Operations Associate Director of Corporate Affairs Assistant Director of Strategic Development Deputy Director of HR and OD Assistant Director of Pharmacy Director of Finance Director of Nursing & Quality
Utilisation of the Service by managers :
46%
11%10%
10%
8%
8%7%
Corporate
Cardiac
Medical
Surgical
Clinical Support Services
Non-Trust
Womens & Childrens
Impact of The Service:
Chief Executive’s Blog
There is already evidence around, that for instance by reducing patient infections you can provide better care for patients at a lower cost. I have had Trevor Morris, our management librarian looking in to this, and I attach an Evidence Search - Quality & Cost, which starts to explore these issues. It is worth dipping in to some of these articles, as it is the philosophy of quality and financial effectiveness that we will be basing our plans on over the next few years.
Supporting QuIPP
Impact of The Service:
Carry out review of the evidence base in relation to the proposed business case:
Looking at current legislation and national guidance Review of all published research in the area Review of peer-reviewed content Identifying similar implementations
Highlighting if the work has been done elsewhere Identify successful implementation Identify lessons learned Provide contacts that have gone through the process
Potential for the evidence base to impact on business case by :
‘Cost of MRSA and MSSA infections or bacteraemia’
Methicillin-Sensitive Staphylococcus Aureus (MSSA) Screening Programme
QuIPP Example:
Evidence search for CSS Division in December 2009:
‘By screening for MSSA at the same time as we screen for MRSA it is expected that we will be able to reduce infection rates and improve patient safety. Were we to achieve similar rates for the reduction of all MSSA infections as we achieved against MRSA bacteraemias (40%), within the first year a net cost saving of £0.3m million could be achieved by savings in from reductions in length of stay’
(Business case for MSSA screening programme, March 2010)
QuIPP Examples:
Clinical Pathway for MSSA Screening Programme now been produced.
Looking to submit it for national recognition.
Management Search Procedure:
How Were These Searches Requested?
38%
39%
18%5%
Informal Meeting
Formal Meeting
Printed Request Form
Management Search Procedure:
Main Sources consulted:
Emerald Collection of Management Resources
NHS Evidence - Specialist Health Management Collection
NHS Institute for Innovation and Improvement
NHS Economic Evaluation Database (NHS EED)
Intute: Business and management Studies
Health Business Elite Database
Health Management Information Consortium (HMIC)
Google Scholar
Sources Consulted
Advanced Search
Impact of The Service:
Attendance at senior management meetings has resulted in information searches taking place on some of the following topics:
Recruitment of nurses – examples of best practice
Closing wards to improve healthcare
Integrating the culture of two organisations during a merger
Student experiences in the clinical setting
Restructuring hospital departments to reflect care pathways
Restructuring Hospital Departments to reflect Care
Pathways
Supporting Clinical Pathways
Service has been involved in the utilisation and promotion of the Map of Medicine across the Trust.
Currently supports the process of developing localised clinical pathways in the Hospital in the following stages:
1. Select and prioritise a topic that is important for your service.
The Service performs a search on current pathways and guidelines.
2. Gather information to underpin the pathway development
Provide an expert literature search of the evidence base
Provide examples of other hospital experiences
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Library
Library
Streamlined process cycle
Virtual review of proposed pathways without waiting for monthly meeting with audit trail
Support and co-ordinate pathway development
Harnessing tools such as SharePoint and Map of Medicine
Supports whole system pathways across the health community
Pathways will now link to the Trusts new £30m EPR system called ALERT
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What’s in a name?
40
Over 78% of people said they don’t have time to find the information they need.
“Clinical practice is far too busy”
Where do people look for information?
Was the librarian’s summary accurate / useful?
What was the information used for?
“We have taken some operating procedures out of the operating theatre and put them into a community clean/clinic room”
“The information identified that investigations from incidents is essential and lessons learned must be implemented in order to prevent incidents occurring again.”
“The information provided useful links and details of authors where I could search for these further articles. I think the service is an excellent provision and it has helped me tremendously with my research.”
Evolution of the Service:
Personalised horizon scanning for senior managers in each division based on their KPI’s
Develop an Intranet hosted database of completed searches, beneficial for identifying what kinds of management questions are asked most often and which questions lack satisfactory answers.
Development of the Management Librarian role to Clinical Pathways Manager
Continuation of the Management Librarian Service by the Library team
‘It is clear that the service is helping us to make better, more evidence based decisions, and supporting better quality care for patients.’
(Aidan Kehoe, CE, 27th May 2010)
Evidence:NICE (2010) Chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.European Association of Echocardiography (2009) Stress echocardiography expert consensus statement
Further resources for patients:Patient UK (2010) Exercise electrocardiogram (ECG)
EXERCISE STRESS TESTING
Debra ThorntonLibrary & Knowledge Services Manager
01253 655596
Trevor MorrisClinical Pathways Manager
01253 655497