Liberating the NHS: Developing the healthcare workforce from design to delivery

October 4, 2013 Comments Off on Liberating the NHS: Developing the healthcare workforce from design to delivery

Source: Department of Health

Link to main document

Publication format: PDF via webpage

Policy published: 10th January 2012
Date of original publication: 20th December 2010

Summary of driver: This document builds on the government’s consultation on proposals to establish a new framework for developing the healthcare workforce in December 2010. The policy framework sets out a new approach to workforce planning and the education and training of the health and public health workforce. It builds on the responses to earlier public consultation and the advice of the NHS Future Forum. .The outcome of these changes will be a better education, training and workforce planning system for health and public health, one that is clearly focused on continually improving the health of the public and services for patients.

Key features of driver:

  • The framework will enable the future health and public health workforce to develop and evolve
  • The system puts employers and professionals in the driving seat enabling them to identify and anticipate future workforce challenges
  • Health Education England (HEE) will provide national leadership and oversight on strategic planning and development of the health and public health workforce, and allocate education and training resources.
  • Local Education and Training Boards (LETBs) will be the vehicle for providers and professionals to work with HEE to improve the quality of education and training outcomes so that they meet the needs of service providers, patients and the public.
  • The Department of Health will set the the education and training outcomes for the system as a whole, and will hold the HEE to account.
  • The funding flows are discussed on page 40 onward; outlining the scope of the budget; distribution of education and training funding; moving to a tariff based system; raising the budget through a levy on providers.

Primary audience: All NHS Trusts.

Impact on library policy/practice: Libraries a often closely embedded/aligned to training within NHS organisations. This policy links to development of new training programmes and funding of services.

Case studies / Local service profile examples mapping to this driver: None as of 4.10.2013

Date last updated: 4.10.2013 (Policy replaced consultation)

Due for review: 4.04.2014

Group member responsible: TP updated

Strategic Clinical Networks

September 20, 2013 Comments Off on Strategic Clinical Networks

Impact on library policy/practice: Strategic Clinical Networks (SCNs) are designed to encourage provision of clinical advice to support local decision making, making it an ideal system for librarians to share their expertise in terms of literature searching, enquiry services and consolidation of information. The challenge may be

Source: NHS England

Link to main document

Publication format: Web site

Date of publication: Various

Summary of driver: Strategic Clinical Networks focus on bringing improvement in the quality and equity of care and outcomes of their population. They bring together providers and commissioners to make improvements to complex patient pathways using an integrated, whole system approach. They work with commissioners, supporting decision making planning; working across the boundaries of commissioner, provider and voluntary organisations as a vehicle for improvement for patients, carers and the public.

Key features of driver:
The networks are divided into 12 regional areas (Senates) and currnetly focus on the following key areas:

  • Cardiovascular (including cardiac, stroke, renal and diabetes);
  • Maternity, Children and Young People;
  • Mental Health, Dementia and Neurological Conditions;
  • Cancer

The networks also work on cross-cutting themes aligned to the domains of the NHS Outcomes framework

  • Prevention
  • Rehabilitation
  • Parity of Esteem
  • Transition
  • Urgent and Emergency Care
  • End of Life Care
  • Integration

Primary audience: Commissioners and clinical staff.

Date last updated: 6.9.17

Due for review: 6.9.18

Group member responsible: TP

No health without mental health

September 20, 2013 Comments Off on No health without mental health

Title of driver: No health without mental health: a cross-government mental health outcomes strategy for people of all ages

Source: Department of Health

Link to main document

Publication format: PDF

Date of publication: February 2011

Summary of driver: This strategy sets out six shared objectives to improve the mental health and well-being of the nation, and to improve outcomes for people with mental health problems through high quality services. It supports the Government’s aim of achieving parity of esteem between physical and mental health. The interconnections between mental health, housing, employment and the criminal justice system are stressed.

Key features of driver taken from the executive summary:

The shared objectives of all the partners who worked with the Department of Health to improve mental health outcomes are:

•More people will have good mental health
•More people with mental health problems will recover
•More people with mental health problems will have good physical health
•More people will have a positive experience of care and support
•Fewer people will suffer avoidable harm
•Fewer people will experience stigma and discrimination

Primary audience: All those working with mental health – in the NHS as well as public, private and voluntary and community sector agencies.

Impact on library policy/practice: One of the future strands in the provision of mental health services is to encourage local organisations and practitioners to have the freedom to innovate and to drive improvements in services. There is an opportunity for library services to support practitioners to:

•consider what works best
•examine the evidence base when considering any changes to the way they practice
•promote the evidence base when considering cost improvement savings
The document mentions ‘evidence’ on 47 occasions.

Case studies / Local service profile examples mapping to this driver: None currently

Date last updated: May 2011

Due for review: May 2012

Group member responsible: Cath McCafferty

Working with Public Health and the Clinical Commissioning Group (CCG)

August 29, 2013 Comments Off on Working with Public Health and the Clinical Commissioning Group (CCG)

Project Team
Caroline Timothy – Public Health & Commissioning Librarian; Gary Sutton – Knowledge & Evidence Service Manager; Tracy Flute – Head of Public Health Analysis

Resources Required
A Service Level Agreement (SLA) between Warrington & Halton Hospitals NHS Foundation Trust (WHHFT) and Warrington Public Health.

Timeframe
A recent successful tender bid secured the contract for WHHFT for a further 3 years until July 2016.

“The Story”
As part of an SLA between WHHFT and NHS Warrington (the former PCT), an Outreach Librarian post was established in 2010. In April 2012, I was employed as Outreach Services Co-ordinator and then in October 2012, the job title was changed to Public Health & Commissioning Librarian to more closely reflect the work of the position. The main purpose of the post is to provide knowledge and library services to Warrington Public Health and Warrington CCG when and where they are needed.

I work as an embedded member of the Warrington Public Health and Warrington CCG teams. Mondays, Thursdays and alternate Fridays are spent working with the CCG, sitting with the staff in their office. Tuesdays, Wednesdays and alternate Fridays are spent with the Warrington Public Health team, again sitting with the team. The main service provided is literature searching. The searches that are requested are quite often on a large scale, in-depth, and require innovative resources to be consulted to find information! Current awareness is the second most requested service. The CCG and WPH Library Bulletins provide news and evidence for requested areas. The Knowledge & Evidence Service’s website is used to both market the service through the Public Health & Commissioning page and also to provide a daily update on the latest news items in public health and commissioning. Inter-library loans are another service that is requested and I provide all papers and books that are required. I also carry out training, which includes “Finding the Evidence”, and this has been requested as a one to one session up to now, although group training sessions are available. I really enjoy my job and am glad to be working with the CCG more closely now that we are in an open plan office. Agile working opens up the opportunity to meet more of the commissioning staff on a daily basis and to sit with different people. I like the fact that no two days are the same, that you are always meeting new people and that you get to help lots of different people with their information needs.

Alignment to local, regional and national drivers
The Warrington Public Health Memorandum of Understanding with Warrington CCG states that Public Health will provide library resources and outreach services to the CCG and local commissioning support should this be the expressed need of the recipients of the service.

Public Health Library and Knowledge Services Audit Report (July 2012)

Impact of this project/service for the:
• customer
• organisation
• library
Feedback from the two teams has been very complimentary and examples are below…
“This stuff is absolutely perfect and spot on with what we’re after”
“This is so useful, just scanned and found a few things that I needed to know”
“Thanks very much for your help with this- really useful – and at the right kind of detail”
The bi-annual reports produced as part of the SLA, show that there has been an increase in usage of the service, especially for literature search requests.

Lessons Learned
The main lesson learnt as a result of this work is that it is essential that the librarian is embedded into the 2 teams that they are working with. The bi-annual report shows that when the librarian has not been present (due to sickness absence with the previous post holder and during long periods of annual leave) the service usage statistics decrease quite dramatically. When the librarian is sitting with the teams, the team members come over to chat or meet the librarian at the photocopier or in the kitchen and often place their request for information then!

Sustainability / next steps?
The SLA between the Knowledge & Evidence Service at WHHFT and Warrington Public Health will end in July 2016 and it is envisaged that a new tender process will begin around that time.
It is possible that the service may be opened up/marketed to social care workers and others in the local authority where Public Health is now based.
My next steps are to attend more team meetings within Public Health and the CCG and to increase the usage of the library service amongst the two staff groups.

Contact details
Caroline.Timothy@nhs.net

Date case study completed
14/08/2013

AQuA (Advancing Quality Alliance)

August 28, 2013 Comments Off on AQuA (Advancing Quality Alliance)

Source: Advancing Quality Alliance

Link to AQuA website

Publication format: Website

Date of publication: n/a

Summary of driver: The Advancing Quality Alliance (AQuA) is the North West’s health care quality improvement organisation. AQuA aims to:

  • promote and share best practice
  • provide improvement training to strengthen NHS organisations locally
  • provide intelligence and comparative information to stimulate innovation

Key features of driver:
AQuA run a number of projects, including Advancing Quality, Stroke 90:10, the North West Reducing Mortality Collaborative, Developing Safety Networks programme, plus a number of training packages.

AQuA also run the AQuA Observatory, which aims to compile intelligence and knowledge in order to ‘stimulate innovation’, share good practice and benchmarked quality intelligence within the North West.

AQuA also support local NHS Trusts in developing their own ‘improvement capacity’ and the training opportunities available are listed on their Portfolio of Improvement Activities.

Primary audience: All NHS Trusts. AQuA’s main focus is commissioner and provider organisations within the NHS. AQuA works with organisational leaders, boards and senior managers and clinicians, as well as with frontline staff.

Impact on library policy/practice: AQuA can provide a useful resource to library staff in highlighting areas of improvement in the NHS. As part of its Innovation Portal, AQuA collates case studies (and produces an accompanying RSS feed) which provide examples of innovation from across the region. These case studies may be useful for library staff in providing examples of good practice to library users via literature searching or current awareness services.

The AQuA website signposts a number of resources for clinical evidence (including NHS Evidence). HCLU are working closely with AQuA to ensure that NHS library and information services are on their ‘map’ of the information world.

Libraries should be aware of the work of AQuA, identify their Trust’s AQuA Associate and liaise accordingly. There is an opportunity that they could raise the profile of libraries. AQuA also provide free courses e.g. on Lean via Webex.

Case studies /Project plan examples mapping to this driver: None as of 30.12.10

Date last updated: 30.12.10

Due for review: 31.12.11

Group member responsible: Not yet identified

Advancing Quality

August 28, 2013 Comments Off on Advancing Quality

Source: NHS Northwest (SHA)

Link to main document

Publication format: Website

Date of publication: 2008

Summary of driver: In conjunction with Premier Inc. this programme aims to improve patient care and patient experience in NHS hospitals across the North West by measuring clinical outcomes, Patient Reported Outcome Measures (PROMs) and patient experience. Advancing Quality is funded by all the Primary Care Trusts (PCTs) in the North West. PCTs are NHS organisations which commission services from their local hospitals. Each North West PCT gave 0.1 percent of its budget to develop AQ.

Key features of driver:

October 2008 – start of the 3 year healthcare improvement programme
Aims to improve care and save costs
Currently focussing on 5 key areas relevant to NW:
heart attacks
pneumonia
heart failure
hip and knee replacements
heart by-pass operations
New treatment areas, including mental health, stroke and primary and community services, will be introduced in the next year (2009-2010)
The project will be evaluated by Manchester Business School over a five year period to assess impact on financial savings, lives saved, reduced length of stay, reduced admissions and reduced complications.

Link here for first set of results published 18th June 2010

Link here for second set of results published 2011

Primary audience: The Advancing Quality agenda relates to NW acute trusts with minimal impact on primary care, although future roll out possible. Meeting quality indicators will translate to financial incentives for successful Trusts.

Impact on library policy/practice: Libraries may be asked to provide evidence to support the implementation of new outcome measures in the 5 key areas or identify best practice and performance in other NW Trusts. You could be asked to find out how PROMs are collected and who they are being submitted to.

Keywords: Acute; Hospitals; Quality metrics

Case studies/Project plan examples mapping to this driver are: None

Date last updated: October 2012

Due for review: November 2013

Group member responsible: TP

Darzi Framework

August 28, 2013 Comments Off on Darzi Framework

Title of driver: High quality care for all: NHS Next Stage Review final report (Darzi Framework)

Source: Department of Health

Link to main document

Publication format: pdf

Date of publication: 30 June 2008

Review date: None specified

Summary of driver: The Review sets out the government’s plans for NHS reform in England over the next 10 years. Its principal focus is on driving up the standards of quality in health care and putting clinicians at the heart of change. It is also intended to be locally driven. The review is based on the reports from strategic health authorities and clinical pathway working groups that presented a vision for change in their particular localities. It is not a ‘national blueprint’ but a means of enabling these local visions to become a reality (excerpt from summary on King’s Fund website April 2010)

The Operating Framework: for the NHS in England 2010/11 (Dec 2009) sets out the enabling system that will deliver the Review

Key features of driver: Introduces a range of local quality indicators – measuring mortality, complication and survival rates as well as patient perceptions – that will enable clinicians to benchmark and improve their performance. A small proportion of trusts’ income will also become conditional on quality indicators. Trusts will be obliged to produce annual ‘quality accounts’ similar to their financial accounts.

The NHS will have a formal constitution, spelling out its underlying principles and values as well as the rights and responsibilities of patients, the public and staff. * Darzi identified a range of hospital services that could be delivered closer to the patient’s home, including minor surgery and many outpatient consultations, although some services such as stroke and heart disease should be more specialist and centralised.

PCTs together with local authorities will now be responsible for commissioning comprehensive well-being and prevention services. They will target six key goals: tackling obesity, reducing alcohol harm, treating drug addiction, reducing smoking rates, improving sexual health and improving mental health
Patients with complex long-term conditions will be entitled to a named care co-ordinator, such as a community matron, to help them access the services in their personal care plans.
(From www.kingsfund.org.uk 14/4/10)

Primary audience: Health and Social Care Professionals (DH website)

Impact on library policy/practice:

Key headings / sections from the Review summary: Easy access for NHS staff to information about high quality care. All NHS staff will have access to a new NHS Evidence service where they will be able to get, through a single web-based portal, authoritative clinical and non-clinical evidence and best practice.

A clear focus on improving the quality of NHS education and training. The system will be reformed in partnership with the professions.

Plus:

Chapter 6: High Quality Work in the NHS, particularly the section ‘High Quality Education and Training’ (11-29)* Many aspects of the review focus on quality improvement; library services can support their organisations to implement changes based on the best evidence

Keywords: darzi, reform, vision, quality, quality accounts, NHS constitution, obesity, alcohol, drug addiction, smoking, sexual health, mental health, long term conditions, NHS evidence

Information reviewed and updated: 14/4/10 (v1)

Due for review: March 2010

Group member responsible: HG

Referrals Project

July 16, 2013 Comments Off on Referrals Project

Title of project: Referrals project – NHS Cumbria

Lead libraries: University Hospitals of Morecambe Bay NHS Foundation Trust and North Cumbria Acute University Hospitals NHS Trust

Summary: The NHS Cumbria Evidence Based Referral document dated 14th July 2009 details the procedures that will not be funded by NHS Cumbria unless the patient meets the specific criteria outlined within the document. The Library services will support the revision of the existing document (due to be published in September 2010) by providing evidence summaries

Alignment to local, regional and national drivers:
NHS Cumbria Strategic Plan 2010, Page 51 http://www.cumbria.nhs.uk/AboutUs/HowWeMakeDecisions/TrustBoard/2010/03Mar/StrategicPlan2010.pdf
Evidence Based Referrals http://nww.intranet.cumbria.nhs.uk/GPZone/ReferralSupportAndPathwayEnhancement/Home.aspx
Mckinsey Report, page 37 http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_116521.pdf

Partner organisations / project team:
University Hospitals of Morecambe Bay NHS Foundation Trust: Tracey Pratchett, Clinical Librarian
NHS Cumbria: Ed Hutton, Implementation Manager
North Cumbria Informatics Service: Pippa Orr, Knowledge Support Librarian

Key Audiences: GPs serving NHS Cumbria will use the Evidence Based referral document to streamline the referrals process

“The story”:  This was a short timescale project and occurred over 2 months. Unfortunately, it was difficult to provide a complete review of all areas of the document due to timescales as there were approximately 40 different recommendations. Initial meetings with the Librarians and Ed included discussions about timescales, identification of key search criteria to be applied to all searches, resources to be searched and priorities. A short agreement was devised outlining the library staff contribution.

Benefits for the customer / organisation: Ensuring that referral decisions are evidence based, streamlining and improving the quality of the referral process, ensuring appropriate access, clarifying the boundaries and ultimately saving money for NHS Cumbria.

Benefits for the library: Raised profile within NHS Cumbria about the skills and expertise provided by library staff. Advice provided on evidence use, copyright and access to resources.

Evaluation/ feedback: Evidence based referral document is in place. Quote from Ed Hutton Project Implementation Manager, NHS Cumbria; “The contributions from the Library Services staff were invaluable. Their depth of knowledge and understanding, as well as their ability to quickly interpret the requirements of the project into practical deliverables, were absolutely integral to the delivery and success of the Evidence Based Referrals initiative. I wouldn’t have been able to pull all this together without you.”

Lessons learned: There was a lack of understanding about sources of evidence and availability of information. Also, unrealistic timescales were set in order to carry out detailed literature searches for all areas involved and unfortunately, not all areas were updated and evidence was not fully incorporated into the document. Ultimately though, the work was completed and the library profile was raised within this area. Also provided library staff with an insight into the issues faced by PCTs and Acute Hospitals and raised awareness of potential conflicts of interest.

Project output: Evidence Based Referral document http://nww.intranet.cumbria.nhs.uk/GPZone/ReferralSupportAndPathwayEnhancement/Home.aspx

Timeframe: March-May 2010

Completion Date: 13.8.2010

Contact details: Tracey Pratchett, Clinical Librarian, (01524) 516021, Pippa Orr, Knowledge Support Librarian, (01228) 814879

Evaluating the Literature Searching Service

July 16, 2013 Comments Off on Evaluating the Literature Searching Service

Title of project: Literature Searching service evaluation

Lead library: Integrated Library Service (ILS)
Wirral University Teaching Hospital NHS Foundation Trust
www.whnt.nhs.uk/library

Summary: The Literature Searching service provides clinicians and non-clinicians with a summary of the available evidence on their chosen topic. This may be in response to a question about patient care, to support audit and research activities, to prepare for a meeting or project, to support educational activities such as Journal Clubs, or simply to keep up to date in an area of interest.
The library service decided it would be a valuable exercise to evaluate this service to try to measure its impact on organisational activities and decision-making.

Alignment to local, regional and national drivers: The results of the evaluation highlight the ways in which the Literature Searching service is aligned with key local and national drivers.
Local drivers
During 2009/10, the key goal of the Trust was to improve the delivery of excellence in quality and safety. The Literature Searching service can support this goal by providing high quality evidence to support the clinical and business decision-making necessary during the improvement process.
National drivers
The Literature Searching service supports the QIPP (Quality, Innovation, Productivity and Prevention) agenda.
Quality: The evidence on which clinical and business decisions can be based is from high quality information sources.
Innovation: The Literature Searching service is expanding outside of the library to provide evidence searches ‘at the elbow’ of the clinician or manager, e.g. at ward rounds or team meetings.
Productivity: Evidence searches are carried out by trained Librarians, saving clinicians and managers valuable time. The results of searches are summarised in an easily digestible format promoting quicker and easier access to the evidence base.
Prevention: Where appropriate the results of a Literature Search can include ‘horizon scanning’ whereby areas of potential risk and examples of good practice in other Trusts are identified. The service also contributes to the reduction of knowledge related risk.
The white paper, Equity and Excellence: Liberating the NHS, emphasises the importance of improving healthcare outcomes and patient experience. The mobilisation of best evidence, which can be supported by an efficient Literature Searching service, is crucial to the delivery of high quality services.

Project team: The service is provided by the Clinical Librarians and Site Librarians within the Integrated Library Service.

Key Audience: The service is available to all staff within the following Trusts:

  • Wirral University Teaching Hospital NHS Foundation Trust
  • Clatterbridge Centre for Oncology (via Service Level Agreement)
  • NHS Wirral (via Service Level Agreement)

The service responds to search requests on clinical topics as well as non-clinical.

“The story”: The Clinical Librarian Service implemented a pilot evaluation to capture data from everyone who received Literature Search results between 1st Jan 2009 and 31st March 2009. This was carried out as part of a wider regional project which involved collaboration with other Clinical Librarians in the North West. The aim of the pilot was to develop a generic evaluation questionnaire which could be localised and implemented by other library services in the region.
The pilot achieved a 62% response rate to an electronic evaluation questionnaire that was created using Survey Monkey. The pilot was considered a success and minor amendments were made to the evaluation questionnaire.
It was decided that everyone who received literature search results would be sent a link to the electronic evaluation questionnaire after a period of three months, in order to give them time to digest and utilise the information provided. This would hopefully allow us to measure ‘actual impact’ rather than ‘intended impact’.
An evaluation of the period 1st March 2010 to 31st July 2010 showed that search results received during that period had high impact on a range of Trust-wide activities, including direct patient care, management decision-making, guidelines development and educational activities.

Benefits of this service for the organisation: Evaluating this service allows users to contribute to the improvement of the service. It also allows the organisation to gain a further understanding how this service is contributing to Trust-wide goals and objectives and aligned with national NHS drivers.

Benefits for the library:

  • Evaluating the Literature Searching service has many benefits for the library service:
  • Impact evaluation: Assessing the impact of our services is an ongoing driver for library and information services in the NHS.
  • Improving services: Feedback gathered as part of the evaluation will assist us in evaluating the quality of the existing service and identify areas for improvement.
  • Demonstrating value: The evaluation process provides formal feedback on how the library service adds value to the wider organisation.
  • User engagement: Evaluation allows us to involve service users in adapting and improving services.

Evaluation: The results indicate a high level of satisfaction with the delivery of the service. 100% of respondents either ‘Agreed’ or ‘Strongly Agreed’ that the search results satisfied their information needs.
92.8% of respondents either ‘Agreed’ or ‘Strongly Agreed’ that their search results were received on time, although one respondent commented that their “results [were] received in good time but not as soon as hoped for”.
However, 100% of respondents would recommend the service to a colleague. One respondent commented:
“Excellent service, good quality information really helps when researching new ideas.”

Impact assessment: The results signal a number of ways in which the service impacts on clinical and non-clinical activities.
Enhances existing knowledge of healthcare professionals
92.3% of respondents either ‘Agreed’ or ‘Strongly Agreed’ that the search results revealed new information to them, and 84.6% either ‘Agreed’ or ‘Strongly Agreed’ that the search results substantiated what they already knew. This demonstrates that the service has a role in providing new evidence to users, but additionally in acting as a quality control mechanism that enables users to corroborate their understanding with reference to the evidence.
The role of the service in highlighting gaps in the available evidence is often an equally useful outcome. One respondent said the service was “very useful as I thought I was looking in the wrong places for information but the service confirmed the lack of information available on the subject”. Another commented:
[The service] “enabled me to use information that I would otherwise have thought was out of date by confirming there was very little on the subject matter”.
Having a trained Librarian undertaking the search also enabled users to be confident that a thorough and systematic search had been conducted. One respondent commented that:
“[The service] identified work which I had not previously found, reassured me that I had not missed any other relevant work.”
Encourages usage of additional library services
As a result of receiving literature search results, 21.4% of respondents requested articles through the library, demonstrating a positive impact on usage of other library services.
53.8% of respondents said that using the literature searching service had prompted them to seek training in the use of electronic / library resources.
Promotes an organisational culture of evidence based practice
The evaluation data identified that search results are not used in isolation by the individual but are shared among a team. 71.4% of respondents shared the information with colleagues within the organisation, demonstrating that the service facilitates the dissemination of evidence into practice amongst the wider healthcare community.
Additionally, 78.6% of respondents obtained the full text of articles for further reading, indicating that the service promotes increased reference to the evidence base.
Supports a range of Trust-wide activities
The wide range of clinical and non-clinical activities that are supported by the evidence provided by the Literature Searching service demonstrates its far-reaching impact on many areas within the Trust.
Saves time
100% of respondents said that the service saved them time in finding the information they needed. This is a key benefit of the service; where searches are conducted by a librarian the clinician or manager can spend the time saved on patient care or service delivery.
Improves information handling skills
The service also demonstrates a positive impact on developing the information skills of the healthcare professionals who utilised the service. 92.9% of respondents said the service had improved their awareness of evidence-based resources. 100% of respondents said the service has improved their ability to access resources. 71.4% said the service had improved their own searching skills.

Feedback: Informal feedback suggests that in most cases literature search requests occur as a direct result of a promotional drive or marketing activity, following Librarian attendance at a team meeting, a conversation with a member of library staff or another ‘outreach’ activity.
Open-ended responses from the evaluation questionnaire reveal the various ways in which the service impacts on the organisation:
“Very positive. Improved knowledge, evidence based care and supported decision making on the ward. Invaluable.”
“The service has contributed to knowledge and the development of clinical care.”
“Improving best practice and evidence based knowledge for me and share on my work area.”
Comments also highlight the role of the service in supporting business decision-making within the Trust:
“[The evidence provided was] used towards guideline development / local practice / CIP targets”
The service has also resulted in spin-off involvement in other service improvement projects:
“Victoria Kirk has been an amazing asset to our team this year and has helped us attain PDU accreditation. Her input with helping us review the latest evidence based practice has had a major input on the service and staff development.”
Search results were used to support educational activities:
“This service was able to simplify and quicken my search that enabled [me] to give an up-date and informative journal club presentation.”
“It has given a head start for me to work on my dissertation, so has increased my motivation.”
“Helped with literature search for the purpose of a presentation, therefore
saving time and improving my resources.”
“The results have been very useful as I am currently working on a systematic review for an MSc dissertation.”

Lessons learned: The literature searching service is a highly valued service that contributes to decision-making with the organisation. Awareness of the service needs to be raised within the organisation to encourage usage.
Where searches are conducted by a librarian rather than a clinician or manager there is:

  • A positive impact on time
  • An improvement in the quality of information retrieved
  • The potential for significant cost savings

Sustainability;next steps:

  • We will continue to evaluate the literature searching service.
  • We will endeavour to promote the service more widely.
  • We will continue to develop the skills of our library staff to deal with the wide range of searches that are received.
  • We will share the results of the evaluation within the wider organisation, with a view to more formal reporting in the departmental quarterly report.

Project output: One of the key resources produced as a result of the evaluation project was a generic literature search evaluation questionnaire that can be adapted locally by other library services within the North West. The project also generated impact assessment data which can be used for a range of marketing and reporting activities.

Timeframe: Evaluation data reported here was from a five month period from 1st March 2010 to 31st July 2010.

Contact: Victoria Kirk
Job title: Clinical Librarian
Telephone: 0151 604 6223 (internal 8610)
E-mail: Victoria.kirk@nhs.net

Date case study completed: 1st September 2010

Supporting a Practice Development Unit

July 16, 2013 Comments Off on Supporting a Practice Development Unit

Title of project: Practice Development Unit (PDU) support

Lead library: Integrated Library Service, Wirral University Teaching Hospital NHS Foundation Trust www.whnt.nhs.uk/library

Summary: The Clinical Librarian was invited to support the Wirral Renal Unit in meeting the required criteria for gaining Practice Development Unit (PDU) status accredited by the University of Leeds. The accreditation criteria required the Renal Unit to demonstrate commitment to evidence based practice and staff development.

Partner organisations: Wirral and Chester Kidney Service http://www.wirralchesterkidney.nhs.uk/

Key Audiences: Multidisciplinary team involved in renal care in Wirral University Teaching Hospital.

“The story”:
Steering Group member
As a steering group member the Clinical Librarian attended all Steering Group meetings and offered updates on the projects the library was involved in, as well as bringing to the group details of new library services and resources.

Literature Searching support
The Clinical Librarian supported staff in identifying the evidence base on the following topics:

  • Evidence of the psychological impact on chronic dialysis patients
  • Examples of PDU accreditation processes in other NHS Trusts – problems encountered, lessons learned, impact and evaluation
  • Published literature about haemodialysis non-compliance, deviation from dialysis prescription, reasons for missed sessions and what effects this has on mortality
  • Evidence about the prevention and control of blood borne virus infection for renal dialysis Sexual Dysfunction in relation to renal patients
  • An overview of leadership styles, in particular transformational leadership

Journal Club support
The Clinical Librarian worked closely with the Clinical Nurse Lead who had an interest in research to establish a Journal Club. The team decided to take a more informal approach to a traditional Journal Club that would be inclusive to all levels of staff.
To many of the staff involved Journal Club was a new concept so some training in searching the literature, practicing critical appraisal and understanding some of the key concepts of evidence base practice was delivered.

Kidney Diseases blog
The Kidney Diseases blog was established in response to a request from the Renal Unit team for a way of collating and distributing alerts about the latest evidence, resources and news relating to kidney disease. Staff were also encourage to submit items for inclusion that they would like to cascade to colleagues, with the aim of reducing the quantity and length of team e-mail chains and also providing a reference point in which to share knowledge within the team. Staff continue to receive email updates from the blog.

Accreditation assessment visit
The Clinical Librarian submitted a personal statement to the assessors and delivered a verbal presentation and display stand on the day of the accreditation visit about library input to the project.

How the initiative or service is delivered: The project was led by the Clinical Librarian Service with support from library colleagues. The project involved promotional activity and attendance at steering group meetings, as well as providing a point of contact for literature search requests, training requests and general enquiries. It also required the Clinical Librarian to write a personal statement, present the involvement of the library service and be interviewed by the assessors during the accreditation visit.

Customer involvement in this piece of work – or service development? The project required the PDU leads to participate in activities to support evidence based practice within their team.

Benefits of this case – activity – service – for the customer: The PDU leads benefited from literature searching support, Journal Club support and current awareness services via a named point of contact from the Integrated Library Service to support evidence based practice and staff development. All of these developments were used as evidence in their accreditation submission.

Benefits for the library/libraries: The library service benefited from the opportunity to work alongside health professionals in actively improving service delivery. The project has resulted in a close working relationship with the Renal Unit and has raised the profile of the library service within the organisation as a whole.

Evaluation: The Leeds University accreditation team awarded the Renal Unit a full stage 2 accreditation.

Feedback: Extract from the final Accreditation visit report:

“The relationship with Victoria is a marvellous example of using her skills to bring new, credible evidence to the attention of clinicians. This work should definitely be written up and published in an appropriate journal as it provides wonderful evidence of the value of a clinical library service to the improvement of practice.”

“Victoria’s blog is a wonderful example of using the available technology to bring up-to-date evidence and research work to the attention of everyone quickly and conveniently.”

Marketing: Many of the staff involved weren’t aware of all the library services available to them, so the marketing approach was face-to-face contact with ward staff and PDU leads at the regular steering group meetings.

Collaborative working: An enthusiastic approach was taken from both the library service and the PDU leads. Collaborative working was helped by the clear criteria set by Leeds University which gave us a shared objective and timeline.

Funding streams: n/a

Lessons learned: The project established a good relationship with the staff working in the Renal Unit who continue to use library services.
The library service can successfully support teams applying for practice development status.

Sustainability; next steps: Although the team was successful in achieving accreditation status, the projects that were initiated are continuing to run, including the Journal Club and kidney diseases blog.

Sources of further information: Wirral and Chester Kidney Service http://www.wirralchesterkidney.nhs.uk/

Start date: September 2008

End date: Stage 2 accreditation achieved in November 2009

Contact: Victoria Kirk, Clinical Librarian, Victoria.kirk@nhs.net 0151 604 7223

Related resources links:
University of Leeds School of Healthcare, Enhancing Practice
http://www.healthcare.leeds.ac.uk/enterprise/enhancing-practice.htm

Date submitted: May 2010

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