Renal Unit ‘Adopt a Librarian’ pilot project

Title of project: Renal Unit ‘Adopt a Librarian’ pilot project

Project team: Victoria Kirk, Clinical Librarian; Gwyneth Marshman, Clinical Librarian; Lauren Gould, Senior Staff Nurse; Jon Casey, Clinical Nurse Lead (Renal)

Resources required

Staffing: The Clinical Librarian will require dedicated time to:

• be available on the ward for 2 hours per week
• attend the Multi Disciplinary Team (MDT) meeting to feed back on search results and progress
• conduct any searches or training that results from the library surgery
• record and collate the necessary data in order to evaluate the pilot

A pilot service will enable staff time requirements to be measured in more detail.

Library Assistant support may also be required for the additional administrative tasks that may be involved (e.g. processing search requests).

Electronic resources: The Clinical Librarian will need access to the evidence base via:

• Health related databases
• Evidence based resources

Timeframe: The pilot will be conducted between 1^st February 2011 and 30^th April 2011 [may be subject to change].

Description of product/service: The Renal Unit has been successful in attaining Level 2 Practice Development Unit status from the University of Leeds. In order to drive forward practice development, the Renal team would benefit from having regular access to a qualified health information professional at the point of need.

The information professional, as part of the multidisciplinary team, can encourage the consultation of research literature and provide a mechanism for getting research into practice, as well as stimulating a questioning and learning culture within healthcare teams.

A Clinical Librarian will be available on the Renal Unit (Ward 31) at Arrowe Park Hospital for 2 hours per week at a specified time to provide a ‘library surgery’ to staff and students on placement.Results from evidence searches and progress on the pilot will be reported back to the Renal Multi Disciplinary Team (MDT) meeting.

Services available to staff and students via the ‘library surgery’ will include:

• Individual assistance with searching for the latest evidence / literature searching
• Tailored ‘ad hoc’ training in accessing health information resources (e.g. NHS Evidence, Pubmed, Cochrane Library)
• Collecting literature searches on topics resulting from patient care on the ward (e.g. issues arising from ward round) and feeding back results to the team
• General enquiries and advice

The project will be conducted as a 3 month pilot.  An evaluation of the pilot will determine if it is feasible to launch this as a permanent service.

Alignment to local, regional and national drivers: This service fulfils part of the ‘vision of the future’ identified in the ILS strategy, to ‘increase support offered to divisions by the Clinical Librarian service’. The ILS strategy states that one of the purposes of the ILS is to ‘provide support to clinical teams in the workplace and enable the evidence based decision making process.’

This service fulfills the ILS objectives to support:

• Clinical effectiveness and governance
• Education and training, professional development and life-long learning
• High quality evidence-based health care

The service supports the clinical governance agenda in the Trust.
The service supports the four key purposes of health libraries as identified by the Peter Hill Review:

1. Clinical decision making by patients, their carers as appropriate, and health professional
2. Commissioning decision and health policy making
3. Research
4. Lifelong learning by health professionals.

The service also supports the vision of the 2010 white paper, Equity and excellence: liberating the NHS, which highlights the need for patient care quality standards to be based on the ‘best available evidence’ (p.23).

Intended outcome for customer / organisation / library: Outcomes measured will be the amount of activity generated as a result (e.g. literature searches).  Additionally, a very brief evaluation questionnaire will be completed by each person who utilises the ‘library surgery’.  The questionnaire results will provide some impact data as well as helping to identify any ‘critical incidents’ that require follow-up. 

Next steps: The project will be reviewed in May 2011

Clinical Librarian Systematic Review : North West Clinical Librarian Collaboration

Title of project: NW Clinical Librarian Systematic Review

Project team: Dr Alison Brettle: Research fellow (Salford University);Michelle Maden-Jenkins; Clinical information Specialist (Edge Hill); Lucy Anderson; Outreach Librarian (Bury PCT); Ros McNally; Librarian (University of Manchester); Anne Webb; Library Operations Manager (Christie); Tracey Pratchett; Clinical Librarian (Morecambe Bay); Jenny Tancock; Clinical Librarian (Morecambe Bay); Debra Thronton; Library manager (Blackpool)

Resources required:

Staff involved: 8 librarians from different organisation throughout the NW. Possible use of library assistants for document supply.

Time: Contributors will be expected to travel to meetings (approx 1 per month), meet with colleagues for small group work and allocate time accordingly. Each member will maintain a diary of time dedicated to the project.

Costs: Refworks; Travel costs; Refreshments; Conference costs

Resources: Grouploop to manage documentation and communicate; Refworks to manage References and share with group; PbWiki – used to supplement Grouploop; Databases – to undertake a comprehensive literature search

Training required: Refworks; Statistics training

Timeframe: Start date: April 2008 – Publication date: 2010
*May continue after publication date in terms of presenting process, reflection etc

Description of product/service: This is a collaborative project involving 8 Librarians from the North West. The project will contribute to the professional body of work relating to Clinical Librarianship by delivering a Systematic review. In addition, the contributors also want to develop their own skills base and understanding of the processes involved and this learning will be shared through a reflective process model.

Alignment to local, regional and national drivers:

Local drivers
UHMBT Strategic Direction Document 2003-8 “We are here to provide … A resource for teaching and research and development, generating new knowledge leading to improvements in population health and in health care delivery”

By learning valuable skills in the systematic review process, this can be translated librarian support and advice for Trust staff undertaking this type of research.

National drivers
Hill review 2008 highlights that health libraries are essential for supporting clinical decision making, commissioning & policy making, life-long learning and research.

By developing skills in this aspect of research, CLs at Morecambe Bay can help to deliver Hill’s view of contributing to these areas.

Intended outcome for customer / organisation / library: By contributing to this regional project, I will further understand research processes and pitfalls involved in undertaking a systematic review. This will enable me to support and collaborate with researchers within my Trust who are interested in undertaking a systematic review.

Next steps: This project was completed and published online in late 2010 and was presented at Health Libraries Group Conference in 2010; winner at DREaM Conference (2012) North West Clinical Librarian Systematic Review and Evaluation Group wins Practitioner Researcher Excellence Award

Publication:
Brettle et al (2010) Evaluating clinical librarian services: a systematic review Health Information & Libraries Journal Volume 28, Issue 1, pages 3–22, March 2011

Linked Case Study “Systematic Review”

Using Clinical Librarians to support evidence-based, cost effective purchasing decisions

Project Team

Tissue Viability Nurse (TVN) Consultant and Specialist Tissue Viability nurses (acute & community) – to review/report on products & evidence and make final decisions.
Purchasing Manager –  supplier/clinician liaison and costings & data provision and analysis.
Assistant Clinical Librarian (CL) – to conduct literature searches.

Resources Required

Library resources: Assistant CL time (34.5 hours to complete 54 literature searches over a 2 month period)

Timeframe

Approx. 6 months from initial meeting to completion of review by TVN team.

“The Story”

The Tissue Viability Nurse Consultant and her team were due to undertake a review of the Wound Care Formulary Review used across the acute and community setting. Having been a frequent user of the CL, the nurse consultant requested CL input to as wanted to ensure that decisions regarding dressing choice were made on a comprehensive assessment of each product (incorporating the available evidence base, cost and availability, staff and patient-reported experience and outcomes).

Assistant CL attended meetings with an iPad to provide quick access to the evidence base for the dressings being evaluated by the group. Subsequent in-depth literature searches were undertaken to ensure a comprehensive evaluation of dressing types as well as specific products. Results were then disseminated across the group.

Meetings took place over the summer of 2013 and 54 searches were undertaken to provide the required evidence.

The project was completed and the new formulary was disseminated amongst the project team in January 2014.

Alignment to local, regional and national drivers

Pennine Acute Hospitals NHS Trust Quality Strategy 2013 – 2018: “to provide the very best care to each patient on every occasion”

National Audit Office: The procurement of consumables by NHS acute and Foundation trusts (Feb 2011) “In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority”

NMC The Code: Standards of conduct, performance and ethics for nurses and midwives “Provide a high standard of practice and care at all times”

Impact of this project/service

TVN team now have a centrally-held repository of evidence relating to their specialist area with arrangements in place for regular updates from CLS.

Timely delivery of new wound care formulary.

Projected cost savings of £50,000 per annum for the lifetime of the formulary (3 years) achieved whilst quality maintained across the organisation.

Increased awareness and actual use of the CL and library service as a whole.

Lessons Learned

Opportunity for ongoing CL input valued by team.

CL able to refine current evidence & knowledge alerts to better suit the information needs of this user group.

Sustainability / next steps?

This project will be the subject of an article in the Trust magazine which will support the marketing of this project to other clinical and care teams trust wide.

This collaboration is to be included in promotional brochure for Learning & Organisation Development department.

Continued collaboration with this clinical team, resulting in actual increased uptake of library services to support the TVN team in both clinical and professional development (e.g. writing for publication, undertaking accredited study and conference presentations).

Anticipated CL involvement in subsequent formulary reviews.

Contact details

Jo Whitcombe,
Assistant Clinical Librarian
Pennine Acute Hospitals NHS Trust
0161 627 8462/ joanne.whitcombe@pat.nhs.uk

Date case study completed:  January 2014.

Systematic Review

Title of project: Case Study Systematic Review

Title: NW Clinical Librarian Systematic Review

Lead library: No lead Library. Contributors from Salford University, Edge Hill University/Aintree Hospital, Univ Hospitals of Morecambe Bay NHS Trust, Bury PCT, Christie Hospital, Blackpool Hospital, NICE/Manchester University.

Summary: A systematic review into Clinical Librarianship will be published in HILJ Dec 2010. This is a collaborative project involving 8 Librarians from the North West. The project contributed to the professional body of work relating to Clinical Librarianship by delivering a Systematic review. In addition, the contributors also developed their own skills base and understanding of the processes involved; this learning will be shared through a reflective process model.

Partner organisations: LIHNN; HCLU

Key Audiences: Clinical Librarians; Library Managers

“The story”: The systematic review aimed to assess the most effective methods of evaluating clinical librarian services. The review was undertaken over a 2 year period and the learning achieved by all concerned was immense. In addition to the main aims of completing the project, the review also identified a dominant model of CL in the UK – one which differed to the original US model. Also through reflective processes the team hope to share their learning, to support other librarians in the health sector who wish to undertake this type of research. The processes involved will be outlined and shared at HLG 2010 and ultimately will be provided via a toolkit. All participants unanimously asserted that they would undertake such a venture again, but would be clearer about the time involved – this was perceived as a key barrier. The richness of the learning experience however, made the experience a worthwhile one.

How the initiative or service is delivered: The project will be published in HILJ Dec 2010 and was presented at EBLIP and ICML 2009. It will be presented at HLG in 2010

Customer involvement in this piece of work – or service development? This project did not involve customers as such.but enhanced understanding of the research process – skills which are integral to the post. By learning valuable skills in the systematic review process, this can be translated librarian support and advice for Trust staff undertaking this type of research.

Benefits of this case – activity – service – for the customer: All clinical librarians felt that it developed their skills and improved confidence in this area. This ultimately will enhance the delivery of librarian support for research (particularly systematic reviews). As a direct result of the experience, the CL at UHMBT felt able to cost librarian time for supporting a systematic review within the Trust.

Benefits for the library/libraries: Raises the profile of the library service within the Trust and the fact that CL’s are actively engaged in this type of work means that confidence in CL ability is improved.

Evaluation: None

Feedback: None as yet

Collaborative working: This regional collaboration across the Northwest has created links and allowed shared learning

Funding streams: Funding for the project was obtained from HCLU to cover some conference costs, purchase of Refworks, Ill’s

Lessons learned: TIME!!! Everyone underestimated the amount of work and time that this review would involve. Lessons learned will be documented in the toolkit and shared with others.

Sustainability; next steps? This project will come to an end shortly, but will be presented via 2 posters at HLG (SR findings; Processes and reflection).
There may be some follow up papers relating to the processes and a toolkit will be developed.

Sources of further information? Not available currently

Start date: April 2008

End date: 31.12.2010 (although may be extended if a further research report undertaken

Contact: Tracey Pratchett
Job title: Clinical Librarian
Telephone: (01524) 516224
e-mail: Tracey.pratchett@mbht.nhs.uk

Aligned to:
Local drivers
UHMBT Strategic Direction Document 2003-8 “We are here to provide … A resource for teaching and research and development, generating new knowledge leading to improvements in population health and in health care delivery”
National drivers
Hill review 2008 highlights that health libraries are essential for supporting clinical decision making, commissioning & policy making, life-long learning and research.
Darzi review

Date submitted: 22.6.2010