Evidence summaries to inform the Lancashire & South Cumbria STP

Project team: Lancashire Teaching Hospitals NHS Foundation Trust

• Knowledge & Library Services Manager
• Operational Librarian (Public Health lead)
• Clinical Librarians
• Public Health staff

Resources required:

• Staff time

Timeframe:

• 4 Week timeframe from request to submission.

“The story”

As part of a collaborative working group, the Lancashire Public Health team were involved in finalising the STP which was due for submission in October 2016. In August 2016 a request was made to the library service for a literature search and evidence review to identify interventions which will deliver health benefits, contribute to quality and release efficiency savings by reducing emergency admissions, A&E attendances and GP consultations.

The library service completed 11 literature searches and carried out a mini-literature review and synthesis on each of the 11 topics including a detailed reference list at the end. The evidence summaries were shared amongst the team and delivered within the agreed 3 week timeframe. The Lancashire Public Health team were asked to prioritise the 11 searches and a strict schedule was agreed. The Library developed a process and sources for searching which was signed off by Lancashire Public Health with a view to streamlining delivery and standardising our approach.

Alignment to local, regional and national drivers:

Sustainability Transformation Plan Lancashire & South Cumbria http://www.lancashiresouthcumbria.org.uk/sustainability-and-transformation-plan Regional Transformation of Healthcare Delivery

Our Health Our Care https://www.ourhealthourcarecl.nhs.uk/ Local Transformation of healthcare delivery.

Impact for the Library

This case study was shared as best practice with other health library teams at a national level. It also raised the profile of the type of work that we do and provided a basis for us to become involved in the local Our Health, Our Care plan as our Clinical Librarian has attended the regional Solution Design Events to support redesign.

Impact for the organisation/customer

This work impacted on a number of areas, the STP was published and the Public Health team perceived that there was more informed decision making. The project also facilitated collaborative working and new ways of learning.

Crucially this project saved 80 hours of Public Health Staff time. “Myself and two other analysts would have ended up doing the searches and a couple of the other specialists. We’ve all been trained on searching, but time we would have spent on searching, which we could have been spending on something else” Kate Hardman, Information, Intelligence, Quality & Performance Manager.

Future impacts

Many of the following impacts will be realised after the STP has been published and changes begun to be implemented:

• Improve patient care
• Developing policies, audit and evaluation,
• Organisation/service development/planning,
• Commissioning or contracting,
• Saving money or contributing to financial effectiveness

Lessons learned

Being really clear about what is achievable within existing timescales and having a clearly structured approach meant that the Library team could work together to turn around this work in a short timescale.

Sustainability/next steps?

The Library team have been able to adapt the content of our current awareness for the Public Health team to reflect the priorities outlined in the STP.

The Library team may be involved in future searches to review specific interventions in more detail.

Contact:

Tracey Pratchett, Knowledge and Library Services Manager

Health Management and Innovation Update (HMIU)

Project summary

• A monthly current awareness bulletin (HMIU bulletin) issued by the Library & Knowledge Service at West Suffolk NHS FT for the Trust Managers and Executive Directors.
• Based on the Health Management Updates bulletin produced by Knowledge & Library Services, Tameside Hospital NHS FT

Project team

• Laura Wilkes Library and Knowledge Services Manager West Suffolk NHS Foundation Trust
• James Allen Senior Library Technician West Suffolk NHS Foundation Trust
• Roshanara Nair, Library Services Manager Tameside Hospital NHS Foundation Trust

Resources required

Cost: Staff time to compile and distribute the updates, the majority of time  being spent by the  two library managers in compiling and arranging the content

People: Laura Wilkes and Roshanara  Nair (Library Managers); James Allen (Senior Library Technician)

Time: 

• For Roshanara to select content from the King’s Fund’s Health Management & Policy Alert which she receives weekly.
• For Roshanara to check other alerting /horizon scanning services & add content as appropriate
• for Roshanara to check and amend all the links, compile her Health Management Updates and distribute it
• for Laura to cut and paste the relevant sections from Roshanara’s Update and add any local news or additional relevant topics, and then to align each story to the Trust’s Vision, Priorities and  Ambitions
• for James to format the bulletin into our agreed format, upload to the website, advertise in the Green Sheet and Tweet the link to the latest Update

Technology: Standard email software to distribute the updates, internet access to carry out the searches and Office software to complete the formatting.

Expertise/skills mix required

•  Search skills in order to compile a relevant search strategy
• Knowledge and understanding of current & prevailing political, financial, quality and economic issues that may affect the NHS
• Good general understanding of local, UK and global health issues
• Ability to carry out horizon scanning or use resources which do so
• Good understanding of current affairs
• Ability to use other alerting services
• Ability to build and maintain good networks within the organisation
• Ability to align the content of the bulletins to local strategy and goals
• Ability to format documents quickly and efficiently
• Ability to use social media effectively to promote the bulletins
• Ability to utilise local promotional resources to promote the bulletins
• Ability to use web content software to update web sites

Timeframe: This is a monthly bulletin, delivered approximately at the beginning or middle of the month in time for the Monthly Board Report. There is an expectation that the bulletin will continue indefinitely.

“The story”

At West Suffolk NHS Foundation Trust, the main aim of the Health Management and Innovation Update (HMIU) is to highlight national policies, evidence and reports which may impact on the Trusts’ Together Framework ‘(Our Patients, Our Hospital, Our Future, Together’) or help us to achieve our strategic goals.

In addition, the HMIU highlights innovation within the NHS and, specifically, local innovations within the Trust. The HMIU is essentially a current awareness bulletin aimed specifically at service and operational managers within the Trust, as well as the executive team.

The HMIU is a collaborative project between West Suffolk NHS Foundation Trust and Tameside NHS Foundation Trust, who produce the source document each month. Tameside have agreed to allow modifications to the basic template, and the LKS Manager at West Suffolk also selects content from other sources, local news and innovations and then adds it to the Tameside bulletin.

The draft bulletin is then formatted to align to the West Suffolk Trust’s Ambitions within the Together Framework – deliver personal, safe, joined-up care, support a healthy start, a healthy life, ageing well and support all our staff.

To ensure sustainability, the search strategy will be compiled and amended to suit the changing priorities of the NHS Trusts involved. More use will be made of additional alerting services to widen the scope of the update as needed.

The content of the update is used to inform sections of the monthly Trust Board Report as confirmed by the Chief Executive of West Suffolk in his Twitter feed.

Feedback is sought each month and testimonials confirm the positive impact of the update:

‘Regarding your HMIU, I always find two or three things of interest which I then look up. In the latest I looked up Deming or die and outpatient survey and 7 day working. I suspect others do the same. It is very helpful’

 ‘This is very useful to me. I don’t always look at every article but do always look to see if there is anything that I have missed that would be useful.’

Alignment to local, regional and national drivers 

Trust strategy (local)

• Our Patients, Our Hospital, Our Future, Together – Strategic Framework for West Suffolk NHS Foundation Trust
• Vision – To deliver the best quality and safest care for our community
• Three Priorities – deliver for today, invest in quality, staff and clinical leadership, build a joined-up future
• Seven Ambitions – deliver personal care, safe care, joined-up care, support a healthy start, a healthy life, ageing well, support all our staff

Library Strategy 2013 to 2016 (local)

• Promotion of innovation within the trust and actively marketing the library service to the Executive Group (TEG) and to service and operational managers

Knowledge for Healthcare: a development framework for library and knowledge services in England 2015-2020 (national)

• Vision – NHS bodies, their staff, learners, patients and the public use the right knowledge and evidence, at the right time, in the right place, enabling high quality decision-making, learning, research and innovation to achieve excellent healthcare and health improvement.

Impact of this project/service

Customer: Feedback from users has been positive and constructive and clearly reveals that the content is relevant and useful.

Organisation: Some of the content from the HMIU is replicated in the monthly Board Report as confirmed by the Chief Executive and the Governance Manager

Library: The HMIU has raised the profile of the Library and the embedded role of the Innovation Scout.

Evaluation: Feedback is sought in every issue and, as well as posting the link to the update in the staff newsletter each month, the updates are added to the Library website and there is a regular distribution list who receive the update direct to their inbox. This includes the Chief Executive and other members of the executive team. The CEO has recorded his use of the content for the monthly Board Report.

Lessons learned: This has been a successful collaborative effort by two NHS library services to reach a difficult audience:  health managers and executive teams. By working together, it has been possible to keep costs within a reasonable limit and save time and duplication. The update enabled us to raise the profile of the Library, in particular our expertise with literature searching, alerting and research.

It is always difficult to obtain feedback which demonstrates impact but some examples have been provided and some new requests to be included on the distribution list have been received.

The update is reliant on the search strategy devised by Roshanara and if she decided not to continue that could create difficulties as we have established an expectation amongst our users that the service will continue.

Sustainability / next steps?  In order to address the reliance on another service to continue to provide the search strategy and to ensure continuity, the next step is to devise our own search strategy and to cast our net wider to gather relevant stories from different sources.

We will occasionally also produce a themed update, aligned to issues which are current within the Trust.

Contact details  Laura Wilkes, Library and Knowledge Services Manager, West Suffolk NHS Foundation Trust

Laura.wilkes@wsh.nhs.uk
Tel. 01284 713112

Date case study completed: 26.11.15

Providing Evidence for Supplies Group University Hospitals of Morecambe Bay NHS FT

Title of project: Providing Evidence for Supplies Group

Project team: Head of Procurement and Supplies; Productive Ward lead/Senior Nurse;
Clinical Librarian; Nurse Practitioner; Accountant; Practice Educators; Ward Managers; Departmental representatives

Resources required: Clinical Librarian time, literature searching, Supplies account for document supply.

Intranet: Supplies Group rep will manage the Intranet content.

Intranet publishing: CL needs Cutepdf installing on computer – liaise with IT

Timeframe: Ongoing: 2010-2011 initially

Description of product/service: The University Hospitals of Morecambe Bay NHS Trust is committed to providing high quality research based care within the resources available. The purpose of the Trust Supplies Group is to consider the research around the clinical efficacy and safety of clinical items available for use and make recommendations based on clinical and cost effectiveness.

A Clinical Librarian will attend the Trust Supplies Group meetings and will provide a literature searching service to support decision-making around procurement. The CL will summarise the search results and recommendations in an evidence based summary which will be published on the Intranet.

Alignment to local, regional and national drivers:

Trust Business Plan 2010-11: “To provide excellent value for money for tax payers and provide sustained long term financial viability”

National: Productive Ward; QIPP; Operating Framework 2010-2011

McKinsey Report page 37

Intended outcome for customer / organisation / library: Support evidence based practice in purchasing; Raise the library profile; Demonstrate contribution to organisational objectives. The aim of the Trust Supplies Group is to save money and streamline ordering for 2010-2011. The Library contribution promotes evidence based decision-making and demonstrates a contribution to achieving the Trusts savings.

Next steps: CL continued attendance at Trust Supplies Group Monthly meetings; CL present highlight report/update at each full team meeting

Milestones:

• Deliver evidence summaries when requested
• Create ‘Supplies’ account for document supply
• Manage content/update Intranet site
• Manage status of proposals on Intranet

Update: This project won the Sally Hernando Ward 2011 for Product Innovation and was presented at a Procurement Conference in 2013

Read the case study which has been added to the Toolkit

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”

No longer lost in translation

This is a story by Outi Pickering from Oxford Health NHS Foundation Trust.

Our interlibrary service occasionally provides articles in languages other than English when a

Image: (CC) http://pixabay.com/en/traveller-world-ball-globe-person-349963/

library user is doing a review which must include other languages. Oxford being very international, our users often have colleagues who can help with some of the languages – but not always, and this is where the library has been able to help. I’m a native speaker of Finnish; in addition, I can call myself fluent in Swedish and Italian and competent in German. As these languages are related to others which may be called for (Dutch, Spanish, Danish come to mind), I’ve been able to decipher a number of different languages sufficiently to say whether for instance the article is about inpatients only, whether there was co-morbidity, etc. The agreement is that if I can provide the information within half an hour, it’s a value added service given by the library, but if more time is needed – particularly if a proper translation is needed – I put my freelance translator’s hat on and do the work in my spare time and the user pays for it. Outcome: satisfied users who spread the word that the library is a useful place! We’re not planning to take this any further though since the service depends on one individual (though there could be others, depending on who we employ!), and we don’t advertise it as part of our official “menu”.

On another similar theme, a Greek junior doctor asked if I knew of anyone who could help her with her English. She didn’t want a language school but an individual who could help her get the feel of the language at a deeper level, and besides, due to her work she couldn’t commit herself to a course. I said I know one – my husband! He is a retired university lecturer (English language, specialising in linguistics) and needs to feel useful and have contacts outside the home. They reached an agreement, and both parties were delighted. In addition to the lessons at our house which my husband provided, we often went out all three together, and were introduced to the doctor’s friends when they visited! She has now moved away from Oxford, but we’re still in touch with her occasionally.

Building bridges to improve patient care

Susan Smith from Mid Cheshire Hospitals NHS Foundation Trust talks about how her service had a direct impact on improving patient care by putting people in touch with each other.

Image: ‘Cafe con leche – Milchkaffee (CC)’ http://www.flickr.com/photos/45409431@N00/2939337382 Found on flickrcc.net

The library offers volunteers full membership of its services and the library is currently working with the group to develop a storytelling service on the wards. One day the volunteer manager, brought down one of the volunteers to join the library. She told me a tale of a patient with dementia she was assigned to and how communicating some of the most basic needs could be challenging. Later that day we had a visit from one of our regular Speech and Language Therapists (SLT) about the issue and she offered to provide picture boards to volunteers and family so patients could communicate if they wanted tea or coffee etc. This information was communicated to the volunteer’s manager who is now aware of the service and can direct volunteers if they have similar needs in the future.

Sharing knowledge to increase engagement

Susan Smith from Mid Cheshire Hospitals NHS Foundation Trust highlights how sharing her experiences from a conference with non-library colleagues helped her to make connections and raise the library profile.

Image: ‘Rainy Day / http://www.flickr.com/photos/84988327@N00/200615055 Found on flickrcc.net

 

In February 2013, I attended the CILIP Umbrella Conference in Manchester.  Normally when I attend a conference I write up little articles on each talk and share around the library staff.  This time I spread the word to targeted colleagues within the Trust e.g. social media to the communications team, talk from the Information Commission to Integrated Governance and e-learning to Post Graduate, Practice Education Facilitators and Learning & Development.

In response to the shared learning, I received the usual thank you and some follow up questioning.  Integrated Governance however took it a stage further and asked me to present and discuss my views on the presentation with their Information Governance team.  At that point we weren’t embedded in the organisation and it helped provide an introduction to key people in the team and improve relations with them.  The actual project planned from the initial discussion fell through, but it still has improved library standing within the organisation.

Morecambe Bay Investigation

Title of driver: Morecambe Bay Investigation

Source: Department of Health

Link to main document: https://www.gov.uk/government/organisations/morecambe-bay-investigation

Publication format: Web page

Date of publication: 12 September 2013

Summary of driver: Between January 2004 and June 2013 there were a series of deaths of mothers and newborn babies in the maternity and neonatal services unit at Furness General Hospital. The Morecambe Bay Investigation looks independently at the maternity and neonatal services in Morecambe Bay NHS Foundation Trust.

Key features of driver:
– The investigation will focus on the actions, systems and processes of the Morecambe Bay NHS Foundation Trust.
– The investigation will also consider the actions of regulators and commissioners where those actions affected the safety of maternity and neonatal services provided by the Trust.
– A report to the Secretary of State for Health will be published by summer 2014.

***Amendment anounced March 2014 – the publication of the report has been extended tothe autumn of 2014

Primary audience: As with any investigation, the lessons from this investigation will be of interest to all healthcare providers.

Impact on library policy/practice: Library staff are collating and managing the information flows with the investigation team

Date last updated: 11.4.2014

Due for review: Autumn 2014

Group member responsible: TP

HCLU Consumer Health Information Website (Health Care Libraries Unit NW)

Title of project: HCLU Consumer Health Information Website

Project Team:

• Health2Works (web designers)
• Director of Health Libraries NW
• CPD & Partnerships Manager

Stakeholders:

• General Public
• Health Providers
• NHS North West CHI Providers

Resources Required: The project will be managed by the HCLU CPD and Partnerships Manager, Gil Young; under the direction of the Director of the Unit, David Stewart. A sum has been allocated by HCLU to develop the website. All other work will be undertaken by the unit and, at this stage of the project, will not require additional funding.

Timeframe: February 2011 – September 2011

Description of product/service: To create a single point of contact for high quality web based health information for the general public with the emphasis on services located in the North West.

Alignment to local, regional and national drivers: 

Liberating the NHS: Developing the healthcare workforce (white paper) Public Health white paper Nov 2010 Department of Health Information Strategy HCLU strategy

Intended outcome for customer / organisation / library: The main outputs of this project will be: A newly developed website providing access to quality consumer health information for the North West public particularly patients and carers. Marketing materials to aid the advocacy of the services Stronger links between the NHS Libraries and the providers of consumer health information in the North West. A raised profile for HCLU

Next steps: The project will share outcomes and learning with stakeholders and the NHS Library community via the HCLU Web Site, the LIHNN newsletter, briefing meetings and the use of e-mail lists. Contacts across the North West will be encouraged to share information with colleagues in order to raise awareness of the project. The project manager will actively seek out opportunities to share project outcomes, for example sharing knowledge with other libraries and health providers, publications and conferences.

At the end of the project period (September 2011), the website will be handed over to HCLU. A brief end of project report will be compiled, together with recommendations on how the project can be developed further.

Supporting health and well-being at work (University Hospital of South Manchester NHS Foundation Trust)

Title of project : Library Services supporting health and wellbeing at work Project

Team Project Lead: Library Manager (1wte)
Project team: Library Team (2.71wte)

Resources Required : Staff time for e.g. selection, acquisition, and processing of resources, trust meetings, marketing, and promotion. (estimate one day per month) Funding via external and/or internal bidding processes Occupational Health Department – recommendations resources, fitness DVDs etc

Timeframe : April 2011 – March 2012 initially but expect it to be ongoing

Description of product/service:

• Build a collection of books and DVDs to support the wellbeing of hospital staff and students
• Broaden collection e.g. Wii Fitness loan (through trust Health & Wellbeing Group)
• Refurbish a section of the library to be a relaxed environment for people to sit in away
• from their workplace e.g. “comfort zone” or “library breakout” etc.

Alignment to local, regional and national drivers:

• Trust Health & Wellbeing strategy
• Healthy lives, healthy people: our strategy for public health in England – provision of reading for leisure supports the health of staff
• Investors in People – health and well-being is a large component of the IiP gold standard for which this trust is required to provide evidence by March 2012
• London Olympics – the trust is involved in bringing the Olympics to the Wythenshawe community – fitness DVDs and books and the trust “Fit for Life” initiative support this
• Working for a healthier tomorrow – Dame Carol Black’s Review of the health of Britain’s working age population

Intended outcome for customer / organisation / library :

• increase library usage
• improve the health of workers through reading for leisure
• improve the health of workers through loan of health books aimed at non-clinicians create an environment conducive to relaxation away from the work place
• library service to be an essential player within the trust health and wellbeing strategy

Next steps :

• Utilise bid opportunities and investigate trust lottery funding – ongoing
• Continue to engage with the designers regarding refurbishment of the “breakout” room
• Organise additional library space for the collections
• Add to marketing plan
• Train staff on new policies and procedures relating to the collection
• Measure library usage increase, reflect on loan of Wii Fitness and DVDs

Aim is to implemented above by March 2012