hlg conference 20 th july 2010
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The Best Kept Secret? Knowledge Support for Senior Managers – Improving Service Delivery & Quality. HLG Conference 20 th July 2010. Debra Thornton Library & Knowledge Services Manager. Trevor Morris Management Librarian. Background. Successful clinical librarian service. - PowerPoint PPT PresentationTRANSCRIPT
The Best Kept Secret? Knowledge Support for Senior Managers –
Improving Service Delivery & Quality
HLG Conference
20th July 2010
Trevor MorrisManagement Librarian
Debra Thornton Library & Knowledge Services Manager
Background
• Successful clinical librarian service
Clinical Librarian Searches March 08 - May 09
05
1015
2025
3035
40
Clinical Librarian Searches
Searches by staff group
Doctor35%
Nurse28%
Midwife6%
Manager17%
Doctor
Nurse
Midwife
Manager
AHP
GP
Student
Other
What’s in a name?
“Like detergent, the word ‘librarian’ is an accurate description of function, but not a value proposition”
(Janice Lachance. Information Outlook 2009)
Develop leaders
Stimulate innovation
University Hospital
Empowerment
Continuous improvement
A LEARNING ORGANISATION
Aligned with Trust Objectives
A ‘leap of faith’
Management Librarian
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.
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.
What the Service has offered the Trust?
Management Librarian to work with management teams throughout the Trust
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
Trusts publishing their own data to
the public
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
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?
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
Restructuring Hospital Departments to reflect Care Pathways
Restructuring Hospital
Departments to reflect Care
Pathways
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
Working closely with service improvement leads to advise on information and evidence to support specific projects and work streams.
QuIPP Programme managed by the Service Improvement Team use service to advise on current legislation, guidance, best evidence and practice to support all future cross-divisional projects and work streams taking place in the Trust.
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
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.
Sources Consulted for National Guidance
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.
6. Gather information to underpin the pathway development
Provide an expert literature search of the evidence base
Provide examples of other hospital experiences
Latest Evidence on Cardiac Rehabilitation
The effectiveness of a newly developed cardiac rehabilitation phase III program -- a quantitative and qualitative approach to enhance service delivery. Crowley L. Physiotherapy Ireland, 01 June 2010, vol./is. 31/1(4-10),
Long-term effect of rehabilitation in coronary artery disease patients: randomized clinical trial of the impact of exercise volume. Hansen D, Dendale P, Raskin A, Schoonis A, Berger J, Vlassak I, Meeusen R. Clinical Rehabilitation, April 2010, vol./is. 24/4(319-27), 0269-2155;1477-0873
Home-based versus centre-based cardiac rehabilitation. Taylor RS, Dalal H, Jolly K, Moxham T, Zawada A. Cochrane Database of Systematic Reviews, 01 March 2010, vol./is. /1(0-), 1469493X
New process for developing clinical pathways:
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
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)
Debra ThorntonLibrary & Knowledge Services Manager
01253 655596
Trevor MorrisClinical Pathways Manager
01253 655497