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Library and Knowledge Services annual Report 2017

Introduction

It is with great pleasure I would like to share with you the 2017 Annual Report of the QE

Trust Library and Knowledge Services.

The activities in this report recount and demonstrate the commitment of Library Staff to contribute to the Foundation Trust’s objectives of providing high quality sustainable clinical services to our local population in new and innovative ways, and to develop new effective partnerships with other organisations. We conform to the Trust’s values based behavioural framework by looking for better ways to do things, upholding a service ethos, and embracing new ways of working, whilst keeping all staff up to date with new initiatives, guidelines, evidence and practice. Despite many commentaries on the demise of libraries and the future of the Library as a

place, the QE Library and Knowledge Service have had an increase in footfall by 20% over

the last year, with Information related enquiries up by 48%.

This year has seen a consolidation of the service and a change of staff. Joanne Naughton the previous Trust Librarian has taken up a secondment role as NHS Library and Knowledge Services Development Manager North East. Dor Wilson has now replaced Joanne as Trust Librarian and has a background not only in Medical Librarianship but also Health Sciences Research Methods which has enhanced the clinical literature searching facility.

The number of users was steady

proportioned out into Allied Health

7%, Med and Dental 17%, N & M

28% , Students 35% with the

balance being administrative and

other Departments. Demographics

remain steady with top users being

Nursing and Midwifery users, 2nd

line was Medical and Dental users,

and third line students from areas

in the Trust such as physiotherapy,

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occupational therapy, Radiology, and Nutritionists and Dietitians.

The Library staff have spent an average of 130 person hours in user education and induction to services, to include physiotherapists, junior doctors, and nursing and midwifery.

Approximately 300 new books have been catalogued, and the top ten titles borrowed over

the last 3 months were regarding citation and referencing - Cite Them Right, with The

Illustrated Textbook of Paediatric as the clinical choice.

Top ten borrowed titles

Cite them right : the essential referencing guide / Pears, Richard; Shields, Graham. (10th ed.) (2016)

Llewellyn-Jones fundamentals of obstetrics and gynaecology / Oats, Jeremy; Abraham, Suzanne. (10th ed.) (2017)

Leadership : theory and practice / Northouse, Peter G.. (6th ed.) (2012)

Obstetrics and gynaecology / Impey, Lawrence; Child, Tim. (5th ed.) (2017)

Illustrated textbook of paediatrics / Lissauer, Tom; Clayden, Graham. (4th ed.) (2012)

Practice development in nursing and healthcare / McCormack, Brendan; Manley, Kim; Titchen, Angie. (2nd ed.) (2013)

Psychiatry by ten teachers / Dogra, Nisha; Lunn, Brian; Cooper, Stephen. (2nd ed.) (2017)

The ECG made easy / Hampton, John R.. (8th ed.) (2013)

Douglas G. Nicol, F. Robertson C. (2013) Macleod’s clinical examination. 13th ed.

Edinburgh: Churchill Livingstone

Hampton. J.R. (2013) The ECG made easy. 8th ed. Edinburgh: Churchill Livingstone

Opening hours have stayed constant with one late night per week with the Library available

both physically and online with 24/7 access. The nature of the service changed slightly to

include both book borrowing and return via promotion of an underused self-service issue

technology, which complements the amazing job staff do at the Service Desk, with a total of

4686 items being issued to users in the previous 12 months.

Library Quality Assurance

As part of the Trust’s Learning and

Development Agreement with

HEE-NE, the Library and

Knowledge Service is required to

complete a self-assessment

against national standards for NHS

Libraries. The framework uses a

Red Amber Green (RAG) rating

system to monitor compliance. In

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2015, the Library achieved a 92% compliance rate which means that it was rated as a green

service. In 2016 compliance of 95% was achieved and as one of the smaller NHS library

services in the region, this represents a significant achievement and reflects the range and

quality of services provided.

Knowledge for Healthcare

The service strategy is closely aligned with HEE England Strategy for Libraries (Knowledge for

Healthcare). The Framework sets the tone for library services development until 2020, and

has already had an impact on library services locally which states that the contribution of

healthcare library and knowledge services to education, lifelong learning, research and

evidence based practice is widely valued, with Prof Ian Cumming Chief Executive of Health

Education England noting:

“Our ambition is to extend the role so that healthcare knowledge services become

business

critical instruments of informed decision making and innovation.” (HEE, 2016).

The following key themes therefore, from ‘Knowledge for Healthcare’ have informed the

development of the library service during 2016/17.

Online access to resources available 24/7 E-resources have been acquired throughout the year. Some were renewals of core

databases such as the UptoDate decision support service, and the joining up with

consortiums nationwide to provide best value for money when purchasing expensive

journals and databases. The Service also benefits from the continued access to HDAS

journals and databases provided by NHS central purchase National Core Content which in

the North amounts to £716,000 of funding.

A new development has been the KnowledgeShare portal,

(supplied by Brighton and Sussex University Hospitals NHS

Trust), which enables targeted current awareness, specified

from user profiles in order to deliver to the desktop latest

evidence in fields of medicine, commissioning and clinical

governance, matching people with people, and people with

resources.

A full suite of Medicine Nursing and Midwifery Journals was

also purchased by the Library and Knowledge Service for exclusive online access for the

Trust, together with approximately 80 online e-books as an ongoing trial to be promoted

and monitored.

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UpToDate continues to be a popular online resource amongst Clinicians and Nurses alike.

Clinicians use it as an evidence-based, physician-authored clinical decision support resource.

It has a rigorous editorial process to synthesize the most recent medical information into

trusted, evidence-based recommendations that are proven to improve patient care and

quality.

QE Hospital Clinicians trust UptoDate to make the right point-of-care decisions and it has

seen a steady increase lately with>120 regular users at present. Mobile adoption has also

proved popular which enables users to view and download information to mobile devices

such as phones and tablets for information ‘on the go’. The graph below shows the peak

when it was launched, the dip when the cyber-attack occurred within all NHS Hospitals, and

then a steadily increasing usage since.

Mobile adoption %

Topics of most interest are neurology, gastroenterology and cardiovascular with users job

roles in specialities such as anaesthesiology, paediatrics and general medicine.

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Value for money

Inter-library loans services are continually used however this year the Service made a cost

saving regarding The British Library by 13% whilst maintaining an increase of 32% in network

borrowing without any cost to the Trust, utilising the LIHNN network (Library and

Information Health Network NW).

With regard to literature searching carried out for the Trust, to date, “There were 101 clinical searches carried out on behalf of Trust staff (a 30% increase on last year)”, and given that there are no overhead charges to Trusts at the moment for continued access to costly healthcare databases, the costings can be benchmarked currently to:

Kings Fund: £500 per day or £250 for half day literature search

RSM: £172.50 (for a search of 2 databases only, restrictions on results, extra charge for summarising/precis of information)

Trust Library and Knowledge Service: Each 4 hour literature search costs overall £152.00 with no restrictions on number of databases searched or references supplied, and inclusive of information summary.

The Trust Library and Knowledge Service therefore overall provides both good value for money, and a particularly convenient service to all Clinical (and non Clinical) Staff in the Trust. To compliment this data comments such as those below offer some qualitative perspective on the work: “The lit searches have been hugely helpful. Mostly for lectures I have given on breast radiology at several recent national conferences and teaching meetings. The current search will feed into a round table discussion at the House of Commons …- we will be trying to move forward on a national level “…

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“The search will feed into a presentation at the Northern Surgical meeting …it will be fundamental to a retrospective research project covering our experience of these cases at QEH”. “the lit search will be absolutely fundamental to how we set up the research project...it is the vital first step, which would not happen without your help”.

“Thanks again for your help greatly appreciated & I passed my module at university with

excellent feedback from my Tutors”

“A ‘Delirium Champions Group’ has been formed on the Critical Care Department. We have

embarked on improving practices related to delirium & patient care. “

Special Projects undertaken in line with engaging within the quality standards now

expected of Library and Knowledge Services.

Patient Information and Public Involvement within the

local community

The service has joined forces with the Patient

Information Facility to aid in the authoring of patient

information. This enables staff to upgrade their skills in

both reviewing information and embarking on new

topics. We can either carry out a comprehensive search

to find the latest, best evidence on a condition or

intervention, or also help to find reliable patient

information sources and to reference evidence correctly

within the leaflets.

A ‘Books on prescription’ event at Gateshead Central

Library, and Carers event held at the Trust 16th June

2017 during National Carers Week 2017, saw the Service represented with The Carers

Association who are very interested in teaming up with the Trust Knowledge Service to offer

support and expertise in searching for trusted information, to carers, volunteers in the

Hospital, and Medical Secretaries. There is a ‘Guide to Trusted Online Health Information’

already in production which will be piloted before the initial launch later in the coming year.

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Careers Event – 3rd July 2017

Gateshead Health NHS Foundation Trust

hosted a Careers Event on Monday 3rd July

2017. 60 students from neighbouring

schools visited the Hospital and the Library

and Knowledge Service represented how

they support all people working within the

Trust in their job roles, and also provided

students with an insight into Medical

Librarianship as a career.

Purpose of the event was to engage with

future workforce at the earliest opportunity,

showcasing as many possible NHS career

pathways as possible.

The full day sessions were well attended and

students clearly were interested in desk top

research as an alternative to hands-on roles

in their career choices.

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Physiotherapy Training Event – April 2017

This was a tailored event to provide better awareness of information sources and resources

which from feedback was hugely successful for a group who had not had the benefit of a

personalised service before.

Impact data from our local survey – July 2017

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The survey was initially to understand the level of engagement and what is/was most

important to users in work, study or interest.

Quiet study away from their desks was of prime importance, as was access to UptoDate

decision support tool. Comments ranged from good for 24 hour access to online access as

being prime. The chart shows fairly even usage as expected across the whole spectrum of

service and resources the Library and Knowledge Service has to offer.

Access to Journals books and computers was considered the most important, whilst current

awareness, help with referencing and training on healthcare databases was deemed more

important than for example training regarding critical appraisal of literature. The majority

of respondents came from the medical profession.

Access to latest contents pages in key journals of interest 5 Updates on new articles published in your speciality 4 Training/support with searching health care databases 4 Training/support with referencing 5 Training/support with critical appraisal 7 Access to resources from home/ mobile access 6

Group study 2 Quiet study 2 Clinical questions service/literature searching service 3 Access to computers 1 Books 1 Journal articles 2 Journal browsing 3 UpToDate access 2

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In the coming year 2017

QE website

The website has continued to provide a means of easy access to resources in one place, however there are plans to personalise the portal to make it even more appealing to users. Redesign of the site from the ground up, in terms of user interface, interaction and visual design, photography, imagery, iconography - all appropriate to the context of NHS clinicians is being undertaken, putting links to knowledge resources to the fore. Tools are being explored to ensure ‘findability’ in all areas of costly resources in order to aid in the usage of those already purchased and underused, together with more personalisation of users areas aiming at a more boutique type of Library and Knowledge Service. The Staff are also keen to engage with users using social media, and consideration of an online chat facility for those who want immediate help, where wait times for a solution to problems could be cut is also being explored in line with the new design.

Nurse Revalidation

As part of the Library and Knowledge Service promotional drive it was noted that Nurses

now need to revalidate in order to renew their registration with the NMC. Part of this

includes reflection on professional reading which the Service has now offered to aid those

wishing to do

Preparatory reading, which the Library will facilitate, will be undertaken using a checklist of

reflective questions to promote discussion. Attendance to the Library and Knowledge

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Service sessions will earn attendees three hours of cpd validated by certificate from the

Trust Librarian. Attendance to the session would also provide each attendee with material

for a written reflective account to put into their portfolio. This has been discussed and

validated by the Head of Education and Development within the QE Hospital Foundation

Trust and will be piloted this summer 2017.

Financial year 2016-2017

Expenditure Recurrent

Staff (gross) 77,430.00

Books and other non-journals materials 20,000.00

Print journals 6,642.00

Print and e-journal (bundle) 9,500.00

Electronic databases 34,054.00

Electronic books 19,106.00

Electronic journals only 9,280.00

Audio-visual and e-learning materials 0.00

Inter Library Lending and document supply 445.00

Marketing and promotion 2,590.00

Library staff training and development 650.00

Total 179,697.00

Other 0.00

Capital charges and maintenance 0.00

Total Expenditure 179697.00

Overall Expenditure (recurrent and non-recurrent)

179697.00

Key Statistics from 2016/17

Visits to the Library: 30,000

4686 loans were provided to users

2207 articles requests were satisfied

There were 60 literature searches carried out on behalf of the Trust staff

6017 searches were carried out on Athens resources by Trust staff (an increase of 21%).

14084 searches were carried out on the UptoDate Clinical Reference Service

Service delivery standards were met at 98.4% for literature searches, 97.3% for book and journal requests and 98.4% for ordering new books.

User Education: 130 hours spent by library and Knowledge Service staff in user education time.

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Summing Up

We contributed to the improvement in patient care in the Trust by increased literature

searching service, by engaging with other areas such as public and patient involvement i.e.

The Carers Association, by aiding in the development of patient information and the skills

needed to produce such guides, and providing all Trust staff with the information tools and

training needed to carry out their day to day work.

When requested by the Trust to control expenditure, we managed to deliver increased

levels of service within budget. Savings of 13% were made regarding the inter library loan

budget and document supply.

We continued to assist staff in accessing the information they need to ensure the best

possible outcomes overall within the Trust – ‘how we did’ - 19% increase in satisfaction over

3 months.

The pressures on Trust staff to improve their CPD, to increase their professional skills or to

develop their roles, will also continue to grow and they will all need a strong and versatile

library service to support them, which the Library and Knowledge Service can provide.

The amount of information available on the Internet will also continue to grow, with the

proportion of “junk info” also increasing. With this increase, the identification of “real”

information will become the challenge. Developments in Google’s search engine will help,

but they will be countered by the increased skew towards a profit-making outcome. This will

make the skills of the library staff essential in the process of seeking out and providing

better and more comprehensive access to quality knowledge.

D.Wilson July 2017 - All citations based upon Knowledge for Healthcare; a framework 2015-

2020) and the HENE Library Services Strategic Framework 2012 – 2015).