Improvement Librarian Next Generation Clinical Librarian Roxanne Hart
Improvement Librarian…. Next Generation Clinical Librarian? Roxanne Hart @roxannehartq HLG 2018
QI SURVEY COMPARE TO CLIN. LIB. WHAT IS QI? BACKGROUND TO QI TEAM JD-WHAT DO I DO? THE ROLE FUNDING FOR ROLE
What is quality improvement? • Not an audit • A joined up and continuous effort to make changes leading to
How did the team come about? • Musgrove Park Hospital (MPH) doing QI for over 13 years • 2016 MPH Board committed to a whole hospital QI approach • Internal QI team
*Citation for the original research study available at end
QI team at Musgrove a bit different Methodology = Model for Improvement Project Management Benefits realisation Evidence
Structure of Boards Outpatient Ophthalmology Colleague Change & Development Patient Safety Inpatient Theatres and Critical Care Collaborative
How did my role come about? • Volume of requests too much • Small pot of money in library only enough for part of role • Made a proposal to Improvement Manager & Improvement Lead
Who do I support? • Musgrove Park Hospital and Somerset Partnership • Staff inside (majority of role) and outside the improvement department working on QI
Where do I work? M T W T F 2 days a week based in Library 3 days a week embedded in Quality Improvement Team
Impact of Role • Case studies • Getting involved • Part of process to seek evidence
Learn Before • Case studies / benchmarking • Literature reviews • Site visits • Peers Learn During • Action Learning • Review new evidence • Capture new knowledge • Huddles – learn from yesterday plan for today Learn After • • Lessons learned • Communications and knowledge sharing • Process improvements for next time Systematic approach to gathering and assessing relevant information to support evidence based decision making
How does the role feel? • Amazing (288 days!) • True part of the team • Flexibility on both sides, attending meetings outside of set ‘days’
What do I do (core parts of role) Ø Literature searches Ø Teach staff about evidence for improvement Ø Attend board meetings Ø Current awareness (2 -3 types) Ø Synthesis
Literature searching • Very different to clinical search, much murkier • Have a checklist of sources (attempt to be systematic) • HDAS no longer first port of call
Spectrum of evidence requests from team
More Examples of Questions… ü Does better management of chronic pain patients result in less strain on other areas of the hospital ü Design of outpatient waiting area ü Income generation ideas ü Survey or temperature check on attractiveness of senior clinical roles ü Cost improvement projects neurology ü Alternative methods for completing discharge summaries ü Ophthalmic Viscosurgical Device comparisons ü Enhanced recovery benchmarking data ü Standardising of safety brief ü Innovative ways of working in an integrated endoscopy pathway ü Leadership/executive visibility: best practice/case studies as to how to lead a geographically dispersed organisation ü Please can you summarise what other trusts do around incident reporting and learning from excellence ü Reduce avoidable admissions from acute trusts to care homes
SBAR
Exciting aspects of role • Opportunities to learn more about clinical work in the wider hospital. • Really targeted, proactive current awareness by virtue of the close working knowledge that comes from being based in the team space. • Evidence directly underpinning projects and influencing project directions and decision making. • Interest in the role from other librarians/QI departments/Trust Execs
Initial Survey Results Support for QI 90% of respondents support any staff undertaking QI 57% support staff from their QI depts specifically Frequency of support for QI 5% (1 respondent) supports QI work daily 30% support it once per week Roles 10% have supporting QI written into their JD 85% support QI under the umbrella of the support to the whole trust • 20 respondents at time of PPT creation. Does not represent the full picture In What Capacity? • Majority of support comes in the form of literature searching
Similarities to Clinical Librarian? • Literature searching = • Close working relationships = tailored CA • Official relationship with team • Attending meetings and sending evidence out post meeting
Differences to Clinical Librarian • Model funded by department in question • Providing the service in a different way as audience is different
Thank you Roxanne Hart, Improvement Librarian roxanne. hart@tst. nhs. uk
References Ø Sturdy, A. J. , Reguera Alvarado, N. , Blanco-Oliver, A. , and Veronesi, G. (2018) The impact of management consultants on public service efficiency. Policy & Politics. Available from: http: //www. ingentaconnect. com/content/tpp/pap/pre-prints/contentpppolicypold 1700072 r 2# Ø Neville, S. (2018) Health Consultancy work under pressure as NHS seeks savings. Financial Times. 18 January. Available from: https: //www. ft. com/consultancy-health
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