Transcript of "Embedding the Team Knowledge Officer role within clinical teams via a pilot clinical librarian service"
Embedding the Team Knowledge Officer rolewithin clinical teams via a pilot clinicallibrarian serviceCatherine EbenezerDurham CAMHS CPD meetingWest Park Hospital29/06/2011
Clinical librarian projects: 1Started in USA 1971-Integrate health sciences library services and literaturesearching expertise of health librarians into clinicalsettingsOvercome time, cost and expertise barriers to adoptionof evidence-based practiceEnhance educational experience of students and juniordoctorsEnable librarian to gain a better understanding of thepatient care context of information needs
Clinical librarian projects: 2Extensive professional literature, includingseveral systematic reviews:Wagner and Byrd (2004)Brettle et al. (2010)Weightman and Williamson (2009)Very few projects in mental health services:Reid et al. (2008) – Barnet PCTUrquhart et al. (2007) – North Wales**Gorring et al. (2010) – Birmingham & Solihull**
Clinical librarian: a definitionA clinical librarian seeks “ to providequality-assured information to healthprofessionals at the point of need tosupport clinical decision making”(Hill, 2008)
Role of the clinical librarian• Attendance at clinical meetings• Attendance at / support for journal clubs• Undertaking literature searches• Evaluating information / criticalappraisal / clinical question answering• Facilitating clinical guideline development• Service promotion and outreach• User education and training
Models of clinical librarian serviceQuestion and answer servicerequests submitted to CL – literature search results provided to userOutreachCL uses a range of means and methods of providing information to users– tries to engage them with library servicesQuestion and answer service plus criticalappraisalresponse to user’s enquiry contains a critically appraised summary ofresultsOutreach plus critical appraisal and synthesisResults of queries include a synthesised critical appraisal(Brettle et al. 2010, p. 12)
‘Hill review’Hill, Peter (2008)National Review of NHS Health Library Services in E. London: DHImportant high-level recommendations re:Knowledge management within the NHSNHS library and information servicesNever officially endorsed by DHOvertaken by ‘Darzi’- led to breakup of NLHImpetus for many clinical librarian projects
Chief Knowledge Officer (CKO)Advocated originally by Muir Gray (1998)“In every NHS organisation someone at boardlevel should be entrusted with the role of ChiefKnowledge Officer for that organisation.”Role: to provide leadership and oversight toenable all NHS staff to access and apply thebest available evidence in supporting everyaspect of the clinical care of patients.(Recommendation 11)
Team Knowledge Officer (TKO)“Every clinical or management team in theNHS should identify someone in theteam as “Team Knowledge Officer” (orequivalent). The Team KnowledgeOfficer will have responsibility forensuring the effective input of evidenceto enable the team to function properly.”(Recommendation 14)
Role of the Team Knowledge Officer: 1Supporting the team through: ensuring the dissemination of externally and internally generatedevidence, research, information, and data facilitating knowledge sharing participating in horizon scanning by anticipating future service needsWorking in partnership with the Chief KnowledgeOfficer by informing him/her about the team’s issues inmanaging knowledgeIdentifying and participating in relevant networksacross the health community in order to make best useof all available information resources
Role of the Team Knowledge Officer: 2Has an enabling role in supporting excellence byimproving: awareness of the evidence access to the evidenceIdentifies relevant colleagues for liaison within andoutside the organisation, e.g. education and training library and knowledge services information departments other providers of knowledgeMaintains an awareness of relevant developments inhealth care e.g. within their speciality, within healthinformation / health informatics services
Role of the Team Knowledge Officer: 3‘Clinical team’ is not defined‘Nature of ‘Team Knowledge Officer’ role isunclear:Hill – a synonym for ‘clinical librarian’ – advocatedan expansion in the number of clinical librariansserving the needs of a limited range of specialtieswithin acute trustsNLH - an extra responsibility taken on by a clinicianwithin a teamWrangling within directorate!
Gorring et al.Four-month pilot project; librarian attended weeklyteam meetings in two community MH teams to helpgenerate clinical questionsSenior medical or nursing lead was present to facilitatediscussion and clinical question formulationA summary of the evidence on each topic waspresented the following weekEvaluation was conducted using a questionnairesurvey, focus groups and interviews
Gorring et al. – reported benefitsLibrarian – built up clinical expertise – clinical context providedimportant background informationConsultant psychiatrists – having an external person from adifferent professional background attending team meetings wasbeneficial – contributions from librarian were ‘unbiased,unemotional and informed’All clinicians – librarian input a useful training tool – ‘broadenedthe knowledge base’ – better understood ‘the librarian’s potentialrole in enhancing learning’Team member – broke down barriers to visiting and using thelibrarySubstance misuse team - improved ability to formulate clinicalquestions
Embedding the TKO roleWorking with each team to develop an agreed TeamKnowledge Officer role to be adopted by one or moreof the members under the direction of the appropriateclinical leadFour services participating:Durham CAMHSDurham AHPDurham LD (TBC)Clinical psychology research structure – Barry Speak
DeliverablesEnhanced information literacy amongclinicians within the participating servicesleading to:Better quality clinician information seekingA detailed specification for the role of TeamKnowledge Officer which could in principle bereplicated across other servicesProfessional publications giving an account ofthe project
BenefitsImproved skills in question formulation,information seeking and critical appraisal onthe part of cliniciansImproved awareness of information resourcesleading to:Improved clinical effectiveness, patient safetyand patient service qualityAn enhanced reputation for the trust forforward thinking as an early adopter of the TKOrole
Issues to considerEvaluation methodologies? – to be determinedInformation needs analyses – required in detailfor each participating serviceTie-in with Professor Joe Reilly’s work oncurrent awareness for the CEOPossible scenario = a network of TKOs acrossthe trust facilitating research awareness,supported by a (permanent) clinical librarian?