Our theme this year is Health Education in Transition at a time when both medical/health education, and the NHS, and indeed the wider landscape of health and social care in the UK, is in a state of change.
Concept of Evolution - Develop gradually, esp. from a simple to a more complex formDevelop over successive generations, esp. as a result of natural selection.
Already a much changed environment since I headed into academic libraries as a young graduateStarted out here in the Current Periodicals Room at Birmingham UniversityAnd then after completing “Library school” went onto my first professional post at Newcastle Poly; where I worked on a User Education project funded by the BL, known as The Travelling Workshops Experiment
Dir Corporate affairs and partnershipsMK: a young, AND an ageing AND a growing population
Effectively flat real terms funding for the next four years; against backdrop of wider economic recessionThe rich world is ageing; more people living longer - at 2030 22% of the people on the planet 65+; Elderly people who are chronically unwell rather than seriously ill can be maintained with nursing rather than medical care in their own homes. Never let a good crisis go to wasteTake the opportunity to do things you think you could not do beforeThe Burning Platform – explosion the Piper Alpha oil-drilling platform in the North Sea in 1988One of the survivors,a superintendent on the rig, jumped 15 stories from the platform to the water – where he knew he could only survive for 20 mins. Why? “It was either jump or fry.” He chose possible death over certain death; the price of staying on the platform was too high.
Demand continues to rise, especially for unplanned and emergency care; rise in levels of chronic conditions and obesityWith 4 hospitals within 30 mins driving distance, - we might expect to see some reconfiguration of health services to offer patients the very best specialist care where availableBetter drugs and improved surgical techniques, along with the advent of day surgery, have meant good after-care, rather than medical intervention, is what increasingly determines a full recoveryA whole year's care by a GP costs about one tenth of a day in hospital. Dealing with the duplication and fragmentation that occurs in care that crosses provider and budgetary boundariesUsing data to illuminate unexplained / inappropriate variation to drive up quality.
The status quo is not an optionInnovation not necessarily invention
Health is a knowledge-based industry Innovation Health and Wealth, p.9
So this is the challenge for us today –
Carl-Ardy Dubois and Debbie Singh. From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management. Human Resources for Health 2009, 7:87 http://www.human-resources-health.com/content/7/1/87
Healthcare is a knowledge based industry;Harsh financial climate
Where can knowledge have the most impact?How can we improve business performance by building know-how?How can we share and spread good practice & embed lessons learned?What do we need in the way of information products and services?
Developing as a high performing organisationand alongside enabling our day to day business, my role is fundamentally about transformation and supporting system reformInnovation, Knowledge Management, Quality ImprovementBuilding organisational delivery capability; staff and leadership developmentForming successful partnerships, member practice engagement,public & patient involvement Infrastructure planning, management and development – commissioning support arrangements; PH MoU; IT system integration; using estates V small directorate; maybe 40-45% of our management costs fund an SLA with GEM as our commissioning support organisation; hold the ring on the service specifications and contract managementMatrix organisation – currently also Exec lead for Commissioning urgent care
BETTER METRICS - Enable systematic challenge of variation –more proactive analytical service (more strategic use of data); Clinical analytics – inc risk stratification
And where can Where can knowledge have the most impact?
Supported by a primary care librarian working in member practices Started in 2007; really about growing clinical involvement & support for innovation at practice level; Challenge is to share & spread
How can CKOs build the Know-How to improve business performance, reduce costs and improve quality?
Whole system approach to service review and pathway developmentEXPLICIT BUSINESS PROCESSES for commissioning & contracting
How can we share and spread good practice and embed lessons learned?How can the CKO build a culture receptive to evidence-based practice, knowledge exchange and learning?Core skills; accessible resourcesBUILDING CAPABILITYPersonal & corporate effectiveness. Learning & networking
Platform for Change: The Educational Policy Statement of the Medical Library Association, The Medical Library Association, 1992http://www.mlanet.org/education/platform/
One of the core areas of knowledge described in the Platform is the health sciences environmentNew kinds of doctor, new kinds of health professionals To help equip new professionals to step onto the burning platform- Do you forsee a shift of budget from libraries to fund free to net publication by researchers?
Platform for Change: The Educational Policy Statement of the Medical Library Association, The Medical Library Association, 1992http://www.mlanet.org/education/platform/One of the core areas of knowledge described in the Platform is the health sciences environment
In the struggle for survival, the fittest win out at the expense of their rivals because they succeed in adapting themselves best to their environmentIt is the expertise of health and medical librarians that can make a difference
The evolving librarian - health and medical librarians in a changing environment
The evolving librarian –health and medical librarians in a changing environment Sue Lacey Bryant Health Education in TransitionUHMLG Spring Forum, 4th Feb 2013
The Evolving Librarian Source: A visualização da imagem anterior desperta para a leitura do artigo: "Evolving Web, evolving librarian" de Amy and Robert Favini balcaodebiblioteca.blogspot.com
1. Introduction2. A burning platform for change3. The pressing need for innovation4. Positioning librarians as catalysts for change5. Bringing knowledge to bear6. The library as a platform for change
Fire fightingThe practice of dealing with problems as they arise rather than planning strategically to avoid them
Omphaloskepsis The contemplation of ones navel which is an idiom usually meaning complacent self-absorption
A burning platform for change • Harsh financial climate • Ageing population • £20 billion of efficiency savings required within NHS by 2015
National priorities•Stemming the increase in emergencyadmissions• Service reconfiguration; making the shift fromhospital to community care; seamless care• Addressing inappropriate variations in clinicalpractice; clinical safety and quality
A pressing need for innovation “We need to radically transform the way we deliver services. Innovation is the only way we can meet these challenges”“Put simply, we must make innovation a priority.We know that the NHS can spread new ideas atpace and scale when it puts its mind to it, and weneed to do more of this.”
Copying is good“ Innovation ... needs to be replicable – and replicated – across similar settings. So innovation is as much about applying an idea, service or product in a new context, or in a new organisation, as it is about creating something entirely new. Copying is good.”
Positioning librarians in the workplace as catalysts for improvement• Aligning with NHS priorities• Multidisciplinary working• Changing skill mix• Role substitution• Role enlargement• Role enhancement
Enhancing the role of librariansRole enhancement involves expanding a group of workers skills so they can assume a wider and higher range of responsibilities through innovative and non-traditional roles
Bringing knowledge to bear in a cold climate: an ABC
A practical approach to ‘KM’• Applying knowledge• Building know-how• Continuing to learn
A = Applying knowledgearound the commissioning cycle
Milton Keynes CCG...• CCG is responsible for £268 million• CCG must be innovative and effective if we are to produce better services whilst reducing the increasing cost of healthcare
Director of Corporate Affairs & Partnerships Corporate Affairs PA Team Administrator Organisational & Infrastructure & Comms andKnowledge Officer Workforce Commissioning Engagement Manager Development Manager Support Lead Project Manager
The intelligent commissionerKnowledge service Business intelligence• Searches - • Monitor, analyse, interpret,• clinical & cost effectiveness report on best practice”; models of cost, activity, outcomes, qua service lity ref contract• Horizon scanning; alerting• Website • Clinical analytics• Disseminate best evidence • Public health intelligence
Role of Knowledge OfficerRole of KO • Lead website steering• Search & summarise info: group – models of service • Commissioning Manual – clinical effectiveness • Innovation action plan – Clinical effectiveness • Promote R&D• Support pathway review • In house: CCG Telephone and service redesign as a directory; Desk pack member of the team • Ensure access• Profile knowledge needs • Information skills &• Targeted and tailored resources Knowledge@lerts
Improving MedicalPractice by AssessingCurrenT Evidence
Understanding the environment• The context in which health & medical information is needed, managers reach decisions about models of care, patients are asked to enter into shared decision-making• Changing healthcare environment: policy, economic, legal issues, education & training patterns, workforce• Changing information environment: virtual learning environments, social networking, the creative cloud, open access access scientific publishing
Preparing for today and tomorrow• Health sciences librarians must prepare to meet the needs of todays and tomorrows health sciences environment• Multi-disciplinary, life-long learning - to serve the needs of health providers and consumersSee Platform for Change, MLA, 1992