CILIP Cymru Wales Conference 2019: Mobilisation & Swansea Bay UHB Libraries
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Rhys Whelan's presentation Improving health literacy levels can enhance treatment outcomes, save time and cut costs. At NELFT, we are undertaking a pilot project to improve the health literacy of staff, patients and the wider communities we serve. We have partnered with local libraries and the Reading Agency to run high-street health information drop-ins. These events raise awareness of the evidence-based Reading Well book collections and signpost members of the public to accessible, peer-reviewed digital resources like the NHS app and the NHS ‘Behind the Headlines’ health news analysis. Future aims of the project include a health literacy e-learning module and reflective workshops.
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CILIP Cymru Wales Conference 2019: Mobilisation & Swansea Bay UHB Libraries
- 1. Mobilisation & Swansea Bay UHB Libraries Rhys Whelan, Librarian @SwanBayUHBLibs @Sbmobileworking
- 2. 1. Swansea Bay UHB 2. Swansea Bay UHB Libraries 3. The Mobilisation Project 4. Library Support for Mobilisation - Information Skills Training - Library Service Website/ App 5. Statistics and feedback 6. Promotional video
- 3. Swansea Bay University Health Board • Formerly ABMU prior to recent boundary change • Approx. 16,000 members of staff • Increasing commitment toward community based care- ABMU Clinical Strategy: ‘We will commit a greater proportion of our resources to delivering care outside hospitals, near or in peoples own homes’. • Part of a wider strategy across the NHS
- 4. Swansea Bay UHB Libraries • Libraries based at main hospital sites Cefn Coed, Neath Port Talbot, Morriston & Singleton • Multidisciplinary service • Small team • Services include: literature searching, current awareness, information skills training • COIN Guidelines
- 5. Swansea Bay UHB Libraries Challenges: 1. Engaging with community and nursing staff 2. Information Skills Training Recent Developments 1. Clinical Librarian 2. Investment in NHS Wales E Library resources by Welsh Government
- 6. The Mobilisation Project • 2015 SBUHB secured £2.5m from the Welsh Government through the ‘Efficiency through Technology Fund’ for the Mobilisation Project. • Mobile working allows any member of staff to connect and access the information they need from anywhere, whether using a health board device or a personally owned phone or tablet. • In 2015- 3000 staff reported that they did not have access to a dedicated computer. - 5000 staff reported that they had no access at all. • There are currently 5000 devices using the service. Over 2000 Ipads have been provided to staff working within the community.
- 7. Benefits of Mobilisation • Staff are able to access the information they need and digital resources from anywhere to help with their working day. • Community teams are adopting mobile solutions to manage their caseload and appointments. • Access to the Welsh Clinical Portal, has allowed access to patient demographics, blood results, and GP record summary.
- 8. How it works • Secure access is provided via Mobile Iron App • Email & Calendar • Docs @ Work • Web @ Work • Apps @ Work
- 9. Future of the Project Strategic enabler for agile working and adoption of high profile national programmes including: • Welsh Community Care Information System (WCCIS) • Welsh Hospital Electronic Prescribing and Medicines Administration (WHEPMA) • Microsoft Office 365
- 10. Library Service support for Mobilisation 1. Training- Provided workshops ‘Access to evidence on a mobile device’. - Ipad induction sessions. 2. Library Service website/ app- IT made the library service website available as an app available through Apps @ Work.
- 11. Information Skills Training • 7 multidisciplinary workshops held across all Libraries • BYOD or Ipads provided • Electronic books & Journals- ClinicalKey • Point of Care tools- Uptodate & BMJ Best Practice • Drug information- BNF & Micromedex
- 12. Library Service Website/ App • Online Registration • Request literature searches • Search library catalogue • Information regarding training sessions
- 13. Project Groups • Digital Champions Group- Community based staff from across a range of teams. Feedback on any issues related to mobile working. • Mobile Solutions Group- Information Governance, patient experience, IT, service leads. Review apps requested with IT portal. • Operational Group- Made up of service leads.
- 14. Statistics App Devices installed on BNF 1036 COIN 977 Library Service App 406 BMJ Best Practice 100 ClinicalKey 89 Micromedex 25 *Figures correct as of 02/05/2019
- 15. Video
- 16. Any Questions?
- 17. References ABMU (2019) ABMU Clinical Strategy, Available at: http://howis.wales.nhs.uk/sites3/documentmap. (Accessed: 01/05/2019). Chambers, R. (2018). Making digital healthcare happen in practice : a practical handbook, Bristol, United Kingdom : Otmoor Publishing. HEE (2019) The Topol Review, Available at: https://www.hee.nhs.uk/our-work/topol-review (Accessed: 01/05/2019). NICE (2019) Evidence standards framework for digital health technologies, Available at: https://www.nice.org.uk/about/what-we-do/our-programmes/evidence-standards-framework-for- digital-health-technologies (Accessed: 01/05/2019). Verkerk, M. M. and D. J. B. Bargiela (2013). "How to appraise medical apps: a guideline based framework." 347: f6286.
Editor's Notes
- Good Afternoon everyone. My name is Rhys Whelan I’m the Librarian for Morriston Hospital in Swansea. I’m following on a similar theme from Catherine’s excellent presentation regarding access to health information. But rather than talking about access to patient information my talk is going to be more focused around access to information for clinicians. I’ll go into more detail about the mobilisation project in a second but its essentially a scheme that’s involved mobile devices being handed out to staff within Swansea Bay Health Board and the purchase of software that has enabled staff to access secure information such patient records, emails and calendar appointments on a mobile device. If you know anyone who’s worked in the NHS and you ask them about IT they’ll probably tell you that it can be pretty restrictive at times with firewalls and hundreds of passwords. But obviously IT have an important job to do in terms of protecting confidential information and if you like at the example of the ‘WannaCry’ cyber attack in England last year this protection is warranted. But essentially it means that for most staff working in the NHS to access emails and patient information they have to log in to an NHS networked computer or laptop and that’s if they are lucky enough to have access to one in the first place.
- I’ll start by giving you a bit of background about Swansea Bay Health Board and some of its aims and the aims of the NHS in general. Sorry if you work in health care you’ll be well aware of much of this but I’m conscious that there maybe those in the audience who don’t. I’ll say something about the library service in Swansea Bay UHB services we offer and some developments that had taken place within the service and within health libraries in general that really enabled us to tie in with mobilisation. Of course I’ll talk about the project itself and give you some examples of the benefits that it has brought to staff within the Health Board. I’ll move on then to talk about the support the library service has been able to provide for mobilisation and that’s been through information skills training. IT early on in the project kindly made our website available as an app that can be downloaded on health board devices. Our It department are able to give us figures for how many times library service app and the other resources that we promote are actually downloaded on to health board devices so that’s useful so I’ll share that you. Finally, hopefully I wont ramble too much and I’ll be able to show you a video that’s been made to promote the project. Its brand new not many people have seen it yet and nicely summarises the project.
- So I say Swansea University Health Board but until very recently we were Abertawe Bro Morgannwg covering Swansea, Neath Port Talbot and Bridgend. We now cover Swansea and Neath Port Talbot So when the project started back in 2015 there were around 16,000 staff working within the Health Board. I know you’ll all be very much aware of the increasing pressures on the NHS with widening health inequalities and people living for longer and the demand that places of services. Swansea Bay is obviously no different. One of the key strategies to tackling this at the moment is an increased commitment to delivering care outside of hospitals and out in the community. Part of ABMU’s clinical strategy to ‘commit a greater proportion of our resources to delivering care outside hospitals near or in peoples own homes’. This is very much part of a wider strategy across the NHS
- We have libraries based on each of the main hospital sites Cefn Coed, Neath Port Talbot, Morriston, Singleton and until recently Princess of Wales as well. We’re a multidisciplinary service so we’re for everybody we provide a service to all staff and students within the Health Board. There was a time when most health libraries in Wales were called medical libraries and were considered to be just for doctors. But that was a long time ago and health librarians across Wales have done a heck of a lot to move away from that. We’re a small team in comparison with the size of the organisation 5 WTE equivalent Librarians and 6 support staff. Some of you may not be know if you’re not familiar with health libraries we provide a literature searching service. When you consider how time pressed clinicians and we offer to save them time finding evidence regarding whatever topic or treatment they are interested in their pretty grateful for this. Also current awareness so we’ll send them updates whenever new research is published in their field of interest. And we’ll provide the information skills training sessions how to search the various biomedical databases. We’re responsible for administering the Health Boards clinical guidelines. COIN is the clinical online information network. So this is a repository of the health boards guidelines. At last count there are just under 3000 documents on there.
- Some perceived challenges we feel we face particularly in light of what I said earlier about plan to move care into the community. The fact that our libraries are based within hospitals means that we’ve had trouble engaging with staff based in the community or in primary care because they aren’t able to come into the physical space of the library so we might find that they didn’t know that we exist. Anyone who’s had anything to do with trying to arranging formal information skills training for clinicians will tell you its really difficult because often when advertise it on the intranet you may get a good number of people booking on initially but then when the day comes again due to time pressures and constraints people pull out because they can’t get off the ward. So the majority of the training we provide is on an ad hoc basis. If you consider the Topol Review published at the beginning of the year which set out to look at how to prepare the future workforce for digital innovations the role of knowledge specialists was highlighted to accelerate the adoption of digital innovations. Some recent important developments which have certainly helped us to engage with mobilisation. Our clinical librarian service so we employed our wonderful clinical librarian back in the Spring 2017 and a big part of her role is rather than waiting for clinicians to come into the library and ask us to help them find evidence we can be a bit more proactive and have a clinical librarian who can go out and attend departmental meetings, audits, journal clubs whatever and be on hand to provide the evidence at point of need. Another major development that’s impacted us recently is the significant investment in e resources for NHS staff by the Welsh Assembly Government. Back in October of last year Vaugh Gething announced that the welsh government would be investing a significant amount of money to increase the range of electronic information resources available to NHS Wales staff. So over 1500 electronic journals have been made available through the NHS Wales E Library. So this is major development and something all staff could access so it was something we wanted to go out and promote.
- So that a bit of an overview of the library service. The mobilisation project itself began back in 2015 when the HB secured funding 2.5 million funding from the Welsh Government through the efficiency through technology fund for the project. The aim was that through mobile working any member of staff would be able to connect and access the information they need from anywhere using a health board device or a personally owned tabled. In 2015 3000 staff reported that they did not have access to a dedicated computer 5000 staff reported they had no access at all Today There are currently 5000 devices using the service. Over 2000 Ipads have been provided to staff working within the community.
- Key benefit is that staff are able to access the information they need to help with their work- So for community teams it means they are able to make notes on patient records and have them stored securely. So this saves them having to return to base and means they are able to see more patients. Access to clinical systems the Welsh Clinical Portal, has allowed access to patient demographics, blood results, and GP record summary.
- How it actually works on your device is that you will download several apps to your device which have different features so the mobile Iron app provides the secure access. You then have an app for your emails and calendar, one for your documents and one to access the intranet. We also have apps @ work which is growing all the time this is an apps library which contains a wide variety of different apps which have been requested by health board staff.
- So this is happening on a local level but is very much part a broader national strategy sounds very grand its part of a strategic enabler for agile working and the adoption of high profile national programmes. Welsh Community Care System which is being rolled out soon as of course staff will then be able to access this on their Ipads.
- So I know I’m talking to librarians so the connection between library and mobilisation would have been very obvious to you as soon as you hear the project is all about connecting staff to information. As librarians we’re all nodding and thinking that’s a coincidence we’re about connecting people to information too. But that’s not always obvious to everyone in fairness the project officer Richard Brown who hasn’t been mentioned up to now was really good. He came out to the libraries at an early stage and we showed him electronic resources that were available and said we could help with training and showing staff how to access these and we have a website and staff can request literature searches through this and that’s all he needed to know. The project were handing out Ipads to staff on a regular basis to community teams they would come into the hospital and be given their new Ipads and they’d be given a training session on how to use them a large number of these hadn’t used an Ipad before and the library would have a slot during those induction sessions to show staff how to access library resources The mobilisation team made our website available as an app only available via the apps @ work platform. So community staff and any other member of staff could request literature searches through that or register to join the library.
- To date we’ve provided 7 workshops across all sites. BYOD or Ipads have been provided. The majority of session would be the clinicians actually using our e resources and then getting the feedback about what was useful for them and what wasn’t. So we get them to use ClinicalKey which contains hundreds of e books and journals Point of care tools that provide evidence based overviews of a range of treatments and conditions And drug information apps like the BNF and Micromedex which provide access to drug monographs and have drug interaction calculators where a clinician can see if certain drug combinations have any potential adverse effects.
- The mobilisation team kindly made our website available as an app on the apps @ work platform. But essentially its just our website but we have these icons on the homepage so it works well with an tablet or phone. Really a lucky coincidence that we had spent a bit of time streamlining the website and making it so that users could fill in an online request to join and request literature searches via the website. We’re quite restricted with what we can do as its an NHS website built with cascade. So it doesn’t look the prettiest but it works and it does what we need it to do. So through the app users can register to join the library, request literature searches, search the library catalogue and find information regarding training.
- We also have librarians involved with various groups that have been set up around the project: the operational group was strategic and made up of the service leads and they would ultimately sign off on apps that had been requested by staff to be added to the apps @ work platform. There’s a mobile solutions group and this is really in the early stages and probably going to require the most work still working on terms of reference for this but its there to test the apps that are being requested by staff. There’s a digital champions group which was really the most crucial because it was made up of the people the project was there to support. Made up of community based staff who were to be advocates for the project and would be able to feedback any problems their team might be experiencing.
- Very useful that IT can now actually provide us with figures as to how many times apps have been downloaded on health board devices. So bear in mind these figures are just for health board devices we don’t have information about how many times apps have been downloaded onto personally owned devices. So we can see by some way the BNF is the most popular apps of the resources we promote. Our local guidelines repository COIN has also been made available as an app on apps @ work- In the video I’m about to show you one of our trainees Hannah actually mentions COIN specifically. Library Service App has been downloaded 406 times which is good to see as well.
- So I’ll play the brand new video that’s been made to promote the project. Covers some of the things I’ve already said but you get the perspectives of the clinicians themselves.
- Any questions.