Embedding the Team Knowledge Officer role within clinical teams via a pilot clinical librarian service

Catherine Ebenezer

Durham CAMHS CPD meetingWest Park Hospital

29/06/2011

Clinical librarian projects: 1Started in USA 1971-

Integrate health sciences library services and literature searching expertise of health librarians into clinical settings

Overcome time, cost and expertise barriers to adoption of evidence-based practice

Enhance educational experience of students and junior doctors

Enable librarian to gain a better understanding of the patient care context of information needs

Clinical librarian projects: 2Extensive professional literature, including

several 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 definition

A clinical librarian seeks “ to provide quality-assured information to health professionals at the point of need to support 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 / critical

appraisal / clinical question answering Facilitating clinical guideline development Service promotion and outreach User education and training

Models of clinical librarian serviceQuestion and answer service

requests submitted to CL – literature search results provided to user

OutreachCL uses a range of means and methods of providing information to users – tries to engage them with library services

Question and answer service plus critical appraisalresponse to user’s enquiry contains a critically appraised summary of results

Outreach 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 England. London: DH

Important high-level recommendations re: Knowledge management within the NHS

NHS library and information services

Never officially endorsed by DH

Overtaken by ‘Darzi’- led to breakup of NLH

Impetus for many clinical librarian projects

Chief Knowledge Officer (CKO)Advocated originally by Muir Gray (1998)

“In every NHS organisation someone at board level should be entrusted with the role of Chief Knowledge Officer for that organisation.”

Role: to provide leadership and oversight to enable all NHS staff to access and apply the best available evidence in supporting every aspect of the clinical care of patients. (Recommendation 11)

Team Knowledge Officer (TKO)

“Every clinical or management team in the NHS should identify someone in the team as “Team Knowledge Officer” (or equivalent). The Team Knowledge Officer will have responsibility for ensuring the effective input of evidence to 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 generated evidence, research, information, and data

facilitating knowledge sharing

participating in horizon scanning by anticipating future service needs

Working in partnership with the Chief Knowledge Officer by informing him/her about the team’s issues in managing knowledge

Identifying and participating in relevant networks across the health community in order to make best use of all available information resources

Role of the Team Knowledge Officer: 2Has an enabling role in supporting excellence by

improving: awareness of the evidence access to the evidence

Identifies relevant colleagues for liaison within and outside the organisation, e.g.

education and training library and knowledge services information departments other providers of knowledge

Maintains an awareness of relevant developments in health care e.g. within their speciality, within health information / health informatics services

Role of the Team Knowledge Officer: 3‘Clinical team’ is not defined

‘Nature of ‘Team Knowledge Officer’ role is unclear:Hill – a synonym for ‘clinical librarian’ – advocated

an expansion in the number of clinical librarians serving the needs of a limited range of specialties within acute trusts

NLH - an extra responsibility taken on by a clinician within a team

Wrangling within directorate!

Gorring et al.Four-month pilot project; librarian attended weekly

team meetings in two community MH teams to help generate clinical questions

Senior medical or nursing lead was present to facilitate discussion and clinical question formulation

A summary of the evidence on each topic was presented the following week

Evaluation was conducted using a questionnaire survey, focus groups and interviews

Gorring et al. – reported benefitsLibrarian – built up clinical expertise – clinical context provided

important background information

Consultant psychiatrists – having an external person from a different professional background attending team meetings was beneficial – contributions from librarian were ‘unbiased, unemotional and informed’

All clinicians – librarian input a useful training tool – ‘broadened the knowledge base’ – better understood ‘the librarian’s potential role in enhancing learning’

Team member – broke down barriers to visiting and using the library

Substance misuse team - improved ability to formulate clinical questions

Embedding the TKO roleWorking with each team to develop an agreed Team

Knowledge Officer role to be adopted by one or more of the members under the direction of the appropriate clinical lead

Four services participating:Durham CAMHS

Durham AHP

Durham LD (TBC)

Clinical psychology research structure – Barry Speak

DeliverablesEnhanced information literacy among

clinicians within the participating services

leading to:

Better quality clinician information seeking

A detailed specification for the role of Team Knowledge Officer which could in principle be replicated across other services

Professional publications giving an account of the project

BenefitsImproved skills in question formulation,

information seeking and critical appraisal on the part of clinicians

Improved awareness of information resources

leading to:

Improved clinical effectiveness, patient safety and patient service quality

An enhanced reputation for the trust for forward thinking as an early adopter of the TKO role

Issues to considerEvaluation methodologies? – to be determined

Information needs analyses – required in detail for each participating service

Tie-in with Professor Joe Reilly’s work on current awareness for the CEO

Possible scenario = a network of TKOs across the trust facilitating research awareness, supported by a (permanent) clinical librarian?

Questions??

Catherine EbenezerLibrary and Information Services Manager

catherine.ebenezer@tewv.nhs.uk

01642 838112

07920 545634

www.netvibes.com/tewv-lis#Home