HLG conference Anne Gray Commissioning Librarian July 2010
17
health:mk The role of the Commissioning Librarian Anne Gray BSc, PGDipLib, MCLIP NHS Milton Keynes Presentation at HLG Conference 20 July 2010
-
Upload
anne-gray -
Category
Health & Medicine
-
view
424 -
download
3
description
How library services can support healthcare commissioning in the NHS.
Transcript of HLG conference Anne Gray Commissioning Librarian July 2010
health:mk
The role of the Commissioning Librarian
Anne Gray BSc, PGDipLib, MCLIP
NHS Milton KeynesPresentation at HLG Conference 20 July 2010
health:mk 2
The White Paper
•
The NHS will be held to account against clinically credible and evidence‐based
outcome measures(1.6) •
The Department is committed to evidence‐
based policy‐making and a culture of evaluation and learning (1.23)
•
NHS will, wherever possible, use clinically credible and evidence‐based measures (3.4)
(Equity and excellence: liberating the NHS, DOH, 2010)
Presenter
Presentation Notes
They still need evidence – data (information) and research, and best practice
health:mk 3
NHS Milton Keynes Quality Improvement model
► Primary care led
‐
clinical leadership and engagement in strategic planning, pathway
review and commissioning
► Evidence‐based care and evidence‐based commissioning
► Patient centred
‐
public and patient engagement and interaction
health:mk 4
NHS Milton Keynes model How are librarians involved?
Evidence based care:
•
IMPACTE groupsImproving Medical Practice by Assessing Current
Evidence
Evidence based commissioning:
•
Supporting commissioners
Presenter
Presentation Notes
IMPACTE – helping GPs to improve their practice and that of their teams,
health:mk 5
IMPACTE model
•
follow through questions raised in routine primary care practice and look at the evidence
to answer these
•
use evidence to close the gaps between current ways of working and best practice
•
make the evidence accessible
“journal clubs”
health:mk 6
IMPACTE ‐ What’s in a name?
Journal Clubs
Evidence Based Discussion Groups
Improving Medical Practice Through CurrenT Evidence IMPACTE
Scary!A
mouthful
Presenter
Presentation Notes
Important not to scare clinicians. Journal club brought back memories of critical appraisal and horrible stats. Needed to bring the evidence to them in the most manageable format.
health:mk 7
What are IMPACTE groups?•
Primary care
team initiative
•
Build consensus to support changes across a whole team / system
•
Questions raised in routine clinical practice •
Track down the best evidence
•
What does the evidence tell us? •
So what?
•
Establish a sustainable action plan•
Audit changes and followup
Presenter
Presentation Notes
Part of a whole system improvement process Started as journal clubs Primary care team initiative – GP practices, AHPs, any other clinical team Supporting clinicians to make evidence based changes – based on their day to day experience - Examination of relevant research evidence – high quality research Build consensus to support changes across a whole team – GPs very much lone workers, forum for discussion and consensus Sustainable changes – embed into system Audit changes and followup – follow through questions raised in routine clinical practice and to look at the evidence to answer these use evidence close the gaps between current ways of working and best practice Identify a specific topic and formulate an answerable question. Track down the best evidence. The evidence can include an article or review critically appraised by the group Map of Medicine pathway NICE guidance Apply the evidence Establish an action plan Implement and Audit Review action plan
health:mk 8
Understanding the research evidence
Centre for Evidence Based Medicine approach–
PICO ‐
is the article relevant to the team?
–
Was the research well done? (critical appraisal)
–
What can we learn from the results?
–
Are there any actions we could take to improve our practice?
–
Action plan
health:mk 9
Light touch statistics
•
Learn to read the results tables
•
Basic understanding of statistics eg
p value, NNT, OR, funnel plot
•
Further statistical concepts (hopefully) explained by session lead or librarian
•
NOT an in depth critical appraisal session
health:mk 10
IMPACTE group model•
Relaxed, informal sessions
•
Regular
•
Topics of general interest with possible practical outcome
•
Use “best”
evidence eg
EBM journal selections, NICE guidelines, Map of Medicine, “experts”
•
Follow up actions and report back
•
Pragmatic
health:mk 11
IMPACTE group membershipGroup organiser
Session lead who has prepared a specific paper
Health professionals eg
GPs, nurses, pharmacists, AHPs, practice manager
Librarian
Find the evidence / support understanding eg statistics / write up / prompt for actions and follow up
**Every group is different**
Presenter
Presentation Notes
Role of the librarian varied in each group, but they were always a stimulus to maintain the momentum. Often find the evidence
health:mk 12
Quality MK website•
Records of all discussions and analysis by topic
•
IMPACTE toolkit : including–
Hints and Tips on setting up an IMPACTE group
–
Where to find high quality evidence
–
Attendance list
–
Summary template
–
Attendance certificate/reflection
•
Evaluationwww.qualitymk.nhs.uk/impacte_groups.htm
Presenter
Presentation Notes
IMPACTE toolkit www.qualitymk.nhs.uk/impacte_tookit.htm Evaluation - http://www.qualitymk.nhs.uk/default-ContentID-3011.htm
health:mk 13
Where next?•
New groups across Milton Keynes‐
for patients & public ‐
in other General Practices
‐
online forum ‐
in other clinical teams
•
Continued funding to develop the model further•
Dissemination of the model–
To clinical staff
–
To librarians–
Paper by Prof Paul Glasziou to be published soon
–
Available to all on the website
health:mk 14
Commissioning Librarian
a personal story •
Commissioners are not aware of support and
resources available•
Commissioning Librarian involvment‐
Service design groups ‐
Strategic boards ‐
Team
meetings ‐
Talk to people•
Give people the information they need‐
Push and Pull
•
Don’t wait till people ask but be aware of email overload
Presenter
Presentation Notes
What can I bring to the table?
health:mk 15
What do commissioners need?
•
Best practice –
guidelines, service specifications, case studies
•
How to run a clinical service –
location, processes, workforce, competencies
•
Monitoring–
performance, outcomes, audit
•
How much does it cost?–
health economics, cost benefit, prioritisation
•
Tools –
NICE, DoH, public health
health:mk 16
Knowledge Zone www.qualitymk.nhs.uk/knowledge_zone.htm
–
Structure mirrors internal organisation
–
Dynamic resource, constantly updated
–
Links to existing resources
•
“Where to find …”
•
“Keeping up to date”
•
“Commissioning Librarian”
•
“Local library sources”
