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

1. Embedding the Team Knowledge Officer role within clinical teams via a pilot clinical librarian service Catherine Ebenezer Durham CAMHS CPD meetingWest Park Hospital29/06/2011

2. Clinical librarian projects: 1 • Started 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

3. Clinical librarian projects: 2 • Extensive 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 PCT • Urquhart et al. (2007) – North Wales • **Gorring et al. (2010) – Birmingham & Solihull**

4. 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)

5. 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

6. Models of clinical librarian service • Question and answer servicerequests 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)

7. ‘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

8. 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)

9. 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)

10. Role of the Team Knowledge Officer: 1 • Supporting 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

11. Role of the Team Knowledge Officer: 2 • Has 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

12. 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!

13. 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

14. Gorring et al. – reported benefits • Librarian – 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

15. Embedding the TKO role • Working 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

16. Deliverables • Enhanced 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

17. Benefits • Improved 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

18. Issues to consider • Evaluation 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?

19. Questions??

20. Catherine EbenezerLibrary and Information Services Manager catherine.ebenezer@tewv.nhs.uk 01642 838112 07920 545634 www.netvibes.com/tewv-lis#Home