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Spreading journal clubs across primary care The Quality: MK experience LfN 28 November 2008

Spreading journal clubs across primary care The Quality: MK experience LfN 28 November 2008. Anne Gray Outreach Librarian, MK PCT. 1. Milton Keynes. Unitary authority Relatively small geographic footprint One general hospital One PCT (Commissioning and Provider arms)

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Spreading journal clubs across primary care The Quality: MK experience LfN 28 November 2008

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  1. Spreading journal clubs across primary care The Quality: MK experienceLfN 28 November 2008 Anne Gray Outreach Librarian, MK PCT 1

  2. Milton Keynes • Unitary authority • Relatively small geographic footprint • One general hospital • One PCT (Commissioning and Provider arms) • 28 General practices, all with a number of GPs and nursing staff

  3. Quality: MK programme “A whole system approach to improving health care in Milton Keynes driven by primary care, patient engagement and evidence-based practice.”

  4. Quality:MKprogramme

  5. Introducing Journal Clubs • Held in 4 GP practices • First meeting led by GP from Centre Evidence Based Medicine (CEBM), Oxford University • Rapid critical appraisal methodology examining published controlled trials • Written record of meeting to document appraisal, discussion, clinical impact • Discussion around next meeting Aim to use the evidence to improve patient care (not education)

  6. PCT/ health:mk Patients Clinicians Questions Specific answerable question Track down best evidence Critically appraised articles NICE guidelines Map of Medicine pathways Expert opinion Review action plans Evidence based clinical discussion cycle Evidence based discussion groups Implement & audit Action plan Apply the evidence

  7. “Track down best evidence” Quality:MK • Primary literature (RCT) • Evidence synopses (Evidence Based Medicine journal or OTSeeker) • Secondary literature (Cochrane review) • NICE guidance • Map of Medicine • Expert opinion Journal clubs  Evidence based discussion groups

  8. Evidence based discussion groups • So what – what are the implications of the evidence? • Different forms of evidence add variety and maintain interest

  9. The Librarian’s role Quality:MK Searches to find a suitable publication Get the articles and distribute them Prepare ourselves by reading the articles Participate in the meeting in the practice Guide the discussions Write up a draft report of the meeting Check actions carried out Be in touch with the feelings of the group Cajole and persuade to maintain momentum

  10. Toolkit Quality:MK 10 Journal club Leaflet Core resources for evidence based medicine Critically appraised topic templates Search request forms Search result forms Attendance record 20/5/2008 Taunton

  11. Critically Appraised Topics (CATs) • Record of the meeting • Bibliographic details • Study methodology • Brief study appraisal • Results • Record of discussion, clinical impact • Follow up actions (if any) • Drafted by librarian, signed off by clinician

  12. EBDGs across MK 4 journal clubs in April 2007 As of November 2008 • 5 GPs • Public health staff • 4 provider teams (OT, Learning disabilities, CAMH, diabetes specialist nurses) • GP VTS trainees

  13. Successes so far Quality:MK 13 Clarification of procedures / protocols within and across practices Highlighting differences in prescribing practice within surgery and move towards consistency Increase in knowledge Changes in practice Audits of drug use

  14. Questions? 14 • For further information contact • Anne Gray, Outreach Librarian, MKPCT • Outreach.librarian@mkpct.nhs.uk Quality: MK website http://www.miltonkeynes.nhs.uk/default.asp?ContentID=1359

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