The role of the Commissioning Librarian Anne Gray BSc, PGDip. Lib, MCLIP NHS Milton Keynes Presentation at HLG Conference 20 July 2010 health: mk
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 evidencebased 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) health: mk 2
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 3
NHS Milton Keynes model How are librarians involved? Evidence based care: • IMPACTE groups Improving Medical Practice by Assessing Current Evidence based commissioning: • Supporting commissioners health: mk 4
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 5
IMPACTE - What’s in a name? A mouthful Journal Clubs Scary! Evidence Based Discussion Groups Improving Medical Practice Through Curren. T Evidence IMPACTE health: mk 6
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 health: mk 7
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 8
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 9
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 10
IMPACTE group membership Group 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** health: mk 11
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 • Evaluation www. qualitymk. nhs. uk/impacte_groups. htm health: mk 12
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 13
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 health: mk 14
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, Do. H, public health: mk 15
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” health: mk 16
www. qualitymk. nhs. uk/knowledge_zone. htm health: mk 17
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