Tag Archives: research

NHS Health Care Libraries Supporting Research by Matt Holland and Victoria Treadway

Research is firmly embedded in the NHS Mandate 2017 – 2018 (see Objective 8 “To support research, innovation and growth”). It probably didn’t need a directive to point out the importance of research to patients and patient care. Research is also core business for NHS libraries. This is a reflection on how we can make research a distinctive part of our service offering. It’s based on personal experience and best practice using the tried and tested ‘n things’ model.

  1. Go to the Research Committee It’s a safe bet that no one ends their career wishing they had gone to more meetings. However, in something as diverse as research in a large organisation the Research Committee can be the best place to get an overview of current and new research activity. If you are not on the committee as a member, you could ask to be an observer or to be circulated the minutes.
  2. Collaborate with your Research Department If you can make friends with your nearby Research Department team there are opportunities to collaborate on events or projects to make life a little easier (and fun?) for your organisation’s researchers. Mid Cheshire are planning a Research Expo for June and Wirral are coordinating a Randomsied Chocolate Trial to celebrate this year’s International Clinical Trials Day (May 19).
  3. Host your organization’s publications database Creating a database exists at on a continuum starting with a quick and dirty solution using freemium reference software (Zotero / Mendeley) and ends with Institutional Repository. The library is the natural home for this project. It also contributes to Knowledge Management objective viz, connecting with corporate knowledge, mapping knowledge assets; collating and enabling shared access to directories; policies, guidance and protocols. Knowledge about the usefulness of a database or Institutional Repository will vary so it may just be a case of carpe diem or getting on with it.
  4. Be the source of information about the research landscape Make the library the centre for information about research methods, academic writing, training courses, support for research, regional and national organisations, newsletters, research information on social media. You could add this into your social media, current awareness mix or set up a separate space for researchers. (See NWAS LKS Case Study on using Yammer).
  5. Be the publications expert for your trust Publication isn’t as easy as it was. There are choices and decisions to be made. Choosing Open Access (Green/Gold), avoiding predatory publishers, fulfilling funding requirements, funding Article Publication Fees (APCs), navigating journal rankings, choosing appropriate journals, copyright, promoting your research and more. Being the expert and the place to go for information for help adds real value, especially for early career researchers.
  6. Offer researchers a bespoke service Clearly all our users are at heart researchers from the humble diploma to post doctoral students. Even if it doesn’t change the service you offer badging part of your service as for researchers can make promoting the library to the research community easier and give you a seat at the research table. This also fits with LQAF 5.3i Library/knowledge service staff support the research activities of the organisation[s] served.
  7. Develop your research skills Nothing helps you to understand the viewpoint of a researcher better than being one yourself. Opportunities for librarians to get involved in research are out there, and may vary from co-authoring a systematic review to getting to grips with qualitative research methodology (as did a bunch of clinical librarians from the NW not long ago).

Matt Holland, NWAS LKS and Victoria Treadway, Wirral University Teaching Hospital NHS Foundation Trust. NWAS LKS is supported by HCLU North.

Clinical librarians really make a difference!

Alison Brettle, Reader in Evidence Based Practice, University of Salford a.brettle@salford.ac.uk
@Brettleali

One of the proudest moments for me professionally this month was the publication of a study which demonstrates the impact of clinical librarians in the North West.  The paper has been a long time coming so it was very exciting to see it finally in print (or should that be online!).  The paper (Brettle, Maden and Payne, 2016) was the result of a number of years work and collaboration between clinical librarians working in the North West and myself.

The project really began in 2009, when I returned from the EBLIP4 conference in North Carolina. As LIHNN had kindly sponsored my conference fees I wrote an article in LIHNNK Up about the conference, expressing some frustration about the lack of evidence within our profession. My practical way forward was to suggest librarians conducted systematic reviews so we would know what evidence there was – and where the gaps were.  I also strongly believed that getting involved in systematic reviews was a good introduction to research. The clinical librarians group in the North West were interested in publishing more about the work they were doing and they got in touch, and to cut a long story short, this was the beginning of a partnership which resulted in the group undertaking a systematic review on evaluating clinical librarian services (Brettle et al, 2011).  The systematic review updated the evidence on effectiveness as well as highlighting what was needed to provide rigorous evidence to demonstrate the impact of clinical librarian services.  The next logical step was to put these findings into practice and conduct an evaluation across the North West.  This was to be the largest clinical librarian study in the UK to date, and all clinical librarians across the region were invited to participate.  Both these studies benefited from small grants from HCLU, which were key to providing a small amount of resources to get the projects off the ground.

Building on the recommendations from our systematic review, our aim was to understand the impacts of CL services within National Health Service (NHS) organisations, by

  • Using a framework that ensured consistent and robust data collection across all participants
  • Testing the Making Alignment a Priority (MAP) Toolkit (https://maptoolkit.wordpress.com) in measuring the CL contribution to organisational objectives
  • Developing research skills amongst the group of librarians involved.

The paper describes the results and the tools used. Using both questionnaires and interviews, we found that the interventions or services provided by CL’s are complex and each contributes to multiple outcomes of importance to their organisation.  So for example each literature search or participation in a journal club or current awareness bulletin could impact on multiple areas and decisions, and will be unique to each encounter.  We found that the questionnaires were useful in providing data about the outcomes to which the librarians contributed, whilst the interviews really brought this data to life, explaining how one piece of information could really contribute in a wide range of ways that are important within the NHS context.

In brief we found that clinical librarians contribute to a wide range of outcomes in the short and longer term and really do make a difference within the NHS. These include direct contributions to choice of intervention (36%) diagnosis (26%) quality of life (25%), increased patient involvement in decision making (26%) and cost savings and risk management including avoiding tests, referrals, readmissions and reducing length of stay (28%).  As well as looking at contributions to patient care, we looked at other outcomes that are important within the NHS (this is where the MAP toolkit came in), so the study is relevant across all types of NHS organisations not just acute patient care.  We were able to show that clinical librarians improve quality and help save money as well as affecting patient care directly – all key outcomes in the current NHS climate.

The third objective of the study was to help improve research skills, and this isn’t really covered in the paper.  The approach we used built on that used in the systematic review project (Brettle et al, 2011) and has since been described as a “hive approach” (Buckley-Woods and Booth, 2013).  Another way of describing it is “doing with” rather than “doing for”. As an experienced researcher I directed and guided the research but it was very much a partnership and mentoring relationship where the clinical librarians really contributed to the research (and it wouldn’t have taken place if they hadn’t done so).  For this project the clinical librarians were invited to take part in the research at a level that worked for them.  For example, some participated in the survey part whereas others took part in the interviews, interview analysis, and writing up the results.  At the questionnaire design stage, a small group drafted the questionnaire, as a group this was discussed and modified to suit everyone’s needs, and then piloted on each service.  Standard documents were developed and provided to all, on how to conduct the pilot and how to obtain ethical and governance approval.  Meetings were used for agreeing procedures and training.  A wiki was used to share and update resources.  At the interview stage, meetings were held to develop the interview schedule and provide training to those taking part in this stage.  Librarians were “buddied” and conducted interviews in each others organisations (to enhance rigour) but with the advantage that the buddies could practice on each other as well as bounce ideas (and fears!).

The tools developed in the project have informed the development of a simpler generic tool for use across all health libraries and have been incorporated in a revised impact toolkit, for those who want to conduct more in-depth, rigorous impact studies.  In terms of further research what we need to do next is find out whether this approach of building research capacity has made a difference in the longer term.  If this is the case we can use this approach more widely to develop the evidence base of health libraries and librarians for the future.

Acknowledgements
This project wouldn’t have been possible without the librarians involved.  Thanks to: Michelle Maden-Jenkins, Clare Payne, Helen Medley, Tracey Pratchett, Michael Reid, Debra Thornton, Rosalind McNally, Pippa Orr, Morag Platt, Denise Thomas, Anne Webb, Riz Zafar

References
Brettle, A., Maden, M., Payne, C. (2016) The impact of clinical librarian services on patients and health care organisations, Health Information and Libraries Journal. Available from: http://dx.doi.org/10.1111/hir.12136

Brettle, A., Maden-Jenkins, M., Anderson, L., McNally, R., Pratchett, T., Tancock, J., Thornton, D. and Webb,A. A 2011, ‘Evaluating clinical librarian services: a systematic review’ , Health Information & Libraries Journal, 28 (1) , pp. 3-22.

Buckley-Woods, H. and Booth, A. (2013) What is the current state of practitioner research: the 2013 LIRG scan.  Library and Information Research, 37(116).  Available from: http://www.lirgjournal.org.uk/lir/ojs/index.php/lir/article/view/598

Shaping a vision for NHS Research Capability Building across the North (October 2015, Leeds)

This workshop was organised by the three northern HEE LETBs with the aim of:

  • Bringing together key stakeholders in research capability building in NHS organisations to develop a vision for research capability building across the north of England.
  • Developing a greater understanding of work already being undertaken in this area and provide the opportunity to learn from each other.
  • Exploring areas of potential joint working across the north.

As there is a number of significant areas of interest common to both KfH and the Research and Innovation Strategy it seemed a good idea to participate and wave the flag for LKS.

We opened with an informative presentation from Ged Byrne (Director of Education and Quality (North) HEE), setting the context for building research capability, both nationally and regionally, and highlighting the key question from the R&I Strategy – how can we build a research workforce i.e. a workforce in which research activity and using/developing innovation is embedded as part of the job?

Later in the day, Stuart Eglin (Director of R&D North West) outlined the R&I Strategy work streams  and asked for feedback and thoughts on what these could or should encompass. The work streams are in their infancy but LKS should look out for reports and progress from these to spot opportunities for connecting.

We had two lively, productive and constructive table discussion sessions relating to both of these:

of the many ideas and thoughts put forward to feed into the R&I Strategy and work streams, the following are those that struck me as having strong potential links to LKS:

  • Need a framework and support for local research and new starters in research – to address perceived barriers of lack of capacity, lack of confidence, lack of familiarity with research language and process;
  • A case study or audit can be a good way to get started – writing an abstract for a poster or conference;
  • Support from library services and research teams;
  • A great deal of innovation takes place ‘day to day’ on the ground – with small changes and improvements in ways of doing things – but it is often not recognised as innovation or research: need to raise awareness and encourage staff to write about and share what they are doing;
  • Find ways to capture and diffuse local research;
  • Develop the LDA to cover all professions and to encourage research.

There was also discussion about the development of a R&I Hub and what this might cover – suggestions included:

  • Examples of best practice
  • Innovations – how to progress/share
  • Signposting to advice/information
  • Funding sources/opportunities/contacts
  • Ethics

There are a number of developmental parallels with KfH – a formal strategy, practical work streams focussed on key areas, a proposed hub – but it is important, I think, that KfH and R&I do not remain ‘in parallel’ but find points of interconnection and synergy where we can demonstrate the added value of input and support from the LKS workforce.

Sue Austin

HENE Library Knowledge Service Lead

susan.austin@stft.nhs.uk