Becoming digital champions

Library and Knowledge Services (LKS) at Nottinghamshire Healthcare sits within the Health Informatics (HIS) department. I’m fortunate that I am a member of the Senior HIS Management Team, which means I am strategically placed to advocate the skills and services of LKS within ICT. I realised that this had obviously worked when the Head of Digital Services (IT) asked if the LKS team would become Digital Champions for the Trust and support the role out of MS Teams across the whole Organisation during the pandemic.

If you have not come across this before, Digital Champions support digital inclusion through sharing their knowledge and experience to help others develop their digital skills. You don’t have to be an IT guru to be one, but what is important is being motivated to help others at their own pace, and most importantly admitting when you don’t know the answer but will find out!

As a member of the Digital Workplace Project Group, responsible for enabling our Trust to work more digitally, I knew the plan was always to roll out teams using a Digital Champion network within both clinical and non-clinical teams across our Organisation. However, COVID forced our hand. The roll out we had been planning was changed from months to days. The Teams pilot, which LKS had been part of, had to be upscaled to the whole Trust in record time.  The LKS team would become the Digital Champions for the entire Organisation to take the additional pressure away from our IT Support Service.

There was no remit of how this support should be delivered but COVID meant that we must deliver support virtually. A dedicated inbox was created to manage enquiries, although we also responded via telephone, MS Teams and email depending on the complexity of the enquiry, enquirers preference and the implied digital literacy level of the enquirer.  We applied the same level of customer service that we use in LKS to respond quickly and answer enquiries directly to keep the business of the Organisation moving.

Based on the frequently asked questions we were receiving we created an MS Teams support page hosted on our Intranet. We created short visual support materials and provided frequent updates to the ever changing functionally of Teams.  This enabled us to signpost to key guidance and encourage independent learning across the Trust. We began hosting weekly ‘Drop in Sessions’ to cover the basics of MS Teams, giving staff the opportunity to see demonstrations and ask questions, as well as providing sessions for individual teams if requested. Due to the success and high demand we now offer daily ‘Drop in Sessions’. We write communications for the daily Chief Executive staff bulletin and weekly Line Managers update highlighting any changes or new functionality and signposting to the help section if a query has been raised several times recently.  We created an MS Team consisting of the Digital Champions and IT Support Service to facilitate knowledge sharing and problem solving. We are now adopting a more strategic level approach to aid adoption across the Organisation by approaching Managers directly, gaining an understanding of their information needs and selling the benefits of using teams and suggesting appropriate tools they could use with their teams.

At project level I have been involved in all aspects of the rollout and decision-making process, including governance and permission settings. Our Microsoft partner recognised the importance of having a Knowledge Manager involved at this level and the enhanced benefits this can bring.  I have been able to argue for the functionality I believe the business needs, including the upgrade of Communities (Yammer), so we can pilot this tool for Communities of Practice. I am the critical friend representing the user point of view, constantly reminding that digital literacy skills vary across the Organisation, and one training style does not fit all. Personally, as a relatively new manager it has been a fantastic learning opportunity to be centrally involved in a project at such scale and to work so closely and learn from our Senior Project Manager.

We made the decision from the onset that we would be transparent about who the Digital Champions were to raise the profile of the library across the Organisation. This may have been considered risky, but I wanted to showcase to our Trust what LKS can do, and we may never have this type of opportunity again. Although I haven’t got any metrics to substantiate this, I believe this has been effective. We have had some fantastic feedback, and colleagues appreciate our swift response to queries and our excellent customer service. Our “can do” attitude has built stronger relationships within not only IT but also with other services across the Trust, where I’m hoping “from little acorns mighty oaks grow”.

Our involvement in Digital Champions will continue whilst the project group work to develop what the long-term support for MS Teams and wider O365 tools will look like for our Trust. In the short- term we are looking to knowledge share and offer further training to volunteers within local teams across the Trust to grow the Digital Champions Network further.

At the beginning we were all apprehensive about taking on this role and moving out of our ‘library comfort zone’, but we knew we had the skills to do this, even if we were still developing the knowledge. All of us have found Digital Champions hugely rewarding as well as challenging at times! Most importantly we can see the difference we are making supporting our colleagues to change their working practices to continue to deliver services in these difficult times.

Samantha Roberts
Head of Knowledge Services
Nottinghamshire Healthcare

Expert Search Early Adopters pilot – pre-switch search data

In mid-September HEE began a pilot to understand how best to help LKS in England move from using HDAS to using provider interfaces (EBSCOhost, Proquest and Ovid – see here for further detail: https://kfh.libraryservices.nhs.uk/resourcediscovery/frequently-asked-questions-2/)

Phase one of data collection ended in November 2020 and we’re able to share some of the results from our survey around pre-switch searches (carried out primarily on HDAS). This was undertaken to capture ‘normal’ search behaviour, so we could do some comparing and contrasting with searches carried out on provider interfaces after the pilot groups switched. The data collected is a great snapshot of search activity and is fascinating reading if you’re interested in search behaviour.

We had 68 searches recorded during this phase. We asked participants to briefly describe their search – purpose, level of complexity etc. As expected, topics were wide ranging and search requesters were from a multitude of staff groups.

The most frequently used resources were HDAS Medline (76% of searches), HDAS CINAHL (63% of searches) and HDAS EMBASE (50% of searches). Results were collated using reference management for 13% of searches, and Endnote Desktop was the most frequently used reference management tool.

Exactly 50% of searches were completed in a single session and the other 50% over multiple sessions. The time it took to complete a search varied wildly, with the shortest taking just 20 minutes and the longest 15 hours – this was a search to support a systematic review. There were two searches captured that fitted into the systematic review category, and as their times vastly skewed the average search time they were removed from calculations. With the remaining 66 searches the average time to complete was 2 hours 51 minutes, with most taking between 1-2 hours or 2-3 hours (44% and 29% respectively).

We asked participants to tell us what had gone well with their search, what didn’t go so well, and what changes could be made to improve their search experience. Things that worked well included being able to search multiple resources without switching interfaces, being able to collate results and search history into one document for the search requester, and searches where the topic was straightforward and therefor easy to find results for. There were common issues around glitches in HDAS, de-duplicating results and the search topic either proving difficult to search for, or being outside of the scope of the databases available to the searcher. Possible improvements included increased stability (fewer interface glitches), less scrolling and a cleaner interface, and having access to reference management software to de-duplicate and collate results.

Finally we asked people to rate their search experience a star rating, where 1 is poor and 5 is excellent. The average rating was 3.7, with 34% rating 3 stars, 42% rating 4 stars and 21% rating 5 stars.

Phase two of data collection is now well under way, and we are asking participants to fill out a similar survey for any searches they carry out on one specific day of their working week. We’ll be sharing the results from this phase over the next few months.

For any questions about the project, please email Emily.hurt@lthtr.nhs.uk.

Emily Hurt
Lancashire Teaching Hospitals NHS Foundation Trust

Vicky Price
Vicky Price Consulting

Mobilising Evidence and Knowledge: A Retrospect

As 2020 draws to a close it is a traditional time for reflection, and we could not reflect on the Mobilising Evidence and Knowledge workstream without at the same time using some of the techniques from the NHS Knowledge Mobilisation FrameworkThe Retrospect

What was the objective? What did or didn’t we achieve and why?

Emphasising the critical role played by NHS knowledge specialists and librarians to mobilise evidence and knowledge across the NHS was a main objective. Much has been achieved in the first five years, mainly due to how well NHS library and knowledge staff across England have embraced this work, building their confidence and developing their skills to mobilise evidence and knowledge.

What were the successes?

#AMillionDecisions

#AMillionDecisions raised our profile. It calls on government and health service providers to meet their statutory obligations to ensure the million decisions made every day in healthcare are informed by evidence. It encourages healthcare staff to work with and use the expertise of librarians and knowledge specialists to get evidence into practice.  From this work evolved a bank of impact case study vignettes and endorsements from a range of senior leaders across healthcare.

Extending Reach

Using a range of evidence and tacit knowledge to inform and respond to system level healthcare has been delivered by the “bottom-up” partnership approach of the STEMClub (Sustainability and Evidence Mobilisation) in the North East of England. Adopting models similar to STEMClub are likely to increase in 2021 with the announcement from NHS England that Integrated Care Systems (ICS) are to have more statutory functions, potentially taking on a commissioning role in 2021. https://kfh.libraryservices.nhs.uk/the-stem-club-in-the-north-east-of-england/

 Skills development – workshops and study days

In February 2020 thirty library and knowledge service staff attended a two-day knowledge mobilisation course facilitated by knowledge management consultant Chris Collison. This core group of individuals work as a reference group for future mobilising evidence and knowledge work.

Tools and Techniques

  • The Knowledge Management Task and Finish Group developed the Knowledge Management Toolkit to share techniques and stories about how knowledge management has been used in practice.
  • Publication of the enhanced NHS Knowledge Mobilisation Framework E-learning introduced the concepts of learning before, during and after and demonstrated the benefits of using 11 simple knowledge mobilisation techniques. The accompanying postcard sets were expanded in 2019 to include additional techniques of Appreciative Inquiry and Fishbowl Conversations. Feedback has been positive with Dr Farzana Hussain, GP of the Year 2019 commenting on the After Action Review technique that
    • It has changed my staff meetings and significant-event analyses, the non-judgemental approach supporting a no blame culture”.
  • The self-assessment tool for organisations to consider opportunities to develop how they are using external evidence and organisational knowledge. A series of modifications were made to the tool and the current version has been used by several organisations to help plan and prioritise activities. We are currently working on developing a digitised format for this tool with the help of our knowledge champions.
  • A space to share ideas, resources and ask questions has been developed with the Knowledge Management Community of Practice. It is a great way to encourage learning, develop a knowledge base and build confidence to practice some techniques.
  • The Policies Procedures and Guidelines Toolkit was developed to capture and share good practice around supporting the production and management of these vital knowledge assets.  
  • Connecting people to people, people to research and raising the profile of an organisation by exploring different ways to promote locally produced research are explored in the Institutional Repository Toolkit which presents an ideas bank and hints and tips for implementing a local repository.  

Learning lessons from Covid-19

Rapid learning, spread of knowledge and use of evidence was essential for the response to the Covid-19 pandemic. CILIP held a virtual conference in May 2020 exploring the role of knowledge management in a time of crisis. Perspectives were shared from knowledge specialists working in various sectors including the NHS. A series of thought-provoking questions were raised, including how we take learning from a crisis and apply to our everyday practice. https://kfh.libraryservices.nhs.uk/what-is-the-use-of-knowledge-management-in-a-time-of-crisis/ This topic was explored further by Holly Case Wyatt who shared tools to rapidly share learning from Covid-19 including a framework from Collaborate for Care https://kfh.libraryservices.nhs.uk/lesson-learnt-supporting-your-organisation-to-capture-the-learning-during-covid-19/ We also produced a short recorded presentation about the Before Action Review, After Action Review and Retrospect as a suite of tools to encourage the sharing and re-use of lessons learnt.

KNOWvember

KNOWvember is an annual celebration and showcase of the work by NHS library and knowledge staff to mobilise evidence and knowledge. The aim of KNOWvember events is to share practical examples of how library and knowledge service staff have used techniques to encourage more widespread use of evidence and sharing of know-how across the NHS. This in turn generates ideas for more knowledge mobilisation to take place.

Four virtual events were held in KNOWvember20 featuring work by various library and knowledge specialists coupled with opportunities to experience a variety of knowledge mobilisation techniques. We were also joined by external speakers including CILIP Trustee Karen McFarlane, who provided an overview of the BSI/ISO 30401 Knowledge Management Systems Standard and CILIP’s Knowledge Management Chartership and Dr Nicola Millard, Principal Innovation Partner at BT who shared insights into the digital workplace. Presentations from these events, plus summaries of discussions and recorded conversations between knowledge specialists, can be found on the Knowledge for Healthcare KNOWvember20 YouTube Playlist.

What could have been even better?

We know that terminology has at times proved challenging.

As the ISO 30401:2018 Knowledge Management Systems Standard says there is no single accepted definition of knowledge management and our preferred term is knowledge mobilisation emphasising that knowledge needs to be used and not just managed. David Stewart’s reflection considers this change in terminology and presents a long view concluding that knowledge management is no longer a “nice to have” trend but that KM will become the every-day core of what we do” – delivering Knowledge and Library Services to ensure that organisational knowledge and best evidence are mobilised to achieve excellent healthcare and health improvement.

Marks out of 10 for the work as a whole? What would have made it a 10?

The work to date deserves at least an eight as demonstrated by the range of mobilising evidence and knowledge work showcased at the recent KNOWvember20 events. It will become a 10 when even more NHS staff routinely use evidence and share knowledge to inform their decisions.

A big thank you to all who have contributed to this work, and in particular to our knowledge champions. We wish you time for your own reflection over the festive break and look forward to working with you on the next chapter of this story in the new year.

To read more about the mobilising evidence and knowledge work see Day A and Goswami L (2020) Driving change with evidence and knowledge: Transforming knowledge services for the NHS across England. Business Information Review Volume 37,
Issue 1 https://doi.org/10.1177/0266382120909240