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

Quality and Impact in 2020: The Value of Knowledge and Library Services

Knowledge and Library Services take the “heavy lifting” out of getting evidence into practice and give the “gift of time” to healthcare professionals. (key message 2, The Value Proposition)

As we reflect on 2020 within the Quality and Impact Group, the first thought might be that it was the year when not everything quite went to plan… However, a tremendous amount has been achieved and we have really been able to demonstrate the impact and value of our NHS knowledge and library services and specialists. In this blog we would like to highlight some of successes over the last 12 months and ongoing developments. We would also like to say a big THANK YOU to all those involved in workstream activities and for the knowledge and library staff continuing to identify and share stories of their impact and innovation.

On 2nd November we launched our Value Proposition; the gift of time at an All Party Parliamentary Group (APPG) meeting. The report explains how knowledge and library specialists in the NHS give the gift of time to busy healthcare professionals, taking the heavy lifting out of getting evidence into practice.

Jacque Mallender of Economics by Design, who led the research, will be hosting two webinars to present the report in the new year. This is an opportunity to listen to the presentation provided at the APPG and to ask Jacque any questions.

“The core value proposition is simple: The service provides healthcare professional staff with time-saving accelerated access to better quality evidence. This enables the NHS to meet its statutory obligations to utilize evidence from research. It enables healthcare professionals to use their time more effectively to drive improvements against the NHS quadruple aims” (key message 5, The Value Proposition

The full report can be found on the HEE website

“Informed decisions improve outcomes, quality of care, patient experience, resource utilisation and operational efficiencies. This is best achieved when healthcare professionals are supported by the right knowledge services, with the right resources and with the right teams and roles” (Key message 3, The Value Proposition)

We have continued throughout the year to receive your impact case studies, and over 100 of these have been approved. Working with our HEE communications team we have started to promote these more widely to stakeholders through twitter and LinkedIn, HEE Innovation and Transformation page. We are also now showcasing an impact case study on a monthly basis. Look out for the new format for the impact vignettes

Case studies of high performing NHS Library and Knowledge Services demonstrate two key enablers for benefits realization: that the service has a clear strategic leadership role in knowledge management and mobilisation and is integrated with service delivery” (Key message 6, The Value Proposition)

Although we had to change the submission dates, in the light of your work pressures during the pandemic, we are grateful to you all for completing the workforce and activity statistics this year. We are working to collate and analyse these and will be producing an infographics report of the key headlines. We are also working with our Business Intelligence team within HEE to develop a benchmarking dashboard based on a few key metrics. Again we plan to share this with you once completed.

When supported by high-performing Library and Knowledge Services, NHS provider organisations are able to demonstrate how they are meeting their statutory obligations to use evidence to inform practice and hence improve their CQC rating (Key message 4 The Value Proposition)

As we move into 2021, we anticipate that the baseline self-assessment of the new Quality and Improvement Outcomes Framework will go ahead. We are currently reviewing the timelines and dates for submission whilst also looking at the longer-term process.

Working with Amanda Stearn, we are in the process of updating High Profile Health Libraries, our toolkit to support advocacy. The newly updated toolkit will provide support materials, and hints and tips, to assist in positioning your service as business critical to your organisation(s).

“Assuming findings from the international literature are applicable to the NHS, the service is potentially already generating an overall economic benefit of £132m per annum for the NHS, delivering a net economic benefit of £77m per annum. This could increase to £106m per annum were targe staff ratios for librarians achieved” (Key message 9, The Value Proposition)

One of the outcomes for the quality and impact workstream is to promote knowledge and library service innovation and good practice. This year we were really pleased to see the outcome of our partnership working with CILIPs Library and Information Research Group (LIRG) to publish a special of the LIR Journal on good practice in NHS-funded library and knowledge services. Please do have a look at the good practice research and case study articles.

“There is growing and consistent body of robust international evidence to support this Value Proposition.” (Key message 7, The Value Proposition)

“Recently published research from the NHS suggests similar benefits may exist for the NHS” (Key message 8, The Value Proposition

We have also been reflecting on the achievements of the Quality and Impact workstream over the last five years. Our case study article on the outcomes of the workstream Quality Outcomes in NHS Library and Knowledge Services has just been accepted by the Performance, Measurement and Metrics Journal. Please do look out for this in the new year.

We would like to end by wishing you all a Merry Christmas
Clare Edwards and Dominic Gilroy