Improvement Librarian…. Next Generation Clinical Librarian Improvement Librarian…. Next Generation Clinical Librarian? Roxanne Hart @roxannehartq HLG 2018

QI SURVEY COMPARE TO CLIN. LIB. WHAT IS QI? BACKGROUND TO QI TEAM JD-WHAT DO I DO? THE ROLE FUNDING FOR ROLE

What is quality improvement? Not an audit A joined up and continuous effort to make changes leading to 

How did the team come about? Musgrove Park Hospital (MPH) doing QI for over 13 years 2016 MPH Board committed to a whole hospital QI approach Internal QI team

*Citation for the original research study available at end

QI team at Musgrove a bit different Methodology = Model for Improvement Project Management Benefits realisation Evidence

Structure of Boards Outpatient Ophthalmology Inpatient Colleague Change & Development Theatres and Critical Care Patient Safety Collaborative

How did my role come about? Volume of requests too much Small pot of money in library only enough for part of role Made a proposal to Improvement Manager & Improvement Lead

Who do I support? Musgrove Park Hospital and Somerset Partnership Staff inside (majority of role) and outside the improvement department working on QI

Where do I work? M T W F 2 days a week based in Library 3 days a week embedded in Quality Improvement Team

Impact of Role Case studies Getting involved Part of process to seek evidence

Learn Before Learn During Learn After Case studies / benchmarking Literature reviews Site visits Peers Learn Before Action Learning Review new evidence Capture new knowledge Huddles – learn from yesterday plan for today Learn During Lessons learned Communications and knowledge sharing Process improvements for next time Learn After Systematic approach to gathering and assessing relevant information to support evidence based decision making

How does the role feel? Amazing (288 days!) True part of the team Flexibility on both sides, attending meetings outside of set ‘days’

What do I do (core parts of role) Literature searches Teach staff about evidence for improvement Attend board meetings Current awareness (2-3 types) Synthesis

Literature searching Very different to clinical search, much murkier Have a checklist of sources (attempt to be systematic) HDAS no longer first port of call

Spectrum of evidence requests from team

More Examples of Questions… Does better management of chronic pain patients result in less strain on other areas of the hospital Design of outpatient waiting area Income generation ideas Survey or temperature check on attractiveness of senior clinical roles Cost improvement projects neurology Alternative methods for completing discharge summaries Ophthalmic Viscosurgical Device comparisons Enhanced recovery benchmarking data Standardising of safety brief Innovative ways of working in an integrated endoscopy pathway Leadership/executive visibility: best practice/case studies as to how to lead a geographically dispersed organisation Please can you summarise what other trusts do around incident reporting and learning from excellence Reduce avoidable admissions from acute trusts to care homes

SBAR

Exciting aspects of role Opportunities to learn more about clinical work in the wider hospital. Really targeted, proactive current awareness by virtue of the close working knowledge that comes from being based in the team space. Evidence directly underpinning projects and influencing project directions and decision making. Interest in the role from other librarians/QI departments/Trust Execs

Initial Survey Results Support for QI 90% of respondents support any staff undertaking QI 57% support staff from their QI depts specifically Frequency of support for QI 5% (1 respondent) supports QI work daily 30% support it once per week Roles 10% have supporting QI written into their JD 85% support QI under the umbrella of the support to the whole trust In What Capacity? Majority of support comes in the form of literature searching 20 respondents at time of PPT creation. Does not represent the full picture

Similarities to Clinical Librarian? Literature searching = Close working relationships = tailored CA Official relationship with team Attending meetings and sending evidence out post meeting

Differences to Clinical Librarian Model funded by department in question Providing the service in a different way as audience is different

Roxanne Hart, Improvement Librarian Thank you Roxanne Hart, Improvement Librarian roxanne.hart@tst.nhs.uk

References Sturdy, A.J., Reguera Alvarado, N., Blanco-Oliver, A., and Veronesi, G. (2018) The impact of management consultants on public service efficiency. Policy & Politics. Available from: http://www.ingentaconnect.com/content/tpp/pap/pre-prints/content-pppolicypold1700072r2# Neville, S. (2018) Health Consultancy work under pressure as NHS seeks savings. Financial Times. 18 January. Available from: https://www.ft.com/consultancy-health