Exploiting the Power of Knowledge in NHS Scotland Integrating Knowledge with Patient Care Dr Ann Wales NHS Scotland Library Service Development Coordinator NHS Education for Scotland

Knowledge - definition “The property of intelligent agents which helps them to reach their goals effectively” Allen Newell, 1981 Technology networks facilitate access to knowledge Human networks translate knowledge into goals.

Knowledge Support for NHS Scotland : Strategic Goals Equipping and empowering staff Partnership – national, local, cross-sectoral Service Modernisation Public Involvement Health Improvement Quality and Standards

Knowledge Support for an Integrated Healthcare System Knowledge Support for NHS Scotland : Strategic Needs

Knowledge Needs of NHS staff Of Knowledge Sources Integration National, Local, Sectoral Managed Clinical Networks, Community Health Partnerships Burnett et al, Knowledge needs analysis of NHS Scotland staff. Robert Gordon University, 2003.

Knowledge Needs of NHS staff With workflow and patient care processes Staff roles and responsibilities Focus, Quality, Relevance All staff grades and disciplines Integration

Evidence on applying Knowledge to Practice Linking Knowledge with Case-finding Systems Reminders / prompts linked with patient records Audit and feedback Peers and Patients as Knowledge Channels Communities of Practice

The Need for Change Existing Knowledge Services Fragmentation Inequity Under-resourced Low strategic / management profile

Vision E-Library as primary vehicle Local / national Knowledge Support Infrastructure With Patient Care Processes With Staff Roles and Responsibilities Modernised by technology Supported by human information and communication skills Integrated

Integration of Knowledge Sources Search on e-Library Is transferred seamlessly to other Knowledge Partners Resource Discovery Network Health Scotland Database of Guidelines and Systematic Reviews (TRIP) Scottish Executive database of policy documents Also cross-searches:

Integrated access to Knowledge Sources depends on international standards for data exchange Same standards can facilitate integrated access to other national and local knowledge sources.

Advanced Search Technologies Focused Subject Search Focusing Knowledge Support

Subject Indexing At detailed level MESH GCL Caredata Natural Language

Portals: Cancer, Coronary Heart Disease, Mental Health Portals planned for: Health Care Associated Infections Remote and Rural Healthcare Stroke Therapy

Knowledge Exchanges Cancer Portal Login to create Personal Knowledge Space Expert Searches Updating Services

My Knowledge Space Tools to manage information overload Create your own knowledge profile Create portable Favourites Create your own Specialist Homepage Receive Alerts on new Knowledge in field of interest

Knowledge Content Biomedicine Nursing, midwifery Allied Health Professions Science and Technology Pharmacy Estates and Facilities Health Improvement 4000 ejournals 200 ebooks 100 databases 1500 free evaluated Internet resources

Roadmap: Linking Knowledge to Patient Care 1. Consolidation of e-Library 2. Integration of Knowledge Sources 3. Linking Knowledge to Human Behaviour 4. Information Skills Training 5. Development of NHS Librarian role 6. Ensuring Quality and Continuous Improvement

Cost of preventable adverse events Additional bed days: £1 billion per year UK-wide Costs of litigation The Cost of Ignorance

Scenario 1: A Public Health Consultant on-call used the e-Library to look up changes in Haemophilus influenza B (Hib) as a cause of acute epiglottis. “The textbooks were way out of date. What I found influenced the management of a child with acute epiglottitis admitted to the local teaching hospital.” Benefits of integrated knowledge support

Scenario 2: Benefits of integrated knowledge support A GP on a house-call to visit a child with croup was unsure about the application of dexamethasone. A 5 minute search of the e-Library gives up- to-date evidence and guidance.

Today’s Seminar Define milestones on roadmap Recognise shared responsibility Understand extended role of e-Library