1. Bridging the Gap: Knowledge and Information Services Collaboration Katherine Cheema, Quality Observatory, NHS South East Coast Emma Aldrich, Maidstone & Tunbridge Wells NHS Trust

2. Who are we? Katherine Cheema: Specialist Information Analyst at NHS South East Coast Quality Observatory with interests in healthcare associated infections, maternity and neonates and long term conditions. Emma Aldrich: Knowledge Manager, working within the Library and Knowledge Team at Maidstone & Tunbridge Wells NHS Trust with interests in rolling out knowledge management tools across the trust

3. Problem……. Evidence –The need for it…… –….and the apparent lack of it Quantitative, numerical, driven by the performance agenda Information for judgement! Issues with commissioner resources and skills

4. Case study MRSA trajectories –Traditionally acute trust focussed –But almost 50% cases acquired in the community –How can these cases be factored into PCO focussed envelopes? –On the basis of the information generally available such an exercise would be very difficult

5. ….Solution Bring together the surveillance data and the research evidence: Define an end point for community MRSA which is –realistic in terms of ability for organisations to achieve –representative of the research to date and the surveillance information available So rather than ‘best guesses’ and an assumption of a blanket reduction in CA- MRSA across all organisations……

6. Pre-48 hour cases (Source: HPA DCS) PRE 48-HOUR CASES (COMMUNITY ACQUIRED) Post-48 hour avoidable cases (Source: Local retrospective review) Post-48 hour unavoidable/complex cases (Source:Local retrospective review) POST 48-HOUR CASES (TRUST ACQUIRED) ALL CASES FUTURE TRAJECTORIES STATIC DEFINED % REDUCTIO N Reduction to an estimated prevalence informed by evidence base We have something more structured utilising all the quantitative and qualitative knowledge we have available at each stage of the model……..

7. Sounds simple….? Ask a Librarian….. 15 years experience of searching healthcare databases Advanced searching skills, filters, subheading searches Specificity, sensitivity Teaming clinical/ mathematical skills with evidence seeking skills

8. The Process Scoping the ProjectFinding search termsDatabases and Limits Background Knowledge: Meetings, emails SEC Dashboard, Knowledge Matters Websites: National Resource for Infection Control DOH HPA NICE NHS Library (general searches) MeSH and.tw. searches for: MRSA/ Staph Infections/ C-Diff Healthcare/ Hospital/ Community Associated/ Acquired infections Cross infection/ nosocomial infections/ Disease transmission Communicable/ Infectious diseases Community Health Services/ Community Health Nursing/ Primary healthcare/ Homecare Services Prevalence Prevention & Control.fs. Transmission.fs. Databases: Medline Embase Cinahl BNI HMIC Health Business Elite Cochrane Library Limits: English Language

9. The Process Results reviewed collaboratively - Articles selected - Searches refined and re-run Joint critical appraisal Literature review

10. Results Ability to develop a statistical model of community acquired MRSA to predict incidence using existing surveillance data sources and the associated evidence base Interest from local health economies on utilising findings for own improvement programmes and strategies Development of recommendations with regards definitions used in monitoring of community acquired MRSA cases at a strategic level

12. What can we learn? Personal reflections… Greater understanding of what each function does – broadening knowledge of where NHS staff can go for information Process different for LKS professional – greater involvement than usual in results/ follow up: seeing it through to the end Discovery of how much more ‘information’ there is out there, and that there are people with the expertise to search, review and collate it

13. What can we learn? Implications for the wider NHS… This project – A meeting and discussion between two regional leads which evolved into a unique collaboration. The collaborative approach must continue to underpin the commissioning and service improvement processes and the promotion of quality. Active marketing of library resources and staff expertise, including outside of the acute sector A formal communication mechanism to be put in place to ensure that these collaborative projects can be undertaken easily in the future.

14. Any questions….?