1. NHS Education for Scotland Management of the Knowledge Base of Healthcare for NHS Scotland Open Forums May 2003

2. Programme Introductions Strategy and Vision - Ann Wales, NHS Scotland Library Service Development Coordinator Building the Bigger Picture –Rhona Arthur, Assistant Director, Scottish Library and Information Council / Chartered Institute of Library and Information Professionals (Scotland) NHS Scotland e-Library Development – Sandra Davies, e-Library Team Leader Managed Knowledge Networks – Annette Thain, Project Manager

3. An Integrated Strategy for Knowledge Management to Support the Patient Journey National Support and Local Challenge Dr Ann Wales NHS Scotland Library Service Development Coordinator Ann.wales@nes.scot.nhs.uk

4. Overview 1.) Policy Context 2.) Service Development Framework: the Patient Journey Model 3.) Service Vision 4.) Key Deliverables 2003-2006 5.) Local Challenges

5. 1.) Policy Context Health Service Management E-Government Knowledge Economy Partnership in Care Evidence-based decision-making Clinical Governance Staff Governance Educational Governance

6. Learning Together (1999) “Within five years (ie by 2004) all staff groups in the NHS in Scotland should have ready access to comprehensive and improved library and information services designed and resourced to meet their needs”

7. HDL (2000) 01: Learning Resources and the Knowledge Base of Healthcare National framework Integrated local service development plans Quality assurance mechanisms

8. National responses: Knowledge Services Group Coordinator Role Remit Integrated local, regional and national framework

9. The wider context Partnership Community focus Single system working Workforce development tiers Patient Involvement Cross-boundary networks (MCN’s) Public Health E-Healthcare Centrality of patient experience

10. 2.) Service Development Framework: The Patient Journey Model Unifying concept Focus on patient need Encounter with NHS- primary /emergency care Acute stay Discharge, rehabilitation, follow-up Information and learning needs: Wider NHS workforce Patients, Carers, General Public

11. Patient Journey Model: Principles Equity of access and support Unified Scotland-wide approach Lifelong learning Outreach to wider community (contractors) Partnership working within the NHS Partnership working with other sectors

12. 3.) Service Vision Is of: “NHS Scotland Library and Knowledge Services transformed in the light of new technology, operating as a network of proactive, skilled information practitioners and managers, empowered to deliver centrally funded resources to point of need on an equitable, integrated nation- wide basis”

13. 4.) Key Deliverables User needs analysis Partnership Framework Development of Library and Knowledge Service Workforce Managed national, regional and subject specialist networks Service Standards – Managed Health Service Network approach? Internal Knowledge Management Patient and public information services

14. E-Library Development Exemplar and practical tool 20 databases, 4000 fulltext journals, 200 e-books, over 1500 free websites Tender for content Support and outreach Search functionality and architecture Interactive resource E-Learning

15. 5.) Local Challenges Shared aims, national principles and priorities Unique and creative local developments Local strategies: April 2004 Coordination harmonisation Outreach (contractors) Cross-boundary services: MCN s, regional networks Cross-sectoral partnerships Transition in librarian role Funding models

16. Conclusion National Support and Local Challenge: Unprecedented Demand and Future Promise

17. NHS Education for Scotland NHS Scotland e-Library Future Pathways Sandra Davies e-Library Team Leader

18. Outline Strategy and history Content development More future developments – design and database structures Information management systems – Athens, ILL, local journals admin,local portals Evaluation and audit Marketing and outreach

19. Strategy and history Our National Health Learning Together Models of local best practice - NHS Glasgow e-Library

20. Resource Content Small beginnings… September 2001 4 databases 163 electronic journals All via OVID Biomedical focus

21. Resource Content Rapid growth since January 2003 Over 4000 full-text electronic journals Over 200 electronic books Over 20 major databases 1500 links to quality health websites

22. Providers OVID EBSCO Science Direct MD Consult Net Library Cambridge Scientific Abstracts Emerald Technical Indexes Pharmaceutical Press

23. New Resources From July 2003 ProQuest (nursing, biomedical, psychology and mental health) Web of Science

24. Focus for expansion Equity of access for all NHS staff at point of need, e.g. Management and OD Public Health and Health Promotion Social Care Estates and Facilities Science and Technology

25. Focus for expansion Personal development and lifelong learning: Wide range of newspapers, popular magazines, and special interest journals via UK Reference Centre

26. Enhanced Content Soon … Librarians’ area News area User guides and training resources Discussion board Reference management software

27. Enhanced Content Later… e-Learning packages Subject portals

28. Further Future Developments Information architecture … Clear and consistent presentation Clear and intuitive pathways to resources More choice in search and browse …room for improvement

29. Redesign Usability and accessibility “An excellent resource but still a little clumsy” – User-testing respondent Improvements required to make pages and resources more usable and accessible Incorporation of standards e.g. World Wide Web Consortium (W3C) and RNIB

30. Usability improvements Navigation paths Improved labelling Explanation of log- in Removal of pop- ups Search and browse from a single page Site map Improved display of search results Simpler routes to authoritative, appraised resources

31. Accessibility improvements Use of ALT tags for images Alternatives to JavaScript navigation features Consistent navigation layout Use of style sheets instead of tables for layout More information on link destinations Use of site map Use of logical tab order for those who use screenreaders

32. Database structures Restructuring of database - Single integrated database Metadata (Dublin Core) and interoperability standards Resources to be MeSH indexed - Mapped to natural language vocabulary

33. Search and browse Simple and advanced User profiling & personalisation Search engine to search full text content of resources as well as metadata records

34. Information Management Systems 1. Online password registration system: Access to all resources via one password Registration from anywhere with Internet access Subadministrator’s scheme Cost savings

35. Information Management Systems 2. Inter Library Loans system: Internet-based Handles - User requests - Processing & administration - Reports and statistics Customisation on request Timetable for roll-out across NHS Scotland

36. Information Management Systems 3. Local electronic journals admin: System which enables local administrators to create e-Library entries for local electronic holdings

37. Information Management Systems 4. Local portals: Local teams to index local information content Submit to e-Library Ability to extract from e-Library database for viewing on local websites

38. Evaluation and audit Pilot usability audit – April 2003 Full user needs analysis – June- August 2003 Unified online books catalogue feasibility study – May 2003-January 2004 Pilot of local portal system, consultation and feedback – September 2003- January 2004 Scoping study for library as e- Learning platform Statistics

39. Marketing and Outreach Strategic principles Support for all stages of patient journey Outreach to primary care staff, incl. Contractors Outreach to remote and rural areas Equity of access to all staff groups Collaboration with IT, Training and Development etc. Support for social as well as medical model of care Support for personal development and lifelong learning

40. Marketing and Outreach Targets by 6/03 compared with 12/02 100% increase in overall usage 100% increase in usage by management, nursing, pharmacy and scientific staff Measurable usage by Estates and Facilities and Administrative and Clerical staff 100% increase in usage in NHS Board areas where e- Library uptake is currently significantly below proportion of NHS workforce Substantial usage of all non-OVID resources

41. Marketing and Outreach Action Plan – Promotional materials Posters, leaflets, pens to target groups New posters: - Patient journey - Community health care staff -Accident & Emergency Resource guides for speciality areas Post-it notes and plastic carriers Suppliers’ materials Resource-specific user guides

42. Marketing and Outreach Action Plan – Training and demonstration To targeted user groups To community staff To remote and rural areas, e.g. Orkney, Shetland, Western Isles Online training – kiosk and mouse-click PowerPoint presentations

43. Marketing and Outreach Action Plan – Cascade approach Direct communication with national leads - seek support from key contacts for targeted staff groups, e.g via Postgraduate Deans, Chief Area Nursing Officers, Allied Health Profession Leads etc.

44. Any questions?

45. NHS Education for Scotland Managed Knowledge Networks For Cancer, Coronary Heart Disease and Mental Health in the West of Scotland Annette Thain

46. Aim To provide equitable access to information and learning resources to staff, and the public, at all stages of the patient journey for cancer, coronary heart disease and mental health in the West of Scotland.

47. Objectives To create subject Internet portals to provide single access points for information To create a network of Library and Knowledge Services across the West of Scotland to support the MCNs and to match the changing pattern of healthcare management

48. Background Changes in organisation of health care following the Acute Services Review in 1998 –formation of MCNs –concept of the ‘patient journey’ Technological developments

49. MCN Definition “..linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner, unconstrained by existing professional and NHS boundaries, to ensure equitable provision of high quality clinically effective services throughout Scotland”

50. Regions

51. Clinical Networks Cancer Managed Clinical Networks Coronary Heart Disease Clinical Networks Mental Health Networks and NHS Organisations

52. Regional Knowledge Networks Response of the NHS LKS to the changing model of healthcare delivery Mirroring the Clinical Networks to meet their information needs Need for strategic developments to incorporate the new wider population of users e.g.Joint Futures Agenda linking the NHS with Local Authority and Social Care Partnership working

53. Transition and innovation Time of change Librarians shaping their future Developing our role Increased specialisation

54. Proactive services Pro active role for librarians via the portals Match the changing needs of the users Investigate ways for the librarians to work together.

55. Standards Standards across the Region Operational and financial models Technical standards –Government and UK standards –Interoperability –Accessibility –Indexing

56. Portals Evaluated Resources Functionality Services Communication - ‘communities of interest’

57. Portals Evaluated resources –subscription resources eg databases and e books and journals provided by NHS Education –Websites –Guidelines and protocols –Clinical Trials databases –Training and educational opportunities via e learning eg. Royal Colleges

58. Portals continued Information on library services and information specialists available to the MCNs MCN websites and information Public/patient information

59. Patient Information Patient information - generic and specific - Signposts Local authority links for patients eg benefits, housing Community groups, self help groups and information providers Charities and Voluntary groups

60. Information Specialist Networks Highlighting relevant evaluated resources for each subject Expert searches Noticeboard / communication links User Education Current Awareness services Personalisation

61. User education Using the systems and resources on the portal Access to training for information retrieval Appraising the evidence

62. Alerting services to manage the information overload Journal contents alerts Current Awareness Bulletins SDI searches (regularly updated) News items New books Personalisation

63. Create your own personal information landscape tailoring a page to meet your own needs Save ‘favourite’ searches, links etc Save frequently used resources Subject specialist interest groups Sector interest groups

64. Evaluation Rigorous evaluation –all sectors of users –ease of use –searching –functionality –communication –editorial control

65. Project Team –Project manager –Information Manager –Web developer 2 year project -Funded by PPP Healthcare Managed by NHS Education Scotland NHS Scotland e Library

66. Project plan - map of services Map the Library and Knowledge Services available to all sectors in the West of Scotland including other information providers e.g. charities We will be contacting all libraries in the West in the next few weeks.

67. Plan - user needs investigation The information needs of all users in all sectors of the patient journey –build on findings of a pilot project looking at needs of the Colorectal Cancer MCN –contribute to a Scotland wide needs analysis

68. Plan - Conference Jan 2004 Conference Jan 2004 to ratify maps and propose changes to the Library and Knowledge Services to better meet the needs of the clinical networks Launch pilot portals Identify any gaps and propose systems and services to fill them

69. Organisation Project Board –all stakeholders Project Panels –information providers Communities of Interest –long term sustainability

70. Conclusion Work with the clinical networks to provide access to the information and learning resources needed by healthcare staff and patients in the West of Scotland. Work with networks of librarians