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National Library for Health

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Title: National Library for Health


1
Knowledge is the enemy of disease Sir Muir Gray
NKS
  • National Library for Health
  • Angie Clarke Head of Service
  • angie.clarke_at_institute.nhs.uk

2
The origin of the National Knowledge Service
  • UK culture when something goes wrong
  • We have a Public Inquiry eg
  • Kennedy Report 2002 which was a
  • Public Enquiry into Childrens Heart Surgery
    Bristol Royal Infirmary 1984 - 1995
  • Higher than average death rates and damage to
    young children undergoing heart surgery
  • Kennedy Report http//www.bristol-inquiry.org.uk/
  • Key factors were
  • Poor quality of information
  • Poor communication
  • Poor training
  • Lack of standards, and
  • Failure to put the patient at the centre of
    care

3
The origin of the National Knowledge Service
(continued)
  • As a result
  • The UK Secretary of State for Health announced
    the creation of the
  • National Knowledge Service in 2002
  • To support the delivery of high quality
    information for patients and staff

4
The National Knowledge Service is responsible for
  • Planning knowledge management
  • Describing knowledge needs in 2011
  • Working on the principle that
  • "The future is here. It's just not evenly
    distributed."
  • William Gibson
  • What will be in general use in 2011 can be seen
    somewhere already today

5
Current Knowledge Status
Knowledge is like water, clinicians and
professionals and patients need clean clear water
for good health. Muir Gray NKS
  • What we have
  • What we want
  • How we will manage it

6
National Knowledge Service why its needed
  • There are a significant number of knowledge
    providers
  • Department of Healths guidance and knowledge
    base, including
  • Care Service Improvement Partnership and the
  • Public Health Observatory
  • NHS Institute
  • National Institute of Health and Clinical
    Excellence (NICE)
  • National Patient Safety Agency
  • Medicines and Healthcare Products Regulatory
    Agency
  • NHS RD Programme
  • Health Protection Agency
  • Information Centre for Health and Social Care
  • Health Care Commission
  • NHS Direct New Media
  • Social Care Institute of Excellence.
  • Knowledge has to flow between all parts of the
    NHS organisation
  • http//www.nks.nhs.uk/cko.asp

7
The NHS Institute for Innovation and Improvement
supports the NHS to ? Transform healthcare for
patients and the public by ? Rapidly developing
and spreading new ways of working ? New
technology and world class leadership.
Learning
Leadership Development
Priority programmes that help drive the NHS
reform agenda
Product and technological Innovation (NIC)
Service Improvement
8
NHS Organisation and Knowledge Management
The best current evidence is where all the
government departments work together to produce
guidance in a manner which is useful to
clinicians. Muir Grey NKS
Chart Source NHS Choices About the NHS
http//www.nhs.uk/aboutnhs/howtheNHSworks/Pages/Ho
wtheNHSworks.aspx
9
National Knowledge Service
  • Information system as a supplement and extension
    of the human memory, delivering knowledge where
    and when it was needed
  • J A Muir Gray 2006 NKS

10
Functions of the National Knowledge Service
  • National Library for Health
  • The National Library for Health...aims to be
    the best, most trusted health related knowledge
    service in the world
  • Responsible for the organisation and gathering of
    knowledge
  • Provide the technical standards and solutions for
    knowledge to be delivered - where and when it is
    needed
  • Either as a result of
  • Pulling the information (direct search)
  • Pushed to them (RSS or blogs)
  • National Library for Health - http//www.library.
    nhs.uk/

11
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12
Functions of the National Knowledge Service
  • Best Current Evidence Service
  • Responsible for the
  • Production, and
  • Procurement (ie from others) of the evidence that
    both
  • Clinicians and patients need
  • Clinicians need evidenced knowledge to ensure
    robust clinical judgment for every patient in
    every part of the NHS
  • Patients need evidenced knowledge as Patients
    share responsibility for managing own health
    Expert Patient
  • Best current knowledge - http//www.nks.nhs.uk/be
    stcurrentknowledge.asp

13
Example of an Evidence Service
  • SCHIN (The Sowerby Centre for Health Informatics
    Newcastle)
  • Clinical Knowledge Summaries (CKS) are concise
    summaries on
  • How to manage almost 500 clinical situations
    (scenarios) commonly encountered in primary and
    first contact care
  • These are underpinned by detailed up-to-date
    clinical knowledge on acute and chronic
    conditions, and disease prevention
  • So whether you need a quick overview or the full
    text on a topic, CKS can help
  • SCHIN - Certification by the British Standards
    Institute (BSI) of International Standard ISO
    90012000
  • SCHIN http//www.cks.library.nhs.uk/search/0/schi
    n

14
(No Transcript)
15
Information Overload
  • Per Year
  • 10,000 new diseases and syndromes
  • 3,000 medications per year (Harvard Business
    School, 2002),
  • Per Day
  • 1,260 new clinical articles,
  • 80 new Primary Care Guidelines and
  • 55 new clinical trials every day (Bandolier,
    2007)
  • Map of Medicine - http//www.mapofmedicine.com/

16
Functions of the National Knowledge Service
  • National Decision Support Service
  • The Support Service Refers to the National
    Library for
  • Guidelines
  • Protocols
  • Care Pathways
  • Map of Medicine
  • Tools and Rules
  • National Library will be working with NICE to
  • Develop tools and resources to support clinical
    decision making
  • Decision Support - http//www.nks.nhs.uk/decision
    support.asp
  • Map of Medicine - http//www.mapofmedicine.com/
  • NICE - http//www.nice.org.uk/

17
Challenges
  • Expanding need for knowledge
  • Shrinking finance
  • Rapid digitisation
  • Expanding Continuing Professional Development for
    all health and support staff
  • Personalisation of this resource to meet
    individual/local needs
  • Contributing to the Patient Pathway (1st visit
    outcome), and
  • Reducing Organisational Risk
  • More competition
  • Complex networks
  • Information overload

18
Direction of travel
  • Always Available
  • Digital, paper and strategically, NLH librarians
  • Local NHS libraries in
  • Hospitals
  • Trusts, and
  • Universities
  • Via the web
  • At work, home or on the move
  • NLH services will be available and embedded in
    the systems staff and patients use on a daily
    basis

19
Direction of travel (continued)
  • Integrated with intermediate services
  • The library will be available as part of a
    variety of other services, including
  • General search engines
  • Google - Microsoft
  • The NHS Common User Interface
  • 40,000,000 development effort by Microsoft
    free to the NHS
  • Customised MS Office and Windows for health so
    that everyone sees the same
  • User interface for clinical systems that can be
    used by software developers
  • Map of Medicine
  • Information resource that visually organises the
    latest evidence and best practice guidelines into
    382 patient pathways
  • Infobutton services
  • Button on the computer desktop direct to NLH
  • Can be customised for areas of interest

20
NLH Customer Base
  • Stakeholders
  • National Library for Health - 1,250 Health
    Librarians other staff
  • Strategic Health Authorities (SHAs)
  • Deaneries (postgraduate medical training
    Drs, Dentists, Ophthalmologists)
  • Trusts
  • Key partners eg
  • Social Services
  • Museums, public Libraries and Archives (MLA)
  • Higher Education Institutes (HEI) - Collages and
    Universities
  • NHS-HE connectivity for students, researchers
    and teachers
  • Enables secure anytime, anywhere access by
    medical, nursing and allied profession students,
    clinical teachers and researchers
  • NHS and Higher Education Organisation
    http//www.nhs-he.org.uk

21
User design experienceThe process
  • LBi were commissioned to report on how people use
    the NLH for searching
  • They carried out an On-line Survey
  • 5 User groups identified
  • Nurses / Midwives / Health visitors
  • Consultants / Doctors /General Practitioners
  • Allied Health Professionals
  • Managers
  • Librarians
  • In-depth interviews with a sample of all these
    groups
  • at their place of work
  • looking at how they used the internet and NLH in
    particular
  • qualitative interviews, not quantitative
  • From this they built up personas, based on their
    style of searching this was not related to their
    roles
  • The personas will be used to inform current and
    future developments

22
Personas
  • Proactive Searchers those who had recently been
    engaged in study or research. They used NLH
    solely for searching and expected similar
    functionality to journal websites.
  • Wayfinders those who expected to be guided by
    what they saw on the home page, following links
    that they recognised. This approach to using the
    web relied on a high level of trust in content
    before exploration could take place. It has also
    been described as an orienteering approach (see
    Teevan et al , 2004). If wayfinders did choose to
    search deliberately they would expect the simple
    search to provide adequate results.
  • Knowledge Managers those interested in up to
    date information and a broad view across
    disciplines. Usually familiar with the NLH site
    and all supporting information sources. Would
    tend to personalise the NLH website and use it as
    a central hub directing them to known sources
    rather using the NLH for searching. This group
    would include librarians.
  • Email Searchers those who had minimal time to
    spend searching for online information and relied
    on information to be pushed to them via email
    alerts or bulletins.

23
My Library
  • My Library is a new feature, which allows you to
    personalise the National Library for Health (NLH)
    so that you only see the content that you want to
    see. Features include
  • Search Facility the Single Search Environment
    enables you to refine your searches so that you
    only search the resources that you want to
    search. You can also save searches and results
    for future use.
  • Home Library your Athens username identifies
    the library closest to your working environment
    and automatically sets it as your home library,
    with a link to their web-site. (The home library
    can be changed if required).
  • Find A Library type in free text or your
    postcode, and find details of medical libraries
    close to you.
  • My Links a resource, which allows you to add
    and categorise your favourite web-sites, so that
    you can make My Library your homepage. You can
    also email links to your colleagues!
  • My Feeds an easy way to keep up-to-date, by
    registering your RSS (Really Simple Syndication)
    feeds on My Library, so that current knowledge
    from your chosen resources is delivered to your
    personal NLH.
  • My Athens all the electronic resources
    available to you both nationally and locally are
    listed in My Library, so that you have everything
    you need in one place.

24
My Library
  • My Library is a new feature, which allows you to
    personalise the National Library for Health (NLH)
    so that you only see the content that you want to
    see. Features include
  • Search Facility the Single Search Environment
    enables you to refine your searches so that you
    only search the resources that you want to
    search. You can also save searches and results
    for future use.
  • Home Library your Athens username identifies
    the library closest to your working environment
    and automatically sets it as your home library,
    with a link to their web-site. (The home library
    can be changed if required).
  • Find A Library type in free text or your
    postcode, and find details of medical libraries
    close to you.
  • My Links a resource, which allows you to add
    and categorise your favourite web-sites, so that
    you can make My Library your homepage. You can
    also email links to your colleagues!
  • My Feeds an easy way to keep up-to-date, by
    registering your RSS (Really Simple Syndication)
    feeds on My Library, so that current knowledge
    from your chosen resources is delivered to your
    personal NLH.
  • My Athens all the electronic resources
    available to you both nationally and locally are
    listed in My Library, so that you have everything
    you need in one place.

25
My Library
26
The Benefits of a National Knowledge Service and
NLH
  • Value for Money Good Communication Network
    Validated Knowledge
  • Access to validated information, articles,
    research and networks
  • Clinicians access to
  • Clinical information and supported decision
    making
  • Patients accessing
  • Validated information and sharing responsibility
    for their health
  • Managers accessing
  • Information for service and workforce planning
  • Workforce access to
  • Support Practice, and
  • Continues Professional Development
  • Service delivery improvement
  • Hospitals

27
Clinical and Financial Benefits of Access to
Research
  • Access to Research
  • 80 clinicians changed their practice as a result
    of evidenced based research
  • Avoided hospital in 12 of cases
  • Reduced length of stay in 19 of cases
  • Changed diagnostic tests in 51 of cases
  • Changed drugs choices in 45 of cases
  • Avoided additional tests or procedures in 49 of
    cases
  • Source Bandolier
  • Map of Medicine - http//www.mapofmedicine.com/

28
Jargon Buster
29
Contact
  • Angie Clarke
  • Head of Service
  • National Library for Health
  • NHS Institute for Innovation and Improvement
  • Coventry HouseUniversity of Warwick
    CampusCoventry
  • CV4 7AL
  • Tel07798367512
  • Email angie.clarke_at_institute.nhs.uk
  • Website http//www.library.nhs.uk/Default.aspx
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