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Information Services - supporting staff, patient care, local communities

Trust Library and Information Services Annual Review

April 2013 – March 2014

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TRUST LIBRARY AND INFORMATION SERVICES: REVIEW OF ACTIVITIES Our vision: to improve patient care by leading in NHS information service provision to enable and transform the way professionals use evidence-based information. Summary The Library and Information Services [LIS] offer a joined up service across South Devon and are regarded nationally as innovative. LIS save staff, students and departments time and money, and directly benefit research and patient care. This review demonstrates continuing demand for core services and wider activities which support health and care delivery. 1. Twelve months in headlines Throughout 2013/14 the LIS team have contributed to the Trust’s wider agenda by:

1. Setting up the Torbay Health Science Café, and winning a national innovation award for it

2. Supporting patient care by taking Library and Information Outreach Services to community staff in hospitals across South Devon

3. Promoting evidence-based practice by delivering information-skills training at

community hospitals across South Devon

4. Delivering monthly suites of informal ‘bite sized’ information-skills sessions aimed at clinical and non-clinical staff, in the Library and elsewhere

5. Contributing to the Trust’s shared-decision-making CQUIN by creating and

maintaining a resources webpage and writing the first quarterly report

6. Tracing published evidence to support complex South-Devon wide Integrated Care and Pioneer work

7. Providing 778 welcome sessions to the LIS throughout the year, to individuals

ranging from trainee doctors, medical and nursing students to bank staff

8. Facilitating the Pain Management team to pilot national Books on Prescription scheme by liaising between them and the Reading Agency

9. Planning and delivering all aspects of a consumer-health-information event

for South West NHS library staff and others in Taunton

10. Promoting safe internet searching techniques to find health information during an interview on BBC Radio Devon

11. Delivering pilot session on finding safe health information to eight members of

public and collaborating with Torquay Public Library’s manager for this event

12. Contributing to community engagement and equality and diversity agendas by organising a public celebration of the Trust’s partnership with Nanyuki Hospital in Kenya.

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In addition to ongoing activities, new services were implemented in 2013/14 to meet users’ changing needs and to improve day-to-day services, including:

1. Piloting extended opening hours from January by remaining staffed until 8pm on Wednesdays

2. Piloting delivery of training via live webinars to the desktops of TSDHCT,

CCG and DPT staff

3. Increasing the support offered to staff involved in research activities by hosting regular drop-in research surgeries via the Research Design Service.

2. Demonstrating quality and accountability The Services are managed and delivered by professionally qualified and trained, expert staff. The small team of four compares favourably with other NHS libraries. Services include sourcing evidence-based information, delivering information-skills training, enabling access to print and electronic books, journals, and providing IT facilities with extensive electronic resources, quiet study and group study spaces. All NHS Information Services are evaluated annually through a national quality assurance framework. South Devon’s LIS is one of the highest performers nationally, currently demonstrating 97% compliance against 49 standards covering strategic and financial management and service development. The current LIS Strategy and Business Plan are available online: http://www.sdhl.nhs.uk/about-the-library.html 3. Supporting staff to provide high quality, safer care: users of the Services User numbers are rising, with 2,834 registered members at 31st March 2014:

In 2013/14 staff across South Devon used the LIS for clinical, educational, research and CPD needs. Provider and commissioning staff were supported: trainee doctors working in the Hospital and GP practices, public health, mental health and a wide range of multi-professional staff; nursing, AHP and medical students also all used the Services. Most members are SDHCT staff, probably because the Library is located in Hospital grounds. Raising awareness and improving publicity is an ongoing activity.

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Library membership at 31st March 2014 by ESR staff group:

Throughout 2013/14, 778 new staff and students received an induction tour of the Library:

4. Service effectiveness and improvement 4.1 Outreach New for this year, the Senior Library Assistant instigated outreach services by taking resources and help out to community hospitals across South Devon on eight occasions, covering Newton Abbot, Teignmouth, Dawlish, Totnes and Paignton. The Assistant Librarian re-launched outreach delivery of information-skills training in community hospitals, making seven visits, to Newton Abbot, Paignton and Rowcroft. Additionally she offered eight live WebEx sessions to staff in Totnes, Rowcroft, the CCG and elsewhere across the South Devon community.

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4.2 Information delivery Trained, expert Library staff responded to information-seeking enquiries, saving time and improving patient care by enabling use of the evidence-base: 500 library.sdhct@nhs.net incoming emails processed and 360 enquiries answered at the helpdesk [averaged monthly figures]. Professional staff searched medical and management databases for published literature on topics including:

Parents’ perceptions of services assessing children for developmental delay

Managing theatre waste sustainably

Management of long-term sickness absence

Details to support a PenCLAHRC bid

And various relating to Pioneer indicators; integrated care; integrated working; GP referrals; talent management

4.3 Training delivery In 2013/14 417 staff received training via 85 group sessions and 69 one-to-ones, compared to 323 in 2012/13. The Assistant Librarian delivered information-skills training to enable evidence-based practice, including launching her new suite of 20-minute bite-sized sessions highlighting a range of information skills and resources. Our impact-monitoring shows how this training led to changes in patient care / work practice:

“We are changing the way we deliver hand exercise programs." AHP

"Has aided the development of a specific patient assessment." A&C

"To inform guidelines, planning teaching sessions, keeping updated." Nurse

“To inform policies and protocols. Evidence for supporting teaching." Nurse. We also provide occasional bespoke teaching, e.g. to provide a day’s cover for a tutor’s sick-leave with an advanced apprenticeship group in December. 4.4 Electronic activities Combining our knowledge, skills and management of Athens, our website and electronic resources, we enable staff to access from work or home numerous resources including databases, journals and electronic books, although these users may not regard themselves as users of the Library. 1,112 SDHCT and TSDHCT staff are registered Athens users at 31st March 2014, shown here by ESR staff category:

“The literature search which you very kindly conducted … on the impact of integration has gathered quite a bit of interest amongst other Pioneer sites via the national Pioneer website... Thanks!” CCG/Pioneer

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The LIS’s website enables 24/7 access to quality-evaluated information, databases and electronic resources for users at work or home. The Assistant Librarian manages our 58 webpages which gain on average 500 website visitors per month who make 1,460 page-views. Social media including Twitter is used to alert colleagues to training opportunities, new resources and topical health-related reports etc. Quick Response (QR) codes are used to direct users straight to webpages and resources on their mobile phones. In an experience mirrored nationally, we have struggled to encourage users to read electronic books, locally averaging about 150 accesses per year [over three years]:

We have actively promoted ebooks at inductions for new staff, using QR codes, displays in the IT room, on reading lists and via 10 bite-sized awareness sessions. 4.5 Supporting evidence-based practice LIS staff used their expertise to save time and money for our users by sourcing 503 journal articles and text books from other libraries throughout 2013/14 (down slightly by about 20 from 12/13):

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Throughout the year 5,504 books and DVDs from our own local stock were issued (remaining consistently around 5,500):

Our impact-monitoring shows how these loans led to changes in patient care / work practice: “I used relevant sections of the books to inform my material, which I am delivering to my

students. My awareness and depth of understanding of my chosen topics has increased considerably due to the quality/variety of the books on offer in the library. This has not only benefited my patient care, but also potentially that of my students - future health care practitioners.” Nurse

“I updated my knowledge which will improve my current clinical practice.” ST1 paediatrics

“I was preparing for the GPST2 exam, and then needed reference books to help me survive the cross cover SHO role where I had to be night cover for Ortho. I used the GP books to revise from & the ortho book to help me interpret Xrays better. I got a place on the GP training program & have survived 5 days so far of the cross cover SHO role.” F2

“I used every book I borrowed, either for background reading or reference. My resulting knowledge has changed my practice in a variety of ways -I have a greater understanding of evidence-based practice, long-term conditions, contemporary occupational therapy practice, and how emotional intelligence is relevant to management. Personally I find real books easier to use than e-books, to locate specific references.” Specialist palliative care OT.

Total Loans

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4.6 Developing resource-provision A review of the entire book-stock was completed in 2013/14. Stock was developed to support course-work and issues e.g. patient care and caring for frail elderly patients. 6,556 total books/DVDs, which are shelved and tidied daily 481 items added in 2013/14 (selected, catalogued, bar-coded, tagged). A substantial review of print journals usage was completed in July and summarised at: http://www.sdhl.nhs.uk/assets/docs/journal_survey_summary_2013.pdf Thirty print titles were subsequently cancelled for 2014. Much of the budget saved was absorbed by increasing prices imposed by publishing companies. Additionally in 2013/14, we:

Trialled a training resource Clinical Skills to inform a subscription from April 14

Facilitated licencing arrangements of UpToDate and BMJ Case Reports for use by clinicians

Promote and train staff to use new regional electronic subscriptions to HSJ and Anatomy TV.

4.7 Dedicated study space Throughout 2013/14 a dedicated IT-room, group study and quiet study spaces were available for users from all staff groups and for students on placement. In a crowded hospital environment having appropriate space to study is essential, for medical and other students, trainee doctors, and staff developing their patient care. Use of space was monitored throughout the year on Mondays – Fridays between 08:30-17:00:

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LIS staff use the group study area for teaching bite-sized sessions and for additional activities e.g.:

Supporting staff across South Devon engaged in research, by arranging, hosting and promoting regular drop-in surgeries for staff and a bite-sized training session delivered by the SW Research Design Service (RDS)

Arranging and hosting a patent-searching session for junior doctors by SWAHSN. 5. Wider activities: contributing to health and wellbeing, patient experience, equality and diversity, community engagement and partnership The Information Services proactively support wider strategic activities across South Devon, regionally and nationally - the Manager regularly meets with other NHS library managers to discuss activities, and represents the South West on two national groups, National and Regional Athens Group [NARAG] and Consumer Health Information Group [CHIG] .

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Activities are promoted in Staff Bulletins and submitted to Trust Board Reports, and in 13/14 have generated a number of positive items covered in the media. 1. The LIS Manager devised and launched Torbay Health Science Café in April 13

– a monthly series of informal discussions for members of the public in the Horizon Centre’s café. Led by a practitioner these offer the opportunity to come on site at times other than medical need, to meet healthcare experts and increase awareness of complex health information. Webpage maintained at: http://www.sdhl.nhs.uk/cafe.html

The Café won a national award for innovation in NHS libraries in January 2014, and receives regular media coverage including an interview on BBC Radio Devon in November, and positive feedback from attendees: “I experienced the evening as enriching and what resonated for me personally the most was what I 'felt' from the two Practitioners. Their steadfast commitment to their work and their caring and communicative attitude touched me. The evening also reminded me strongly of my own responsibility that I have towards my own health.” Email received from attendee at a Café discussion on diabetes research.

2. The LIS Manager collaborated with the Chronic Pain Management team to

improve patient experience by arranging for them to pilot ‘prescriptions’ of the Reading Agency’s national Books on Prescription collection, being the only acute trust to explore this opportunity

3. The Assistant Librarian created and manages a webpage collating knowledge

and evidence for the integrated shared-decision-making CQUIN group at http://www.sdhl.nhs.uk/shared-decision-making.html; the LIS Manager wrote the CQUIN’s first quarterly report

4. We showed commitment to equality and diversity by supporting Project Search

- showing a young man who worked for ten weeks in the Directorate how to un-wrap and stamp in-coming journals

5. We delivered the Torbay/Nanyuki partnership event in May 2013, celebrating

diversity, supporting community engagement, and attended by staff, public and national E&D guests

6. We created posters and information displays e.g. for E&D events, Annual

Members’ Meeting in September and a reception for Health Minister Lord Howe in November.

6. Financial balance and income generation The Library and Information Services were delivered and developed within budget during 2013/14. This required collaborative work with library managers at other local trusts. The year was regarded as ‘transitional’ owing to lack of clarity regarding eligibility and associated funding streams for certain user groups, and because it was known that the current match-funding mechanisms agreed between the former-SHA and local trusts would be replaced from April 2014 with a tariff-based income stream. The team negotiated additional funding from HESW for fulfilling two regional activities: 1. Managing Athens accounts for NHS and other eligible staff in SW England and

representing them at national meetings, plus a protracted and complex extra

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Athens project reflecting changes introduced by NICE and Eduserv to Athens registration and admin processes

2. Representing SW England on a national group working to improve delivery of consumer/patient health information. Planning and delivering all aspects of a successful workshop for SW NHS library staff and others in Taunton, featuring a patient, a GP, NHS Direct and the Patient Information Forum; attended by public health staff and public library staff alongside NHS librarians.

7. Evaluation and reflection Measuring impact is difficult and time-consuming; all the team have made efforts to address this across a range of our services. Viewed together, statistics, monitoring activities and feedback illustrate the LIS’s positive impact both on the success of staff and students’ academic studies, and on how staff inform and improve their patient-care and work practices. The LIS has a reputation for offering an innovative, high quality service, but there is scope to provide excellent information services to more stakeholders. Changes to the funding-streams from April 2014 will determine which user groups are eligible to use the services. The desire to help more users must be balanced against the need to secure the funding required to achieve this. The main gap in service-provision identified through self-reported monitoring for national LQAF in September 13 was that the LIS could be doing more to support local research activities. Since September this is being addressed as outlined in Section 4.7 above. 8. Priorities for 2014/15 A national review of NHS library services is due to be published during 2014/15, and may inform direction. Meanwhile, the aim is to support SDHCT and TSDHCT by keeping the Library and Information Services at the forefront of information delivery for funded stakeholders. This will require continued “horizon scanning”. Improvements to service delivery scheduled for 2014/15: 1. Further developing outreach opportunities by building stronger links with

community staff as the ICO progresses 2. Reviewing journals holdings again; further cancellations of print subscriptions are

anticipated and an electronic collection Clinical Key will be trialled as a more modern alternative

3. Exploring ways of increasing electronic book usage, e.g. by trialling delivery to

users’ desktops/mobile devices via a flexible new service called Ebook Library 4. Working with tutors to plan information skills training to support new Level 4

health and social care group starting in April 2014 5. Working with tutors to introduce information-skills to Critical Care Nursing NURB

at the outset of their course, for new cohort starting April 2014

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6. Working with clinical colleagues to support updated clinical induction programme starting May 2014

7. Continuing our pilot extended opening hours until 8pm on Wednesday evenings,

from April to June then review

8. Piloting an extension to our traditional enquiries service - to implement “Library

Help” using social media instant-chat technology

9. Creating and trial new current awareness system and/or tables-of-contents alerts

10. Developing our bite-sized suite of information-skills sessions to include “lunch-“

and “tea-bites” – delivered in the Library and via WebEx

11. Seeking to initiate and respond to a changing landscape regarding consumer

health information demands - given the increasing emphasis on regarding patients as equal partners, health information for patients and staff will be of increasing importance. E.g. the Café scheme could be expanded – RIF bid submitted May 14. Dependent upon additional funding-streams.

12. Negotiating appropriate funding as appropriate to provide a service to other user-

groups as/when identified. The LIS is currently funded to provide a service to SDHCT and TSDHCT during 2014/15.

Further details of all services summarised in this review can be provided upon request. Statistics for this Review compiled and presented by Tim Worth, Senior Library Assistant Review written by Helen Wharam, Library and Information Services Manager July 2014

Front-cover photos: Top left: Bite-sized information-skills training session in the Library Top right: Welcome-session in the Library for new trainee doctors Bottom Left: Impromptu class in the Library for advanced apprentices Bottom right: Members of public at the LIS team’s Health Science Café on health information.