knowledge into action - tests of change€¦ · web viewknowledge network/broker – look at...

Knowledge into Action Details of suggestions and ideas for tests of change collated from Knowledge into Action event on 30 January

Local activities – suggestions which require a small amount of input or support from the K2A change team

Type of Knowledge into Action activity

Brief description Partners / Stakeholders

Main contact / Suggested by

Relational use of knowledge

Social Networking – improve integration within board NHS Forth Valley


Lunchtime critical appraisal (journal club) – juniors not really interested due to time. Learning from library staff.

NHS Ayrshire & Arran

Mhairi McMillan, Head of Knowledge ManagementSally Smith, Executive lead


Peer assist review sessions to gather expert knowledge at start of improvement project.Discussed possibility of librarians facilitating such review sessions.

? ?

Search & Synthesis

Pushing out evidence reviews around specialities – uses BMJ evidence updates. Widen to nursing and AHP colleagues, clinical improvement team. This is sustainable – it gives library assistants a role in managing and moving away from traditional lib assist role.



Search & Synthesis

To have an evidence-based “skin tear box” (containing steristrips etc) and accompanying best practice statement available in all wards and clinical areas to treat patients with skin tears in a standardised way. Need to pilot in one area.

NHS Fife Lynn Coyne, Specialist nurse, Queen Margaret Hospital, Dunfermline.

Search & Synthesis

Ensure the evidence around delayed cord-clamping of the newborn is implemented in practice.

NHS Fife Annette Lobo, clinical midwifery services co-ordinator, Victoria

For more information contact:Suzanne Wilson, Improvement Manager (Knowledge into Action)[email protected]

mailto:[email protected]


Improve neonatal outcomes.Potentially reduce requirement for resuscitation of newborns.

Hospital, Kirkcaldy.

Search & Synthesis

Test search and synthesis service within Physiotherapy. To support physiotherapist staff in answering clinical queries as part of their day to day practice.

NHS Greater Glasgow & Clyde: Knowledge services & Physiotherapy

Fran Harkness, Knowledge ServicesSara Conroy Practice Development, Physiotherapy – initial contact

Search & Synthesis

Clinical effectiveness programme for AHPs cohort. To provide support (Information skills training, searching services) and guidance to AHPs undertaking a 1 yr clinical effectiveness project.

NHS Greater Glasgow & Clyde:Knowledge services and AHPs

Fran Harkness, Knowledge SevicesSara Conroy Practice Development, Physiotherapy – initial contact

Search & Synthesis

Rapid search and synthesis services for Neuroradiologists at SGH. Consultant Neuroradiologists currently as a group carry out Medline search for unusual cases and discuss as a team to reach conclusion. Scope out pilot to see how/if library staff can better support Neuroradiologists in identifying relevant evidence in timely manner for unusual clinical cases. Perception was that the library was for research/education/publication but that the turnaround would be too slow for clinical queries…

NHS Greater Glasgow & Clyde: Consultant Neuroradiologists at SGH

Ravi Jampana, Consultant Neuroradiologist.

Search & Synthesis

Rapid search service for Renal Unit at WIG for questions raised during ward rounds. Could pilot something similar to ICU?

NHS Greater Glasgow & Clyde: Knowledge Services & Renal

Catherine Stirling, Consultant Nephrologist




Unit, WIGSearch & Synthesis

Ward round attended by knowledge broker. Pilot to gather answers to clinical queries that occur on ward. For learning but also real clinical need. Could be pre-warned.

NHS Lothian: patients, junior doctors

Sonia Joseph (RHSC/Royal Victoria new build)

GP to try CLEAR and feedback to partners NHS Tayside Christopher Weatherburn, GPSearch & Synthesis; Actionable knowledge

Signpost clinicians developing new guidelines/clinical pathways to local knowledge broker – include in clinical pathway development guide. Ensure adequate support data at the beginning of their work.

NHS Tayside: group clinicians & knowledge broker

Rebecca Locke

Search & Synthesis

Evidence summaries to support change clinical management. Clinicians contracting new or revised guidelines/clinical pathways.

NHS Tayside: knowledge broker led evidence search & group clinicians

Rebecca Locke

Search & Synthesis

AHP physical activity pledge – support pledge to improve clinical practice of AHPs to address Scotland PA challenge. Improve Health.

NHS Tayside: Knowledge broker

Kay Brown, AHP

Search & Synthesis

Diabetes foot disease & use of slipper casting to reduce infection & amputation rates, increase patient comfort and mobility. Knowledge network/broker – look at evidence to support test of change and training to implement.

NHS Tayside: Podiatry, specialist/multi-disciplinary team

Kay Brown, AHP

Search & Synthesis

To use knowledge brokers to support staff projects – encourage evidence-based search prior to starting actions. Sessions with knowledge brokers to develop own skills in searching, question development and measurement

NHS Tayside: AHP managers and staff, knowledge brokers

Nic Richardson

Search & Synthesis; Broker role

Implement a ‘broker’ to support development of a delirium evidence bundle.Improvement and Implementation unit & Knowledge Management team

Healthcare Improvement Scotland & National Delirium Steering

Penny Bond




GroupBroker role Implement brokers to assist with programme development, to

embed K2A approaches to make suggestions about K”A and other expertise.

Healthcare Improvement Scotland

June Wylie

Broker role Supporting implementation of NHS Health Scotland’s Corporate Strategy.The project will identify, capture and apply the knowledge that exists within Health Scotland to support implementation of its corporate strategy. (Existing test of change)

Health Scotland Matt Lowther

Broker role Improve use of CLEAR service by clinicians. (Continuation of test of change)

NHS Forth Valley Emily Fotheringham

Broker role Awareness and perception – of KB services. Needs to be better. Opportunity to engage with Clinical Governance Group – raised the possibility of issuing another questionnaire within board as 4 years since the last. Changing perception of the librarian.



Broker role FY staff – induction or other opportunities. Impt of embedding in education.



Broker role Clinical Librarian role – once per week intervention at team meetings (already underway). Having a KB conversation. Feedback from juniors positive. Attending multi-disciplinary meetings. iPad to facilitate discussion.






Change team input – Suggestions which require significant input from members of the change team




Search & Synthesis; Actionable knowledge

Intranet > Internet – transfer/mirror.To make searching easier e.g. paediatric guidelines. Easier to link, speed of access, closer to real time. Pilot with advice on indexing and technology.

NHS Lothian: all departments, web master & editors

John Steyn

Search & Synthesis; Actionable knowledge

Develop online technology bundles – clinical decision tools to help staff make decisions. Via iPads and mobile devices. To increase access to high quality resources – to give access to ‘limited’ quality info for speed of access to the best info.

NHS Lanarkshire: Knowledge & library services, OD, IT, PEF/nursing colleagues

Amanda Minns, Knowledge & Library Services

Search & Synthesis; actionable knowledge

How to get clinical guidelines into practice – specifically for Acute Kidney Injury. Identification and management could be improved. Bundle approach – solutions to be defined

NHS Greater Glasgow & Clyde: Knowledge Services & Renal, Medical Receiving

A collaborative approach:Catherine Stirling, Consultant Nephrologist.Medical Receiving clinical lead to be identified.Knowledge Services, Clinical Governance, and Medicines Info group to support.

Actionable knowledge

NHS Dumfries and Galloway producing mobile app – can add to tests of change as basis for transferable learning; incorporate in Knowledge Network mobile knowledge area. (Underway)

NHS Dumfries and Galloway

Anne-Marie Coxon





Pathway publication toolkit – how easy is it to generate, can an individual do this readily?

NHS Tayside Christopher Weatherburn, GP


Testing and roll out the publication toolkit. Could be tested as part of the AKI ToC – and /or be part of a test of a Knowledge Services/Clinical Governance support package for Clinical Guidelines.

NHS Greater Glasgow & Clyde - To be finalised – possibly AKI, or other guidelines

Knowledge Services and Clinical Governance (Med Info too?)In partnership with the clinical guideline owners/areas.


Adopt NES taxonomy and clinical Publication Toolkit. For use with Clinical guidance Intranet

NHS GrampianCGI steering groupPrimary and acute clinicians

Steve Baguley


Use of CDSS browser plug in NHS Fife

Actionable Knowledge

Potential for development of CDSS browser plug-in for Hospital@Home Team to be used on mobile devices.Immediate access to relevant information while visiting patients in the community

NHS Fife Marianne Murdoch, Practice Educator, NES/NHS Fife.


Developing Apps for dentists to support decision making NES TRIADS team


Pathway tool – NES to arrange a workshop. NHS Ayrshire & Arran & NES



Mobile awareness, workshop opportunities – NES to arrange an awareness session. Look at how we share.

NHS Ayrshire & Arran & NES



Decision Support – embedding Dynamed in trakcare. eHealth as a barrier. Trakcare move towards this being the system of choice. Need to persuade clinicians beyond use of up-to-






date. Browser plug-in also a possibility linking with patient context to Dynamed. Needs clinical buy-in – clinical directors, medical director, medical education.

Broker role Develop basic Knowledge Network /Knowledge into Action elearning resource; upload to LearnPro for national use as part of induction.Provide basic learning and support tailored to the needs of frontline staff. National use by frontline staff.

NHS Dumfries and Galloway & NES

Helen Coles, NHS Dumfries and Galloway.NES role to produce this resource.


‘Roadshow’ style events to spread the word of KIA NHS Lothian.NES (presence and marketing materials)Health promotion

Mairi Simpson

Co-ordinated processes – suggestions which may be delivered locally but would benefit from national co-ordination via the K2A change team




Search & Synthesis

Evaluation of impact of literature searches in NHS Borders already underway –suggested including this in portfolio of tests of change; and share learning with other Boards. (Underway)

NHS Borders Kath Liddington

Search & Provide knowledge into action support to Clinical Advisory NHS Highland Anne Gillespie.




Synthesis Group.Mainstream knowledge into action support within clinical priorities.Evidence searching and perhaps other knowledge into action services.

Emma Watson

Search & Synthesis

Produce summary of evidence for paramedic topic; include use of clinical knowledge publisher to visualise as pathway. Provide quick and easy access to clinical knowledge for practice tailored to needs of paramedics.Sourcing and summarising of evidence for paramedic questions in particular clinical topic. Package and present in highly usable format tailored to paramedic needs. Visualisation as pathway likely to be helpful.Noted that this should be accompanied by training of SAS staff – a) of selected posts to contribute to such developments in future and b) to increase general self-sufficiency among clinical workers in sourcing, sharing and using knowledge.

Scottish Ambulance Service.

Since SAS has no librarian/KM service within the Board, this will require support from the wider knowledge broker network, as well as providing the opportunity to develop roles and skills within SAS.

Christopher Conroy

Search & Synthesis

Expanding uptake of CLEAR service to address capacity limitations in supporting clinical evidence search and synthesis in Boards with low library staffing levels.Tests of change of use of CLEAR service by clinicians in 4 new Boards.Noted need to define prioritisation model and scope of appropriate use of CLEAR in each Board – e.g. for State Hospital it is important for librarian to be directly involved in searches specific to corporate needs.

NHS BordersNHS D&GState Hospital(Possibly Scottish Ambulance Service and NHS Highland)

Rebecca Hart (State Hospital)Kath Liddington (NHS Borders).Anne-Marie Coxon and Audrey Marshall (Dumfries and Galloway).

Possibly – Christopher Conroy (SAS) and Anne Gillespie (NHS Highland/University of Stirling).




Should be accompanied by programme of training for frontline healthcare staff in sourcing, sharing, using knowledge, so that knowledge brokers are being asked only to conduct searches for the more complex or urgent needs.

Search & Synthesis

Alternative & Augmented Communication project NES Susan Shandley , NES

Search & Synthesis

Promoting the CLEAR service to dentists in the community NES TRIADS team

Search & Synthesis

Promoting CLEAR service to General Practice Specialists Trainees

NES Ron McVicar, NES Highland

Search & Synthesis

Guidelines – local v national. Mentioned emerging nurse guidelines (Marie Nimmo)



Capacity & Capability

Investigate how K2A can support education for the new roles associated with health and social care integration in Highland and Orkney

NES Pam Nicol, RRHEAL,NES

Capacity & Capability

Investigate how K2A can support the changing role in Rural General Hospitals

NES Pam Nicol, RRHEAL,NES



knowledge into action - tests of change€¦ · web viewknowledge network/broker – look at...

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