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Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk 1. IMPACTE toolkit intro v4.5 Feb 2010
Quality:MK IMPACTE toolkit
This toolkit, gathering together templates and guidance to support evidence based working, has been prepared by Anne Gray, Commissioning Librarian, NHS Milton Keynes and Ann Skinner, Information Specialist, as part of the Quality:MK project. IMPACTE groups have been developed from 'Journal Clubs' and 'Evidence Based Discussion Groups', and have been named IMPACTE to more accurately reflect what they achieve- Improving Medical Practice by Assessing CurrenT Evidence.. A number of IMPACTE groups are being successfully run across Primary Care in Milton Keynes. The toolkit currently includes the following material to support IMPACTE groups
IMPACTE groups : Improving Medical Practice by Assessing CurrenT Evidence : a general leaflet
Hints and Tips on running an IMPACTE group
Core Resources for Evidence Based Practice
IMPACTE group summary templates to record discussions
o General summary where evidence is RCT, Systematic Review, qualitative research or
guidelines
o Social Marketing
Search strategy form
Search Results
IMPACTE Meeting record
Certificate of Attendance including PDP summary
Athens registration details
Map of Medicine – best practice pathways
o Details of new route for access via Athens registration
o Quick reference guide
Online Learning Resources
How do you JUDGE what you find on the Internet?
The toolkit is also available on the Quality:MK website at www.qualitymk.nhs.uk/impacte_toolkit.htm Find out more about IMPACTE groups from
Anne Gray [email protected] Linda Potter Primary Care and elearning Librarian [email protected]
Nicola Smith, GP Co-ordinator [email protected] Give your feedback on its usefulness, gaps, errors and omissions to
Anne Gray [email protected] .
Visit www.qualitymk.nhs.uk
health:mk Quality: MK v.5.2 April 2010
Quality: MK Evidence Based, Primary Care Led, Patient Centred
IMPACTE Groups
Improving Medical Practice by Assessing CurrenT Evidence
Quality:MK is a whole system approach to quality improvement driven by primary care, patient engagement and evidence. It aims to close the gaps between current ways of working and best practice. One way is to support multidisciplinary groups to follow through questions raised in routine clinical practice and to look at the evidence to answer these. The original Evidence Based Discussion Groups, grounded in everyday practice and generating stimulating discussions in an informal and supportive atmosphere have now evolved into IMPACTE groups to reflect their role in Improving Medical Practice by Assessing CurrenT Evidence. The discussions generated within these groups has built up enough of a body of discussion from which to select and then start to implement quality improvements genuinely driven by primary care. IMPACTE groups can be run within practices, across teams or as an online discussion forum. Details of the current groups can be found at www.qualitymk.nhs.uk/ impacte_groups_programme.htm
The steps of evidence based practice which are the basis of the discussion groups are
Identify a specific topic and formulate an answerable question. This can derive from a problem common to many patients or a single case.
Track down the best evidence. The Librarian can help with this. The evidence can include
an article or review critically appraised by the group Map of Medicine pathway NICE guidance
Apply the evidence What are the implications for practice and what steps do we need to take to apply the evidence to current practice? The discussion around the impact of the findings on practice is the most important outcome of the meeting
Establish an action plan Fundamental for putting the research evidence into clinical practice and facilitating change. More questions may need to be answered before implementing any changes
Implement and Audit Preferably audit before and after implementation
Review action plan
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health:mk Quality: MK v.5.2 April 2010
Revisit and review action plans from previous discussions
Setting up an IMPACTE group Training and information support to set up IMPACTE groups is available . The information specialists have developed a toolkit to support IMPACTE groups. This includes a ‘hints and tips’ leaflet and summary templates which form a written record of the discussions. This toolkit is available at . http://www.qualitymk.nhs.uk/impacte_toolkit.htm. For more details about how to move forward please contact Linda Potter (Primary Care Librarian) [email protected] Nicola Smith (GP Co-ordinator) [email protected] Nazia Mohammed (GP Co-ordinator) [email protected]
The summaries of discussions for the original Evidence based discussion groups and IMPACTE groups are
published at http://www.qualitymk.nhs.uk/impacte_groups_discussion_summaries.htm . Resourcing quality improvements Project monies may be available to support quality improvements, for example to fund an auditor, allow back-fill for staff time. Find out more about this from:-
health:mk Innovation fund Contact Project manager: Sue Pilgrim [email protected]
IMPACTE groups have evolved from the methodology for journal clubs developed by the Centre for Evidence Based Medicine at Oxford University http://www.cebm.ox.ac.uk .. The information in this leaflet is based on the experience and expertise of the SALT team at MKPCT, CEBM at Oxford University and Quality:MK Evidence into Practice project team. You may use this leaflet in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors Anne Gray & Ann Skinner
Questions
Clinicians
PCT/ health:mk
Patients
Review action plans
Specific answerable question
Track down best evidence
NICE guidelines Map of Medicine pathways Critically appraised articles
Apply the evidence-
the discussion around the impact of
the findings on practice
Action plan
Implement & audit
IMPACTE
groups
Quality:MK
www.qualitymk.nhs.uk Quality:MK : a whole system approach to quality improvement driven by primary care, patient engagement and evidence AG/AS . April 2010.– Hints & Tips for IMPACTE groups. V.3.3
Improving Medical Practice by Assessing CurrenT Evidence
Hints and Tips on running an IMPACTE group
Principles 1 How do we get started? 1 Where do we get ideas for questions, topics? 2 Where can we find the evidence? 2 At the meeting / On the day 2 Looking at the evidence 3 Applying the evidence 3 What do you do next? 4 Where can we get more help and advice? 4 For more details about how to move forward 4
Principles
IMPACTE groups are not educational exercises, but should be expected to have an impact on patient care
They should be informal, non threatening and friendly
The role of the “leader” is to maintain the momentum, not do all the work
These are an opportunity to discuss the evidence and share practice with colleagues
It is important to ally fears that it will involve high level critical appraisal and statistics which is what is expected from traditional journal clubs.
Each IMPACTE group works differently.
IMPACTE groups work on a ‘plan, do, study, act cycle – see the general leaflet on IMPACTE groups for more details
How do we get started?
Someone within the group or team or practice will need to set up the initial meeting. This person will probably organise dates, circulate papers and book rooms etc, but they do not always have to lead – this should be shared around the members.
The meetings are designed to be fitted into a lunchtime or even an early morning ‘breakfast’ meeting without putting anyone on the spot or giving anyone indigestion.
As many people as possible should be involved, it should be multi-disciplinary e.g. GPs, nurses, pharmacists, practice manager and other practice staff
Chose a topic of general interest to everyone, in particular for the early meetings
Is there a local champion you can call on who is aware of the latest guidelines and evidence who is willing to summarise the evidence and answer questions?
Try to hold the meetings on a regular basis so that it gets into people’s diary.
Quality:MK
www.qualitymk.nhs.uk Quality:MK : a whole system approach to quality improvement driven by primary care, patient engagement and evidence AG/AS . April 2010.– Hints & Tips for IMPACTE groups. V.3.3
Where do we get ideas for questions, topics?
PUNs (Patients Unmet Needs) and DENs (Doctors Educational Needs)
New NICE guidance
Articles in latest issues of professional journals
Critical Summaries in EBM (Evidence Based Medicine) or EBN (Evidence Based Nursing) journals
“Bright ideas” – I wonder if....
At the meetings everyone can suggest topics and then participants can vote on the ones they are interested in – this can produce a list of topics for the next 4-5 meetings.
Evidence behind prescribing targets
Current ‘ hot topics’
Where can we find the evidence?
Initial sources to look in include: o Guidance e.g
NICE http://www.nice.org.uk/guidance o Synopses of evidence based journal articles e.g.
Evidence based medicine (EBM) http://ebm.bmj.com Evidence based nursing (EBN) http://ebn.bmj.com
o Systematic reviews e.g Cochrane http://thecochranelibrary.com MeReC bulletins http://www.npc.co.uk/ebt/merec.htm
o Summaries of evidence e.g. Clinical Knowledge Summaries http://cks.library.nhs.uk/home
If you use a synopses you still probably need to obtain a copy of the original paper to be able to answer all your questions
Chose a reputable source to increase the chances that the study has been well done and worth spending the time on.
If possible chose evidence known to be of high quality so that you can move on to the discussion more quickly
Use the studies of primary literature section in the ‘Core Resources for Evidence Based Resources’ in the toolkit to find useful original journal articles such as RCTs, Clinical trials and qualitative research. You will need to critically appraise these articles
Remember, if you haven’t got electronic access to the full text of the evidence you will need to allow time for the library to obtain a copy for you.
Try to circulate the paper/ document before the meeting but do not discourage attendance because people have not read it.
At the meeting / On the day
Who is leading the session
Who is taking notes? A blank form to record discussions and actions is in the EiP toolkit
Remember to recap on the action points from previous meetings, this could be a quick 5 minutes at the beginning.
Blank attendance records and an attendance certificate with space for reflection which can be used for a CPD record are in the EiP toolkit. It is useful to have these available at the meeting so individuals can fill in the reflection points as they go along.
Quality:MK
www.qualitymk.nhs.uk Quality:MK : a whole system approach to quality improvement driven by primary care, patient engagement and evidence AG/AS . April 2010.– Hints & Tips for IMPACTE groups. V.3.3
Choose the topic or question for the next meeting - ensure that it is of general interest to encourage attendance.
Ask different individuals to lead the group and write up notes at the next meeting
Looking at the evidence
Give people time to scan the material at the beginning of the meeting.
If you have a pre-appraised version (e.g. from EBM or EBN) or summary of the evidence this allows people to come up to speed more quickly than reading the full paper. But don’t rely on someone else’s summary to answer your questions, you still need the original article to refer to.
What is the paper about – is it relevant?
Use the IMPACTE record form to guide the discussion.
A PICO analysis (Patient/population ; Intervention ; Control ; Outcome) will allow you to decide if the study is relevant to the group
If you decide the study is not relevant – STOP and enjoy your lunch Was the study well done?
If the study sounds relevant, it is important to be sure that it was well done and that the results are actually worth spending time on.
Use the EiPDG appraisal notes to guide the discussion around different types of evidence and to record significant aspects of the document
If you decide that you do not have confidence in the evidence – consider looking for other similar studies to study
What are the implications of the evidence?
Record the clinical significance of the study to members of the group.
Encourage discussion around the current practice and the potential impact of the evidence on practice.
Everyone at the meeting will have a different understanding of the implications of the study; the discussion around the impact of the findings on practice is the most important outcome of the meeting.
What next?
One research study should not usually be used to change practice– are there other studies to corroborate the findings?
If there are differences in interpretation of guidelines can the group reach a team/practice consensus?
If there are issues which are not clear - is there someone you could call on or is there other evidence worth examining?
Applying the evidence
Remember to produce an action plan, with dates and who is responsible.
Action points can vary from simple actions to more detailed e.g. o checking whether a particular leaflet for patients is available in the practice, o following up a reference in the paper, o contacting an author for further information, o putting a shortcut to a Read code onto the patient system o carrying out an audit
Quality:MK
www.qualitymk.nhs.uk Quality:MK : a whole system approach to quality improvement driven by primary care, patient engagement and evidence AG/AS . April 2010.– Hints & Tips for IMPACTE groups. V.3.3
o reminder to all practitioners about referring particular patients to the speciality nurse in the practice
The note taker needs to record the action plan on the discussion group summary form and to make a note of the specific date agreed for the actions to be followed up.e.g. audit now and in six months,
What do you do next?
Roll out ideas that work to other practices, e.g. at Protected Learning Time meetings, discussions with other practices, by contacting the GP Champions (details below)
Project monies may be available to support quality improvements, for example funding an auditor, allowing back-fill for staff time.
o To find out more about this contact o Sue Pilgrim, Project Manager, Health:mk for details of their Innovation Fund
Where can we get more help and advice? A toolkit has been compiled to support the work of IMPACTE groups which includes
IMPACTE groups : Improving Medical Practice by Assessing CurrenT Evidence : a general leaflet
Hints and Tips on running an IMPACTE group
Core Resources for Evidence Based Practice
IMPACTE group summary templates for recording discussions o General summary where evidence is RCT, Systematic Review, qualitative
research or guidelines o Social Marketing
Search strategy form
Search Results
IMPACTE Meeting record
Certificate of Attendance including PDP summary
Athens registration details
Online learning resources
How do you JUDGE what you find on the internet? The toolkit is available at http://www.qualitymk.nhs.uk/impacte_toolkit.htm and you can be provided with a copy when you start your group
For more details about how to move forward
contact Linda Potter, Primary Care Librarian, based at Milton Keynes Hospital Library, . [email protected] Tel: 01908 243077 Dr. Nicola Smith, GP Champion Quality:MK [email protected] Dr. Nazia Mohammed, GP Champion Quality:MK [email protected]
www.qualitymk.nhs.uk
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk Quality:MK Core Resources for EBM v 4.7 Dec 2009.
Compiled by Anne Gray,( [email protected] ) , and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge the Quality:MK project
Quality:MK
Core Resources for Evidence Based Practice
Decision Support Systems Searched N/A
Map of Medicine (MoM) http://england.mapofmedicine.com (Athens username & password required)
Summaries of evidence
Clinical Knowledge Summaries (CKS) http://cks.library.nhs.uk/
GPNotebook http://www.gpnotebook.co.uk/
NHS Evidence http://www.evidence.nhs.uk/
Specialist Collections
TRiP http://www.tripdatabase.com
Drug Information:
a) National electronic Library for Medicines http://www.nelm.nhs.uk
b) National Prescribing Centre (incl. MeReC bulletins) http:// www.npc.co.uk
http://www.npc.co.uk
Social Care Online http://www.scie-socialcareonline.org.uk/
Synopses of evidence based journal articles
BMJ Evidence Updates http://www.bmjupdates.com/index.asp
Evidence Based Medicine journal (EBM) http://ebm.bmj.com )
Evidence Based Nursing journal (EBN) http://ebn.bmj.com )
OTseeker (Occupational Therapy) http://www.otseeker.com/
PeDRO (Physiotherapy) http://www.pedro.fhs.usyd.edu.au/
Syntheses of primary literature – evidence based reviews
Cochrane Library (Systematic reviews) http://www.thecochranelibrary.com
Centre for Reviews and Dissemination http://www.crd.york.ac.uk/crdweb/
Health Technology Assessments http://www.york.ac.uk/inst/crd/crddatabases.htm
Campbell Collaboration (Social care) http://www.campbellcollaboration.org/
Studies of primary literature
NHS Evidence Specialist databases www.library.nhs.uk (Athens login)
a) MEDLINE (Gen Med)
b) EMBASE (Gen Med)
c) British Nursing Index (BNI)
d) Cumulative Index to Nursing & Allied Health Literature (CINAHL)
e) PsycINFO (Psychology/psychiatry)
f) DH-DATA (Health Management)
g) King’s Fund (Health Management)
PubMed (Public version of Medline) http://www.ncbi.nlm.nih.gov/sites/entrez
Education Resources Information Center (ERIC) http://www.eric.ed.gov/
www.qualitymk.nhs.uk
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk Quality:MK Core Resources for EBM v 4.7 Dec 2009.
Compiled by Anne Gray,( [email protected] ) , and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge the Quality:MK project
Based on: The Literature Review Process: Recommendations for Researchers and Literature search appendices.Developed by the Thames Valley Literature Review
Standards Group on behalf of the Thames Valley Health Libraries Network. 2006 (http://www.oxforddeanerycdu.org.uk/tvsha/libraries/doc/Literature_review_checklist.pdf)
(http://www.oxforddeanerycdu.org.uk/tvsha/libraries/doc/Literature_review_appendices.pdf )
Systems
Summaries
Synopses
Syntheses
Studies
Examples
Computerized decision
support
Evidence-based
collections of resources
Evidence-based journal
abstracts
Systematic reviews
Original journal articles
The evolution of information resources
for evidence-based decisions
Adapted from: Of studies, syntheses, synopses, summaries and systems: the "5S" evolution of information services for evidence based health care decisions by R. Brian Haynes Evidence Based Med. 2006: 11:162-164. Full text available Best levels of evidence
Therapy/prevention RCT
Etiology Prospective cohort study
Differential diagnosis/Symptom prevalence
Prospective cohort study with good follow-up
Diagnosis Cross section study
Prognosis Inception cohort study
Cost analysis Economic analysis
After: Oxford Centre for Evidence-based Medicine Levels of Evidence (May 2001) http://www.cebm.net/index.aspx?o=1047
Quality:MK
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk IMPACTE summary v1.3 December 2009. Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected] ) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
IMPACTE Group summary
Practice/Group: Date:
Question/Topic :
Evidence used: i.e. References
Type of evidence
1RCT,
2Systematic Review
3Qualitative Research
4Guideline
Prompts on how to appraise the different types of evidence, and space for comments are given on the back of this sheet.
What the evidence is about Population/Setting
Intervention:
Comparison: (optional)
Outcome:
Is the evidence relevant to our practice? Is this a good source of evidence?
Results, clinical bottom line: Is this new evidence ( or old evidence not yet acted upon) that could have an impact on patient care? Are the results credible and clinically significant? Is there a large variation in current practice? What barriers exist to its implementation?
Discussion points
How are we going to follow up e.g. Do we need to find more evidence / have training/ undertake an audit / take advice from specialists / spread to other practices / change our practice management / follow-up with health:mk What action are we going to take Who by Date by
.Drafted by: Date: verified by: Date:
IMPACTE summary v1.3 December 2009. Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected] ) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Appraisal of different types of evidence
1RCT
Recruitment Were the subjects representative of the target population?
Allocation? Was the treatment allocation concealed before randomisation, were the groups comparable at the start?
Maintenance
Follow up over 80%?
Measurements
Were the outcomes measured with: Blinded subjects and assessors and/or Objective outcomes?
Statistical Results: eg Risk Reduction
(RR), Number Needed to Treat (NNT), Number Needed to Harm (NNH), Confidence Intervals (CI), P values
2Systematic review
Question Does the research ask a clearly focussed question (PICO) and is it relevant?
Found all studies Did the search find all of the best evidence? (search strategy/publication bias
Appraisal/quality Have the studies been critically appraised
Synthesise Have the results been synthesised with appropriate summary tables and plots?
3Qualitative Research
Sampling strategy: Data collection methods : Data analysis methods: Relationship between the researcher and participant
:
4Guidelines Nationally recognised Guidelines e.g. NICE, SIGN, BTS are assumed to be based on high quality evidence and do not need to be appraised.
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk IMPACTE group summary (social marketing) May 2009 v. 1.3 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Quality:MK IMPACTE group summary (Social Marketing)
Practice/Group: Date:
Question
Citation
Type of study:
Social Marketing study
Benchmark criteria Study strengths Study areas for improvement Local lessons
Customer orientation ‘Customer in the round’ develops a robust understanding of the audience, based on good market and consumer research, combining data from different sources
Behaviour Has a clear focus on behaviour, based on a strong behavioural analysis, with specific behaviour goals
Theory Is behavioural theory-based and informed. Drawing from an integrated theory framework
Insight Based on developing a deeper ‘insight’ approach – focussing on what ‘moves and motivates’
IMPACTE group summary (social marketing) May 2009 v. 1.3 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Exchange Incorporates an ‘exchange’ analysis. Understanding what the person has to give to get the benefits proposed
Competition Incorporates a ‘competition’ analysis to understand what competes for the time and attention of the audience.
Segmentation Uses a developed segmentation approach (not just targeting). Avoiding blanket approaches.
Methods Mix Identifies an appropriate mix of methods ‘Intervention mix’ = Strategic SM ‘Marketing mix’ = Operational SM
Follow-up/further action Action to Date by
CAT drafted by: : Date: CAT verified by: Date:
Adapted from French, Blair-Stevens (2006) adapted from original benchmark criteria developed by Andreasen (2002) .
Available at http://www.nsms.org.uk/images/CoreFiles/NSMC_Social_Marketing_BENCHMARK_CRITERIA_Sept2007.pdf
IMPACTE group summary (social marketing) May 2009 v. 1.3 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Benchmark What to look for
1. CUSTOMER ORIENTATION ‘Customer in the round’ Develops a robust understanding of the audience, based on good market and consumer research, combining data from different sources
• A broad and robust understanding of the customer is developed, which focuses on understanding their lives in the round, avoiding potential to only focus on a single aspect or features • Formative consumer / market research used to identify audience characteristics and needs, incorporating key stakeholder understanding • Range of different research analysis, combining data (using synthesis and fusion approaches) and where possible drawing from public and commercial sector sources, to inform understanding of people’s everyday lives
2. BEHAVIOUR Has a clear focus on behaviour, based on a strong behavioural analysis, with specific behaviour goals
• A broad and robust behavioural analysis undertaken to gather a rounded picture of current behavioural patterns and trends, including for both – the ‘problem’ behaviour – the ‘desired’ behaviour • Intervention clearly focused on specific behaviours ie not just focused on information, knowledge, attitudes and beliefs • Specific actionable and measurable behavioural goals and key indicators have been established in relation to a specific ‘social good’ • Intervention seeks to consider and address four key behavioural domains: 1: formation and establishment of behaviour; 2: maintenance and reinforcement of behaviour; 3: behaviour change; 4: behavioural controls (based on ethical principles)
3. THEORY Is behavioural theory-based and informed. Drawing from an integrated theory framework
• Theory is used transparently to inform and guide development, and theoretical assumptions tested as part of the process • An open integrated theory framework is used that avoids tendency to simply apply the same preferred theory to every given situation • Takes into account behavioural theory across four primary domains: 1: bio-physical; 2: psychological; 3: social; 4: environmental / ecological
4. INSIGHT Based on developing a deeper ‘insight’ approach – focusing on what ‘moves and motivates’
• Focus is clearly on gaining a deep understanding and insight into what moves and motivates the customer • Drills down from a wider understanding of the customer to focus on identifying key factors and issues relevant to positively influencing particular behaviour • Approach based on identifying and developing ‘actionable insights’ using considered judgement, rather than just generating data and intelligence
5. EXCHANGE Incorporates an ‘exchange’ analysis. Understanding what the person has to give to get the benefits proposed
• Clear analysis of the full cost to the consumer in achieving the proposed benefit (financial, physical,social, time spent, etc.) • Analysis of the perceived / actual costs versus perceived / actual benefits • Incentives, recognition, reward, and disincentives are considered and tailored according to specific audiences, based on what they value
6. COMPETITION Incorporates a ‘competition’ analysis to understand what competes for the time and attention of the audience
• Both internal & external competition considered and addressed – Internal eg psychological factors, pleasure, desire, risk taking, addiction etc – External eg wider influences / influencers competing for audience’s attention and time, promoting or reinforcing alternative or counter behaviours • Strategies aim to minimise potential impact of competition by considering positive and problematic external influences & influencers • Factors competing for the time and attention of a given audience considered
7. SEGMENTATION Uses a developed segmentation approach (not just targeting). Avoiding blanket approaches
• Traditional demographic or epidemiological targeting used, but not relied on exclusively • Deeper segmented approaches that focus on what ‘moves and motivates’ the relevant audience, drawing on greater use of psycho-graphic data • Interventions directly tailored to specific audience segments rather than reliance on ‘blanket’ approaches • Future lifestyle trends considered and addressed
8. METHODS MIX Identifies an appropriate ‘mix of methods’ ‘Intervention mix’ = Strategic SM ‘Marketing mix’ = Operational SM
• Range of methods used to establish an appropriate mix of methods • Avoids reliance on single methods or approaches used in isolation • Methods and approaches developed, taking full account of any other interventions in order to achieve synergy and enhance the overall impact • Four primary intervention domains considered: 1: informing / encouraging; 2: servicing / supporting; 3: designing / adjusting environment; 4: controlling / regulating
French, Blair-Stevens (2006) adapted from original benchmark criteria developed by Andreasen (2002)
Social marketing National Benchmark Criteria. National Social Marketing Centre The benchmark criteria are essentially those elements to look for in an intervention to determine whether it is consistent with social marketing.
IMPACTE group summary (social marketing) May 2009 v. 1.3 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected]) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
They have been developed to help strengthen the use of effective social marketing approaches. They were developed following a two year independent review in 2006 which examined social marketing methods and approaches. The review identified that there was an increasing tendency for work to describe itself as social marketing without necessarily reflecting social marketing core concepts and principles. The eight point benchmark criteria built on the review findings and also Alan Andreasen’s previous six point benchmark from 2001. The benchmarks are designed to support the following:
• to increase understanding of core social marketing concepts and principles • to increase consistency of approach and thereby their potential impact and effectiveness • to maintain maximum flexibility and creativity, to craft and develop interventions to different needs • to assist more systematic capture and sharing of transferable learning between interventions • to assist effective review and evaluation of different types of intervention
It is important that the benchmarks are not confused with a process of how to do social marketing. There are other models such as the ‘total process planning’ approach which places a strong emphasis on the front-end ‘Scoping’ stage. Instead the benchmarks are essentially the key elements that should be in place if an intervention is to accurately describe itself as social marketing. The benchmarks have been framed in such a way as to ensure that they do not restrict the ability of practitioners to develop creative, imaginative and flexible solutions to the different types of behavioural challenges they face. However the criteria provide a robust framework to assist those planning and developing interventions to ensure they are consistent with best evidence-based principle and practice in the social marketing field. Finally it is important to note the reason why other factors, which are critical to any successful intervention have not been included. Obvious examples would include: strategic planning, partnership and stakeholder engagement, review and evaluation, (to name a few). These are clearly all important in there own right, and key to successful interventions.The reason they are not part of the benchmarks is that they are not unique to social marketing. Their presence (or absence) does not indicate if something is social marketing or not. The eight criteria included in the benchmark are however, the things that have to be present in order to be described as consistent with social marketing. Commissioners: Can use them to incorporate into tender briefs and send them to people wanting to bid for specific work, with a request that all proposals or bids should clearly indicate how the work proposed will
ensure it incorporates, and is consistent with, each of the criteria. They can then be used in preparing tender interview panel questions, to test out the extent to which those making bid presentations have understood and genuinely incorporated them into their proposals.
Agencies, consultants & other contractors: Can use the benchmark as a guide to presenting bids or proposals to funders, to clearly show how their proposal or bid will be consistent with social marketing
principles and practice.
Intervention planners and developers: Can use these as a robust guide to ensure what they do is consistent with core criteria. As core criteria they have been specifically framed to allow maximum
flexibility for adaptive and creative solutions. However while they are not a ‘how to’ process they provide a steer to ensure that, as work is developed, it can be checked to ensure it is consistent with the core components of social marketing.
Evaluators & researchers: Can use them when reviewing the impact of interventions, to reinforce the focus on determining if specific behavioural impacts have been achieved or not. They can also be used by
those seeking to compare and contrast learning from different interventions and programmes and to help identify aspects of transferable learning.
Trainers: Can use them to highlight key features of social marketing and provide a framework from which to examine and explore key concepts and principles.
Different ways that the National Benchmark Criteria can be used
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk
Search Strategy v2.4 May 2009 Created by Anne Gray ([email protected]) and Ann Skinner You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Quality:MK
Search strategy
Topic:
Practice/Review team
Date required:
Clincal Link :
Searcher:
Date search sent:
Search Time :
Clinical Question to be addressed: Background:
Patient/population/problem
Intervention
Comparison/control
Outcome/effects
Based on Literature Search Request Form compiled by Thames Valley Health Libraries Network Search Skills Subgroup http://www.oxforddeanerycdu.org.uk/tvsha/libraries/search-skills-sub-group.html
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk
Search Strategy v2.4 May 2009 Created by Anne Gray ([email protected]) and Ann Skinner You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Date Action
Include: Search (resource and strategy); document delivery; discussion
group meeting; travel time; emails/phone; writing CAT
Time
taken
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk
Search results v4.1 May 2009 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected] ) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Quality:MK Search results
Topic
Practice/Review Team
Clinical Link
Search carried out by, date & time taken:
Resources used:
The library will endeavour to use the best, most appropriate and most recent sources of information available to it, but can make no warranty, express or implied as to the accuracy of any information or advice supplied.
Search concepts: Population: Intervention: Comparison/Control: Outcome:
Findings:
Guidelines: Systematic Reviews: RCTs: Qualitative studies: Other:
Search results v4.1 May 2009 Created by Anne Gray ([email protected] ) and Ann Skinner ([email protected] ) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
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Resources and Search strategy Resource Strategy
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk IMPACTE Meeting Record v2.4 Mayl 2009 Created by Anne Gray ([email protected]) and Ann Skinner
([email protected] ) You may use this in its present form or adapt it for your own use but we request that you acknowledge Quality:MK and the original authors
Quality:MK IMPACTE Meeting Record
Practice / Group:
Date
Facilitator No of Attendees
Attendees Name
Practice / Job title
Date of next meeting :
Send info to Done
Topic
Topic
QMK IMPACTE Certificate v3.1 09/06/09
Quality:MK
Evidence into Practice
This is to certify that
……………………………….
attended an
IMPACTE Discussion Group
Improving Medical Practice by Assessing CurrenT Evidence
at
………………………………………
on …………………
The aims of the IMPACTE Discussion Group are
to identify a specific topic and formulate an answerable question
to track down the best evidence
to apply the evidence to current practice
to establish an action plan
to implement and audit any changes
to review action plans
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk
QMK IMPACTE Certificate v3.1 09/06/09
CPD Record Name: IMPACTE meeting @ Date: Development Topic:
What is the evidence?
What did I learn?
How will this affect my practice?
QMK IMPACTE online Certificate v3.2 22/02/10
Quality:MK
Evidence into Practice
This is to certify that
………………
Contributed to an
IMPACTE Online Discussion
Improving Medical Practice by Assessing CurrenT Evidence
on
…………………………….
The aims of an IMPACTE Discussion Group are
to assess the current evidence
to apply the evidence to current practice
to establish an action plan
to implement and audit any changes
to review action plans
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
health:mk
QMK IMPACTE online Certificate v3.2 22/02/10
CPD Record Name: Date: Discussion Topic:
What is the evidence?
What did I learn?
How will this affect my practice?
Quality:MK
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
Athens registration and guide v2.3 December 09
health:mk
What is an NHS Athens account and how do I register? An NHS Athens account will enable you to access a collection of electronic resources bought for you by the NHS. These include:
bibliographic databases (such as Medline, British Nursing Index, Health Management)
over 1200 full-text electronic journals (including the JAMA and BMJ collections)
E-learning resources (such as BMJ Learning)
Map of Medicine (from July 2009) See overleaf for more details
Who can have an NHS Athens account?
Most staff working within the NHS are eligible to have an NHS Athens account. If you have questions about eligibility please contact the Library.
Some social care staff employed by Milton Keynes Local Authority are eligible for an NHS Athens ID.
There are additional resources available to social care staff in South Central SHA through SCIE. For more information go to the Social Care online website http://www.scie-socialcareonline.org.uk/help/athens.asp
To Register for an NHS Athens account go to: https://register.athensams.net/nhs/nhseng
NHS Staff – for quickest response use your NHS email address Choose South Central England and
then select NHS Buckinghamshire and Milton Keynes PCT
Enter the personal details as requested
Social Care staff – it is preferable if you use your miltonkeynes.gov.uk email address. Choose South Central England and then
select NHS Buckinghamshire and Non NHS staff working in Bucks
Enter the personal details as requested An email address is essential.
Your account activation email will be sent to this email address. For NHS email addresses this may take up to 24 hours. For other email addresses your registration will be verified manually and this may take up to 2 weeks.
Follow the instructions in the email to activate your account Managing your NHS Athens account
You can change the email address, password or organisation details via the My Account tab at the top of the NLH webpage.
NHS Athens resources
There is a list of some of the resources available to you overleaf.
To see a complete list, login using your ID and go to My Library at http://www.library.nhs.uk/mylibrary/default.aspx
Frequently Asked Questions http://www.library.nhs.uk/athens/selfregistrationfaq
For support in using the electronic resources available to you via your NHS Athens ID contact : Staff Library, Postgraduate Medical Centre, Milton Keynes Hospital Tel: 01908 243774 or Email: [email protected]
Quality:MK
Athens registration and guide v2.2 June 09
Athens resources available to NHS staff in Milton Keynes Map of Medicine http://england.mapofmedicine.com (from July 2009) BMJ Learning http://learning.bmj.com
interactive website designed for all healthcare professionals to support their personal development, learning and CME (Continuing Medical Education) needs.
NHS Evidence http://evidence.nhs.uk The NHS Evidence provides access to a wide range of knowledge collections which are open access to UK (England) public, and in some cases wider. These include:
Guidelines, www.library.nhs.uk/guidance including Clinical Knowledge Summaries, NLH Guidelines Finder and NICE guidelines.
Evidence Based Reviews, www.library.nhs.uk/evidence including Cochrane Database of Systematic Reviews, DARE, HTA database and NHS NEED.
30+ Specialist Collections, www.library.nhs.uk/specialistlibraries Collections of the best available evidence for communities of practice based on specialties, patient groups and particular aspects of the health service
Medical Images, www.library.nhs.uk/images a searchable collection of freely available medical images.
For patients, www.library.nhs.uk/forpatients over 100 sites accredited by NHS Direct Online.
Medicines, www.library.nhs.uk/drugs British National Formulary (BNF), BNF for Children, National Electronic Library for Medicines.
NHS Evidence healthcare databases www.library.nhs.uk/booksandjournals
with links to the electronic full text of articles where available, and notification of print copies in your local NHS library. Databases provided through NHS Evidence are: AMED, BNI, Embase, HMIC: DH-Data and Kings Fund, Medline and Psycinfo (all OVID) and CINAHL (EBSCO)
My Journals http://www.library.nhs.uk/booksandjournals/journals/
provides a complete A-Z listing of all the journals you can access, both in print and electronically. NHS Evidence healthcare journals collection including
BMJ http://www.bmj.com Updated daily, bmj.com provides access to original scientific research from the BMJ Journal. Users can also gain access to articles prior to publication in the BMJ Online First section
BMJ Journals Collection http://journals.bmj.com/athens All 22 of the BMJ Publishing group journals with current full text.
JAMA & Archives Journals http://pubs.ama-assn.org/athens publish original high quality, high impact clinical and research articles on a diverse range of medical topics.
Cambridge Journals Online http://journals.cambridge.org/athens scholarly journals, ranging across the humanities, social sciences and STM disciplines,
e-Journal collections:
ejournals (ProQuest) http://proquest.umi.com/login/athens ProQuest provides full text journals. Major journal titles from medicine, nursing and allied health, psychology and health management are included.
Health Business Elite (EBSCO) http://search.ebscohost.com/athens.asp provides full text coverage for about 500 journals on all aspects of health care management.
British National Formulary (BNF) http://bnf.org/bnf/athens.htm British National Formulary for Children http://bnfc.org/bnfc/athens.htm
From 1 July, there’s a new routeto best practice pathwaysBT and the NHS are bringing health professionals inSouthern England greater functionality and improvedaccess to Map of Medicine’s best practice guidelines.The new log on and associated benefits will make theMap even more valuable in the health communitiesacross the UK, including the South, where it isalready being implemented.
Just remember – from 1 July 2009 you need to be registered with the NHS Athens accessmanagement system.
From 1 July 2009, log on at http://england.mapofmedicine.com
New log on, improvedfunctionality
With the changeover you’ll find Map ofMedicine at a new address,http://england.mapofmedicine.com andyou’ll log on through Athens provided by NHS Evidence Health InformationResources.
You’ll enjoy a range of benefits includingeasier access from anywhere, easier logons and more functionality.
More functionality
With the new system you’ll be able to:
- Access referral forms online and havethe right documents at your fingertips
- Add your own notes as reminders toyourself and keep track of the pathwaysyou’ve viewed
- View and track feedback history so youcan stay engaged with thecontributions you make
- See recently-viewed pathways so youcan find them quickly again when youneed to
- Switch to all other health communitiesviews of the Map so you can share theirknowledge and practice.
Map of MedicineMap of Medicine is an online clinicalknowledge resource delivering 370pathways developed from up-to-date, evidence based-informationpresented in easy-to-use visualformats. It provides a ‘sat nav’overview of ideal patient journeys
that can help drive clinicalconsensus to improvequality and safety in anyhealthcare organisation.
Buckinghamshire
South Devon
Milton Keynes
Medway
Kent & Medway
Central Sussex
Avon
Easier access
You’ll be able to access Map of Medicinefrom any internet-enabled computer. Youcan consult the Map’s peer-reviewedbest practice guidelines for nearly 400common conditions from your surgery orclinic, or even at home. It means 24/7convenience.
Easier log ons
Logging on with Athens means you haveyour own, personalised log on account.It’s more secure and also means youdon’t have a shared username andpassword to remember.
Marked locations areEarly Adopters of theMap in SouthernEngland.
© 2009 Map of Medicine Ltd. No unauthorised reproduction.BT Logo is a registered trade mark of British Telecommunications public limited company.
For further details contact:
Name
Customise thisRole
Customise thisOrganisation
Customise thisEmail
Customise this
Enjoy extra Athens benefits
Athens is a system that gives its usersaccess to a wide range of web-basedservices with one sign-on. It has beenproviding access to the National Libraryfor Health (NLH) for NHS staff since 2000.
Registering for Athens will give youaccess to Map of Medicine and NLH andother valuable professional tools andservices including:
- NHS Core Content and local resources
- Hundreds of journals and ebooks
- The world’s most comprehensivehealthcare databases
- News feeds straight to your inbox.
What you need to do
You need to register with Athens. Then,the first time you log on to the Map afterthe changeover, you’ll need to registeryour Athens details. And that’s it.
You register with Athens via NHSEvidence Health Information Resources, and you should do it from an NHS netcomputer. It’s very quick: you just needto check you’re eligible, have a suitableemail address and know your NHSorganisation.
Simply register fromhttp://england.mapofmedicine.com orgo to https://register.athensams.net/nhs
Who’s affected?
The changeover will apply to all threesouthern NHS regions – South EastCoast, South Central and South West.
Remember, anyone in the NHS canaccess the Map.
FAQs
How do I get an Athens account?
Simply register fromhttp://england.mapofmedicine.com orgo to https://register.athensams.net/nhs.It’s very quick: you just need to checkyou’re eligible, have a suitable emailaddress and know your NHS organisation.
What do I need to do now?
You can begin using the new service on1 July. All you need to do now is get anAthens account. If you would like toinclude local info on the Map, please seethe contact details section below.
What happens if I go to the old webaddress?
You’ll be automatically re-directed to thenew website. To proceed from thereyou’ll need your Athens details.
What do I do if I have a problem?
If you have any other problemsaccessing the Map, you can contactyour local IT Helpdesk. If you need helpwith Athens, contact your local librarian.
How can I promote local guidelines or information?
Please contact your Map of Medicinelead using the contact details below.
South DevonSouth Devon Local Health Community is an Early Adopter of the Map of Medicine in theSouth West of England.
The Map has been utilised as a service redesigntool to assist in achieving the objectives of theRight Trac Programme (Right Treatment andChoice) to:
- reduce waiting times from referral to treatment
- promote referral to appropriate services
- decrease inappropriate referrals
- improve the patient experience of the carejourney from primary to secondary care
- embed the use of evidence based carepathways via the Map in healthcare
- promote efficiencies in the healthcare systemthat can be redirected to improve serviceprovision for patients elsewhere.
Milton KeynesMilton Keynes is an Early Adopter of the Map.The aim is to engage clinicians in accessinglocal information about clinical pathways, based on best evidence.
The objectives of the Map project in MiltonKeynes are:
- to use the Map to support the delivery ofevidence based care to the people ofMilton Keynes
- to ensure robust governance processesin the localisation of pathways
- to work collaboratively with all partners inassimilating existing localised clinicaldocuments that guide practice into the Map
- to support the clinical localisation of pathwaysand the addition of local administrativeinformation
The Map will initially be piloted with GP’s, withother healthcare professionals to be supportedin accessing the Map in the future.
Central SussexWith variability in local guidelines and difficultiesin communicating them across Brighton andHove, the healthcare community needed a best-practice referral site to provide reliable, quick,easy access to local information.
By localising the Central Sussex view of theMap, they have produced a ‘GP Quick View’which is intended to:
- Help GPs refer their patients to the right place,first time
- Provide locum GPs with a wealth of localknowledge
- Improve the patient experience
- Increase consistency of care across thehealthcare community.
Map of Medicine in Southern England
Buckinghamshire
South Devon
Milton Keynes
Medway
Kent & Medway
Central Sussex
Avon
www.mapofmedicine.com
Visualising and IntegratingClinical Pathways
- Robust content acquisition and developmentprocess
- Over 350 Pathways across major specialties
- Each Pathway node has supporting information,graded evidence and references
- Covers diagnosis, management and treatment aswell as prevention, screening and rehabilitation
- Accreditation by appointed national body
- Provides knowledge support and improvespatient outcomes
What is the Map?
COPD Pathway in the Map of Medicine
Map of Medicine is a peer-reviewed, web-based, easy to use, source of best practiceguidelines for common conditions. It helps to visualise and integrate clinical pathwayswhich work as a platform for sharingknowledge between teams and care settings.
Benefits of the MapAccess to evidence-based knowledge“The Map of Medicine is a valuable tool for healthcareprofessionals. Because it is underpinned by NICE guidance,where this is available, it supports our commitment toencourage implementation of our guidance and encourageevidence-based practice in healthcare.”Andrew Dillon CBE, Chief Executive, National Institute for Health and Clinical Excellence (NICE)
Flexibility to add local, clinical andadministrative information“Map of Medicine gives us a blueprint for localising carepathways and a structure for creating new ones. It has helpedus set up effective governance systems and it helps us sharepathways across the health community.”Dr Maureen Swanson, Medical Director, Western Cheshire PCT
Communicates idealised patient journey“Map of Medicine is an up to date, evidence based, clinicalpathways tool for NHS Wales which joins the patient pathwayacross primary, community and secondary care and canincorporate information on local services.” Dr Martin Murphy, Clinical Director, Informing Healthcare Wales
Helps meet clinical governance standards“Map of Medicine is an excellent starting point for clinicalservice redesign. All the information is there for clinicaladaptation and use. It provides a visual tool for presentationand implementation and allows change to be formalised andnew service disseminated.” Dr Kerry Tinkler, Associate Clinical Director, Royal Free Hospital, London
Easily integrated with clinical systems“We found it very easy to integrate the Map into the Adastraprogram. In the urgent care situation the clinician does notusually know the patient. Now with one click they can jump to the relevant part of the Map quickly and find the latest, evidencebased guidelines and manage the patient appropriately.”Dr Alex Yeates, Medical Director, Adastra Software Ltd
Accessthe MapTo use the Map you need to be part of a Map of Medicine-licensed healthcare community.The Map is currently licensed toNHS England, NHS Wales andQueensland, Australia.
To see if the Map is available fromyour location, and how to accessit, follow the steps on the Accessthe Map page at:
www.mapofmedicine.com
For PatientsWithin England and Wales theMap is accessible to everyoneincluding patients through theNHS Choices website atwww.nhs.uk.
Healthguides is a limitedfunctionality version of the Map that allows patients to see what the doctor sees. They present thedifferent steps of a patient journey,from symptoms to diagnosis andtreatment, using the same easy tofollow charts as the Map of Medicine.
Outside England and Wales only20 sample Pathways are visible.
If you are interested in licensingthe Map of Medicine please [email protected]
Questions? Contact us at www.mapofmedicine.com
The Map in PracticeMap Pathways can becustomised to communicate howlocal services are organised, orcould be organised, in order todeliver the best care for localpatients. The Map customisationprocess is called ‘localisation’.
Map Pathways can be customised to reflect local care by having information added or byhaving their structure altered.
The Pathways are an excellent starting point formanagers and clinicians developing locally-optimised pathways. As the Map undertakes toincorporate new evidence and guidance, userscan be confident that their localised pathwaysare always up to date.
© 2009 Map of Medicine Ltd. No unauthorised reproduction.
International view Localised view
Quality:MK
Quality:MK a whole system approach to quality improvement driven by primary care, patient engagement and evidence
page 1
Online learning resources v1 June 2009
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On Line Learning Resources
This is a selection of modules and online learning packages to support IMPACTE. Further information about the modules and providers are given at the end of the list Audit
Audit for doctors (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=5000077
Audit: How to do it in practice (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=6053095
Change management
Introduction to change management (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=5004459
Becoming an agent of change: key principles and practical examples of managing change (BMJ Learning)
http://learning.bmj.com/learning/search-result.html?moduleId=5004461 Evidence based medicine
Evidence based Medicine : a users guide (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=6056424
Evidence Based Medicine : how to find the answers to your clinical questions (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=6051523
Research Method – types of research methods and hierarchy of evidence (UHL) http://www.uhl-library.nhs.uk/elearning/LiEv/index.htm
Critical Reading Made Easy - an introduction to critical appraisal principles and tools (UHL) http://www.uhl-library.nhs.uk/elearning/LiCA/index.htm
Getting research findings into practice – a series of papers in the BMJ (1998) http://resources.bmj.com/bmj/topics/other-series
How to read a paper (Greenhalgh 1998)– a set of ten guides on critical appraisal and statistics, available as a book or online (Athens registration required)
http://www.bmj.com/collections/read.dtl Searching skills and using the internet
'Principles of searching' e-learning - an introduction to database searching (UHL) http://www.uhl-library.nhs.uk/elearning/LIFI100/index.htm
NHS Evidence e-learning - A series of modules on using NHS Evidence Resources (based on PowerPoint slides using NLH as starting point) (UHL)
http://www.uhl-library.nhs.uk/trainingnlh.html Overview of NHS Evidence resources Healthcare databases : simple search advanced search Evidence based reviews Using NHS Evidence guidance NHS Evidence specialist collections NHS Evidence image search NHS Evidence for patients
Quality:MK
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Online learning resources v1 June 2009
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Internet tutorials for different professions (Intute) http://www.vts.intute.ac.uk/
Medicine, Allied Health, Dentistry & Oral Health, Pharmacists, Nursing & Midwifery, Health & Social Care, Biosciences, Image searching
Statistics
Understanding statistics (BMJ Learning) http://learning.bmj.com/learning/search-result.html?moduleId=5003158
Understanding statistics 2: is there a significant difference? (BMJ Learning ) http://learning.bmj.com/learning/search-result.html?moduleId=5001080
Introduction to statistics - displaying, summarising and testing data (UHL) http://www.uhl-library.nhs.uk/elearning/LiStats1/index.htm
BMJ Learning http://learning.bmj.com/ Interactive website designed for all healthcare professionals to support their personal development, learning and CME. Registration on site required Athens username and password or BMA membership required for some modules. . GPs who complete learning modules can use these as evidence in their appraisals. INTUTE: Virtual Training Suite http://www.vts.intute.ac.uk/ Free interactive tutorials to improve your Internet skills in a range of topic areas Each package gives:
Tour – best of the web in the area of interest Discover – how to search the internet effectively Judge – which websites are worth using Success – stories to inspire you
UHL: University Hospitals of Leicester NHS Trust Library Services http://www.uhl-library.nhs.uk/training.html This library web page lists a series of e-learning modules and tutorials as well as help sheets and guides and links to other freely available e-Learning packages.
Quality: MK
AG How do you judge what you find on the Internet.v.2 July 2009
How do you JUDGE what you find on the internet?
Who….. Where…. When…..
Think about who is providing the information Anyone can say anything they like on the Internet.
Ask yourself:
Who has written / published the information?
Are they a trustworthy source of information?
Are they trying to persuade me / sell me something / inform or misinform? o Can you find the author's name or name of the organisation publishing the information? o Look in “Contact Us” for address / email o Look in the “About Us” section
Think about where the information is coming from Information on the Internet might be based on a computer anywhere in the world.
Ask yourself:
Which country is the information coming from?
Where is it held?
Does the origin affect the relevance/significance of the information? o Look in the URL (web address) (See below) o Look for the name and location of the organisation publishing the information o Look for any mention of the origins/research behind the information o Look in the “About Us” section
Think about when the information was produced Information on the Internet can be out of date, change without warning or disappear completely. Ask yourself:
When was the information originally produced? Is it still useful? Has it been updated? Is it going to be updated? Is it being preserved in its original form?
o Look for a publication date o Look for a review/update date
health:mk
Quality: MK
AG How do you judge what you find on the Internet.v.2 July 2009
What can a web address (URL) tell you?
URLs can be a useful way to work out "who" and "where" information in a website comes from. They are made up of a number of component parts. Let's look at the following Web address in detail: http://www.intute.ac.uk/news/index.html
URL What's this? Tell me more...
http:// Transfer Protocol
The first part of the URL is called the protocol. It tells your browser how to deal with the file that it is about to open. The most common you will see is HTTP, or Hypertext Transfer Protocol. (https:// indicates a secure server)
www.intute Server Name This refers to the computer (or server) where the Web pages or files you want to view are hosted. It usually contains the name of the organisation responsible for the site; in this case, "intute" (representing Intute).
ac Top Level Domain/Organisational Code
This tells you something about the type of organisation responsible for the site (see below for more information).
uk Country Code This tells you in which country the site is hosted (find out more below).
news Directory This is a specific folder of information on the server (although it's not always given). There can be any number of these in a URL, indicated by "/" characters.
index.html File Name / File Type This is the file you are, or will be viewing. In this case, .html is the file extension. This can change depending on the type of file: eg .mov is a video file; .doc is a document; .gif is an image.
More clues: looking at organisational codes You can often find out more about the nature of the organisation that owns the server from the organisation code. For example:
.ac, .edu academic or educational servers eg http://www.rcplondon.ac.uk .co, .com commercial servers www.surveymonkey.com .gov government servers eg www.dh.gov.uk, http://www.ncbi.nlm.nih.gov .nhs.uk NHS website eg www.institute.nhs.uk (not all NHS websites use this code) .org non-governmental, non-profit making organisations eg http://www.primary-care-db.org.uk
More clues: looking at country codes You can sometimes find out more information about the country in which the server is based from the country code. For example:
.au Australia .ca Canada .de Germany
.fr France .uk United kingdom
Two health website accreditation schemes are worthy of note:
Information accreditation The DH has developed the Information Standard, a new certification scheme for health and social care information producers. Those organisations that meet the criteria of The Information Standard will then be entitled to place a quality mark on their information materials so people searching for health and social care
information can easily identify it as coming from a reliable, trustworthy source. The Information Standard looks at processes for developing information rather than individual pieces of information. Information Standard accreditation will be launched in summer 2009 http://www.dh.gov.uk/
Health on the Net (HON) The Health On the Net Foundation promotes and guides the deployment of useful and reliable online health information, and its appropriate and efficient use. The HONcode is a code of ethical conduct designed for the general public and the web publisher, actively involving the site owner in the process of certification. http://www.hon.ch/
Quality: MK
AG How do you judge what you find on the Internet.v.2 July 2009
Useful websites
NHS Evidence - http://www.evidence.nhs.uk An NHS service where NHS staff are able to get, through a single web-based portal, authoritative clinical and non-clinical evidence and best practices. NHS Choices – http://www.nhs.uk A comprehensive information service that helps to put you in control of your healthcare. The service is intended to support decision making around health, including lifestyle decisions through to the practical aspects of finding and using NHS services in England. TRIP Database http://www.tripdatabase.com/index.html A database of high quality clinical evidence for clinical practice. PubMed – http://www.ncbi.nlm.nih.gov/sites/entrez A large database of abstracts of clinical journal articles, some of which have links to full text articles Journals – http://www.library.nhs.uk/booksandjournals/journals The collection of full text journals available to all NHS staff in Milton Keynes PCT (Always log on using your NHS Athens ID before searching ) Patient UK – http://www.patient.co.uk Comprehensive patient information as provided by GPs and nurses to patients during consultations. Register for an NHS Athens ID here: https://register.athensams.net/nhs/nhseng
This leaflet has been based on: Intute JUDGE tutorial http://www.vts.intute.ac.uk/he/tutorial/medic/?sid=3048806&itemid=12073 and London South Bank University, 2004 Referencing Electronic Sources http://www.uhl-library.nhs.uk/pdfs/citing_websites.pdf Anne Gray [email protected]
Referencing internet resources
Always keep a copy of the web address of any resource you quote or wish to pass on. (Point to the Address line with your mouse, left click to select the URL. Right click and select Copy, then Paste the URL into your document/records). Just as you give a reference (cite) a printed source, you must also give a reference for any online websites mentioned in documents you write. This should be in the format: AUTHOR, INITIALS (year) Document title [Online] Available at location of document (accessed date) Further support is available from: London South Bank University, 2004 Referencing Electronic Sources [Online] Available at http://www.uhl-library.nhs.uk/pdfs/citing_websites.pdf (accessed 17 July 2009)