Monday, 27 September 2010

Clinical Governance: doing the right thing

I attended a workshop on clinical governance on 23 September, hosted by CLIST and held at the Bloomsbury Healthcare Library. I decided to go more out of duty than interest as clinical governance is one of those things I find it very hard to get excited about. I was pleasantly surprised by what I heard however and found the session much more interesting than expected. Our speaker, Nada Schiavone, who is currently the Patient Safety Lead at NHS London, was a very engaging speaker with much experience in both clinical and managerial work. Her presentation was peppered with real examples of situations she has faced and she was very candid about her concerns regarding the changes currently planned for the NHS and how they will affect patient safety and clinical governance.

The course consisted of a presentation about clinical governance itself (very simply put, clinical governance is about doing the right thing, at the right time, in the right way, in the right place for the right patient) and how it fits in with the aims and objectives of the NHS. This was followed by her thoughts on how NHS library services could have a positive impact on clinical governance. Finally we split into groups and worked through some scenarios. As part of the presentation Nada asked us to guess the average cost of litigation claims against the NHS costs the average acute Trust and it turned out to be £21 million a year – that is £21 million per Trust, per year! So, very important to get things right, obviously.
As far as library involvement in clinical governance, Nada proposed the following questions:

- Are you on the right committees for supporting evidence-based practice?
- Are you visible?
- What evidence base can the library produce to support integrated governance (a fancier word for clinical governance, which includes governance other than just clinical)
- What information does the service provide for patients?
- How do you demonstrate support for audit/research projects?
- Can you help with presenting data? Writing a report? Publishing a piece of work?

She also stressed the importance of being aware of service redesigns and aligning library resources to Trust strategies and staff needs, all of which sounded very familiar! I went away with a lot to think about and will possibly now be able to summon a little more excitement about clinical governance…

Feast or Famine...

Having just complained last week that it was a bit quiet it has suddenly gone busy again here in the Healthcare Library. Staff inductions have started up again and we also had a new intake of student doctors which can only mean library tours and presentations for all. We are also running a journal survey across all three sites and have had over 100 responses so far – much better than expected. I spent much time the week before last played about with our LMS so we could send out an email to all our users (who have email addresses). This will serve a dual purpose: catching people who are library members but not Athens users and seeing just how comprehensive (or not) our records are on the LMS. It will also test the capabilities of the LMS itself which is quite good at ingesting data but not so admirable at spitting it out again. Spent a while with the Senior Library Assistant experimenting and we eventually got it to run a report as a text document which I opened in Access, refined some of the data, saved as a text document again then opened in Word to insert the required semicolons needed for Outlook.

Of course when I sent my marvellous instructions to the Library Manager at our other site he sent back an email with a much easier way but the nice thing about my way is that we get all the bounced back emails, which the poor Library Assistant (and myself!) spent a few hours amending last week. It gave us a chance to clear out some old records as well so I think the experiment worked quite well...

I have attended a few meetings and training sessions the last few weeks including a CLIST meeting, a clinical governance training session (which I will talk about in a separate blog post) and the R&D Committee meeting. CLIST, held at the Bloomsbury Healthcare Library, is always a good chance to catch up with what has been going on with the other information skills trainers in London and my counterpart at another site library met afterwards to plan our critical appraisal session in October. We sent the communication out last week and already have about 8 takers! I have also recently joined the Trust R&D Committee and attended my first meeting last Friday where new proposals for research in the Trust were heard and matters around research were discussed. I found it very interesting, informative and highly professional, even though I didn’t understand everything discussed it gave me a sense of how the library could get involved in research at the Trust.

And finally, we have been in the news again – even hitting the BBC headlines last week! I have a feeling it's going to be a tough winter...

- Patients ‘at grave risk’ from poorly trained doctors (Independent on Sunday, 19 Sep 2010)

- Sidcup hospital to close A&E and maternity over the winter (BBC News, 22 Sep 2010)

Monday, 6 September 2010

Back on the Blog Wagon

I have inadvertently taken a break over the summer from my blog as things have been a bit quiet on the training front but as it is now September I have started to feel familiar twinges of guilt so it’s time to get back on the wagon and blog on a regular basis again. Not a great deal has happened since my last post on the White Paper and in fact the White Paper parade has all gone a bit quiet lately. However people are busy writing more papers in preparation for it becoming law and no doubt we’ll be hearing more when it comes out of consultation on the 11th Oct. For a good resource on all things White Paper I can recommend nothing better than the Health Management Specialist Collection’s White Paper page which not only has all the documentation for the Paper but all the responses from various organisations and media reports as well.

I attended the HLG Conference 2010 on the 19th-20th July which took place this year in Salford Quays near Manchester. The theme was ‘Keeping information centre stage amidst changing scenery’ and there were many interesting seminars and workshops to attend and the venue was really lovely (see attached photo which I took on my first day). My only problem was that there was no wireless access and as mobile signals interfered with the sound equipment in the main lecture theatre it meant I couldn’t tweet my experience as it happened – something I had been really looking forward to! However I did have a good time, met some interesting people and dutifully wrote up my report for the HLG Newsletter which you can read here.

I went on a systematic reviews training day at the end of July which was held at Guy’s campus and hosted by information specialist staff from Cochrane and CRD. They gave very in-depth and informative sessions on the work that goes into producing a systematic review and I found the presentation on searching at systematic review level especially helpful. It certainly gave me a lot to think about and aspects to include in my Systematic Reviews workshop.

I also paid a visit to the Royal College of Physicians library a few weeks ago which proved very dramatic as upon my arrival a BBC film crew were outside the building in Regent’s Park filming a TV drama! Once I navigated my way around the cameras, SWAT teams and semi-automatic rifles into the building we were given an excellent tour of the different bits of the library, which is spread across two sites. They have a very impressive collection of both old and new stock which is accessible to all members of the Royal College and have the largest collection of medical education books in the country. Unfortunately because of building regulations they are unable to put a sign outside the building directing people to the Medical Education Resource Centre so they rely very much on word-of-mouth recommendation. In the Heritage Centre library on the other site I was especially excited to catch site of books owned by John Dee which had been stolen sometime in the 16th century and somehow ended up in the hands of a Duke who contributed his collection to the RCP. Certainly none of our books have such an exciting progeny!

As far as training is concerned it has been quiet over the summer and I decided not to run group training in August to allow myself to catch up with other things. These included trying to convince health managers at the hospital to sign up for Athens accounts (which failed miserably), tracking down some book titles for Learning and Organisational Development to buy on our behalf and promoting the Medicine Collection journals. My new training schedule was advertised last week and I have had a few takers but not as many as I had hoped! Still I suppose people are still getting back from holiday mode etc so I have to hope I will get a few more in the weeks to come. My colleague in Bromley and I are running a joint session on critical appraisal at the Queen Mary’s site in mid-October. She will be doing quantitative (thank goodness!) and I will be doing qualitative and we will be trialling a new critical appraisal technique involving Quality Street chocolates...more on that when it happens!