The following blog post doesn't really have much to do with libraries or information of anything of that ilk but last Thursday on my way to work I fell off my bike after a rather stupid-looking black Alsatian ran into me. Fortunately it happened in the park right behind Lewisham Hospital so I made my way over to A&E and was seen and tended to by the lovely staff there very efficiently. The upshot of the whole affair is that I have fractured my humerus, of which the only humorous - ha, ha! - thing is that I can say I now literally have a chip on my shoulder, and am reduced to living my life with one arm.
The timing isn't great - I am maid of honour at my sister's wedding in two weeks time and while the colours of the occasion are yellow and purple, I'm not sure the horrendous bruising on my inside upper arm are really what people want to see! But it could have been a lot worse - it's my left, not my right arm that is out of action, I fell just outside a hospital and I have incredible family, friends and work colleagues who have rallied around and given me so much love and support I am overwhelmed with gratitude! It has also been interesting seeing the NHS from the other side and I am so impressed by the care I was given at Lewisham Hospital. All the staff I encountered were friendly, efficient, professional, and up on the latest evidence. The nurse practitioner who wrote out my pain meds prescription came back a few minutes after giving me the scrip and changed it based on new research she had heard about from consulting with a colleague.
I am back there tomorrow morning for an apppointment at the fracture clinic so am hoping all shall be well. At some point I am going to write a post on living life with one arm and rate various activities one takes for granted on a sliding scale from relatively easy to impossible. Which shall hopefully be quite amusing but also remind me how lucky I am. After all, some people live their whole lives missing a vital limb and this will be my tribute to them!
Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts
Tuesday, 17 May 2011
Sunday, 24 October 2010
An Information Revolution...without libraries?
The Department of Health’s Liberating the NHS: An Information Revolution consultation document was published on Monday this week (18 Oct 2010) and lays out a strategy for the way the NHS should manage information in the future. As Andrew Lansley quite rightly states in the Foreward of the document, “we must not lose sight of the primary purpose of information in the health and care system: to ensure that every patient and service user receives high quality care” (p3). All well and good but the term “information” in this document is somewhat nebulous, used as an umbrella term for everything from patient records to health websites to audit to evidence. Furthermore there is no mention of libraries or library services anywhere in the document apart from a reference to the “Indicators for Quality Improvement library” (p36) which I for one have never heard of.
While the bulk of An Information Revolution is concerned with patient records and the flow of medical data there are certainly a number of areas where libraries are involved or could be involved. Section 4.6 states “in order to grasp the opportunities offered by the information revolution, clinicians and care professionals need to be able to access the best evidence (including international evidence) of outcomes, interventions and risks. Evidence needs to be user-friendly, up-to-date and available at the point of care, to inform discussions with patients and service users…Individual professionals, teams and organisations need to be supported to access information of this kind, which can make all the difference in ensuring safety and effective outcomes” (p36) Ummm, yes – do they not realise that this information is already being provided by hundreds of NHS medical libraries across the country every day? There is a short paragraph dedicated to NHS Evidence, described as a service which “is an important addition to commercially provided data services (which are often subscription-based and aimed at particular specialist audiences)” again ignoring the fact that such subscriptions are usually paid for by NHS library services on behalf of their users.
The document strongly supports better access to medical information for patients, which of course is laudable, but takes a rather simplistic view of what is a very complex subject. The emphasis on the internet as a channel for medical information is very obvious but is fairly silent on the subject of information literacy and evidence-based medicine. The three criteria for effective information is that it should be:
- informing, so that they know it is comprehensive and can be trusted;
- engaging, so that they are willing and able to use it; and
- empowering, so that they know how it can make a difference (p11)
How about authoritative, evidence-based, reliable?
The document states that “for some time now, people have been using the internet to explore a diagnosis after (or before) they visit their doctor” (p10) quoting a study of patient use of the internet which showed 11% of patients for neurology outpatients at the Walton Centre for Neurology and Neurosurgery in Liverpool in 2001-5 accessing the internet prior to clinic attendance. 11%?! It’s hardly statistically significant is it? The document also mentions “the role of websites such as ‘Mumsnet’ in generating new ways of sharing insights and information – including health information – is having a lasting effect on our society. Carers, patients, service users, care workers and clinicians are increasingly able to access forums to discuss the issues that matter to them, and offer support from others with experience of their condition” (p10) and exhorts that “the NHS, local authorities and care providers should be responding to and supporting these new approaches” (p11). Now I have been on a few of these forums in my time and have found them pretty useless to be honest, mainly involving somebody complaining they have a strange rash, followed by a slew of respondents all saying they have something similar but nobody knowing exactly what it is or how it should be treated.
Libraries, both medical and public, are extremely well-placed to provide authoritative, reliable information to patients. Many libraries already do and even more would be willing to do so. Why is this not mentioned in An Information Revolution? It may well be that “information cannot be seen as something that is the sole responsibility of the specialist” (p39) but why not harness the knowledge and experience of information specialists such as librarians and avoid reinventing the proverbial wheel?
Finally, I did have to laugh at the statement on page 14: “Whilst any associated costs will need to be met within the Department of Health’s Spending Review settlement, there will be no additional central funding to pay for the information revolution…Whilst there will inevitably be costs, which could fall centrally and/or locally, the information revolution should, ultimately, pay for itself.” Not surprising really that the government thinks good quality information can be produced on the cheap, but it makes the whole document ring rather hollow.
I shall definitely be responding to this consultation document and hope many other medical librarians will as well. After all, there is not going to be an Information Revolution in the NHS without us!
While the bulk of An Information Revolution is concerned with patient records and the flow of medical data there are certainly a number of areas where libraries are involved or could be involved. Section 4.6 states “in order to grasp the opportunities offered by the information revolution, clinicians and care professionals need to be able to access the best evidence (including international evidence) of outcomes, interventions and risks. Evidence needs to be user-friendly, up-to-date and available at the point of care, to inform discussions with patients and service users…Individual professionals, teams and organisations need to be supported to access information of this kind, which can make all the difference in ensuring safety and effective outcomes” (p36) Ummm, yes – do they not realise that this information is already being provided by hundreds of NHS medical libraries across the country every day? There is a short paragraph dedicated to NHS Evidence, described as a service which “is an important addition to commercially provided data services (which are often subscription-based and aimed at particular specialist audiences)” again ignoring the fact that such subscriptions are usually paid for by NHS library services on behalf of their users.
The document strongly supports better access to medical information for patients, which of course is laudable, but takes a rather simplistic view of what is a very complex subject. The emphasis on the internet as a channel for medical information is very obvious but is fairly silent on the subject of information literacy and evidence-based medicine. The three criteria for effective information is that it should be:
- informing, so that they know it is comprehensive and can be trusted;
- engaging, so that they are willing and able to use it; and
- empowering, so that they know how it can make a difference (p11)
How about authoritative, evidence-based, reliable?
The document states that “for some time now, people have been using the internet to explore a diagnosis after (or before) they visit their doctor” (p10) quoting a study of patient use of the internet which showed 11% of patients for neurology outpatients at the Walton Centre for Neurology and Neurosurgery in Liverpool in 2001-5 accessing the internet prior to clinic attendance. 11%?! It’s hardly statistically significant is it? The document also mentions “the role of websites such as ‘Mumsnet’ in generating new ways of sharing insights and information – including health information – is having a lasting effect on our society. Carers, patients, service users, care workers and clinicians are increasingly able to access forums to discuss the issues that matter to them, and offer support from others with experience of their condition” (p10) and exhorts that “the NHS, local authorities and care providers should be responding to and supporting these new approaches” (p11). Now I have been on a few of these forums in my time and have found them pretty useless to be honest, mainly involving somebody complaining they have a strange rash, followed by a slew of respondents all saying they have something similar but nobody knowing exactly what it is or how it should be treated.
Libraries, both medical and public, are extremely well-placed to provide authoritative, reliable information to patients. Many libraries already do and even more would be willing to do so. Why is this not mentioned in An Information Revolution? It may well be that “information cannot be seen as something that is the sole responsibility of the specialist” (p39) but why not harness the knowledge and experience of information specialists such as librarians and avoid reinventing the proverbial wheel?
Finally, I did have to laugh at the statement on page 14: “Whilst any associated costs will need to be met within the Department of Health’s Spending Review settlement, there will be no additional central funding to pay for the information revolution…Whilst there will inevitably be costs, which could fall centrally and/or locally, the information revolution should, ultimately, pay for itself.” Not surprising really that the government thinks good quality information can be produced on the cheap, but it makes the whole document ring rather hollow.
I shall definitely be responding to this consultation document and hope many other medical librarians will as well. After all, there is not going to be an Information Revolution in the NHS without us!
Sunday, 25 April 2010
Ash clouds and critical appraisal
Well there was a bit of drama in the Healthcare Library this week when my manager was caught up in the ash cloud mayhem and ended up being stuck in South Africa for over a week when he was only supposed to be there for 5 days. I think he's getting a flight out tomorrow and should be back with us on Tuesday, a week later than expected. To make things even harder on himself he's planning on flying out again on Friday, this time to Bulgaria! I bet you never thought librarians had such a jet-setting lifestyle....
I on the other hand had my feet firmly on the ground this week and had two group training sessions - one on Finding High Quality Websites (thinking I need a more catchy title...) and Critical Appraisal: Qualitative. The websites session ended up being a one-to-one as I didn't get many takers but there were four at the Critical Appraisal. I'd already run one of these back in early March so was feeling fairly confident but this one didn't go as well. The group was very quiet and then at some point one of attendees suddenly burst out complaining how qualitative research was all rubbish anyway as it was really down to personal opinion etc etc and although I tried very hard to steer it all back to the critical appraisal checklist it really never got back on track. At the beginning of every critical appraisal session I ask everyone how they would rate the article before appraising it and give them a choice of happy face, middling face and sad face. Weirdly the same guy who complained about qual research gave the article a middling face at the beginning and a happy face at the end! Maybe he was feeling bad about giving me such a hard time but it just made me even more confused...
Quite a few one-to-ones this week and one exciting outcome from one was the potential of being asked along to the Microbiology journal club to give a little talk on critical appraisal. I have also been trying to put together my dates for group training for the next 3 months - always very frustrating as I feel I'm picking dates and times out of the air and have no idea whether they fit in with people's work schedules. We also had a very inspiring talk on Map of Medicine at the London trainer's (CLIST) meeting on Thursday so am planning on sending out an email tomorrow encouraging people in the trust to give it a go.
Also coming up this week - another critical appraisal session, quantitative this time. Which I'm dreading even more now considering what happened this week. I also may be spending a bit of time out on the front desk as our library assistant is on holiday and I really must get my new dates out and do a bit of publicity this week. And apparently the D-Day for HLG conference bursaries is on Thursday so I will have my fingers and toes crossed for that. Oh and I really need to start thinking about thr the article I have been asked to write on Twitter for the Libraries for Nursing bulletin as copy must be in by mid-May! Looks like it's gonna be another busy one....
I on the other hand had my feet firmly on the ground this week and had two group training sessions - one on Finding High Quality Websites (thinking I need a more catchy title...) and Critical Appraisal: Qualitative. The websites session ended up being a one-to-one as I didn't get many takers but there were four at the Critical Appraisal. I'd already run one of these back in early March so was feeling fairly confident but this one didn't go as well. The group was very quiet and then at some point one of attendees suddenly burst out complaining how qualitative research was all rubbish anyway as it was really down to personal opinion etc etc and although I tried very hard to steer it all back to the critical appraisal checklist it really never got back on track. At the beginning of every critical appraisal session I ask everyone how they would rate the article before appraising it and give them a choice of happy face, middling face and sad face. Weirdly the same guy who complained about qual research gave the article a middling face at the beginning and a happy face at the end! Maybe he was feeling bad about giving me such a hard time but it just made me even more confused...
Quite a few one-to-ones this week and one exciting outcome from one was the potential of being asked along to the Microbiology journal club to give a little talk on critical appraisal. I have also been trying to put together my dates for group training for the next 3 months - always very frustrating as I feel I'm picking dates and times out of the air and have no idea whether they fit in with people's work schedules. We also had a very inspiring talk on Map of Medicine at the London trainer's (CLIST) meeting on Thursday so am planning on sending out an email tomorrow encouraging people in the trust to give it a go.
Also coming up this week - another critical appraisal session, quantitative this time. Which I'm dreading even more now considering what happened this week. I also may be spending a bit of time out on the front desk as our library assistant is on holiday and I really must get my new dates out and do a bit of publicity this week. And apparently the D-Day for HLG conference bursaries is on Thursday so I will have my fingers and toes crossed for that. Oh and I really need to start thinking about thr the article I have been asked to write on Twitter for the Libraries for Nursing bulletin as copy must be in by mid-May! Looks like it's gonna be another busy one....
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