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The evolving librarian –
health and medical librarians
 in a changing environment

        Sue Lacey Bryant

  Health Education in Transition
UHMLG Spring Forum, 4th Feb 2013
The Evolving Librarian




        Source: A visualização da imagem anterior desperta para a leitura do artigo:
                        "Evolving Web, evolving librarian" de Amy and Robert Favini
                                                   balcaodebiblioteca.blogspot.com
1.   Introduction
2.   A burning platform for change
3.   The pressing need for innovation
4.   Positioning librarians as catalysts for change
5.   Bringing knowledge to bear
6.   The library as a platform for change
University of Birmingham, main library
DH



      NCB

                                NIHR




                             LETB
                                    HEE
PHE


The new
NHS
infrastructure   NICE
Fire fighting

The practice of dealing
    with problems
     as they arise
      rather than
 planning strategically
    to avoid them
Omphaloskepsis

                 The contemplation of
                      one's navel
                   which is an idiom
                   usually meaning
                      complacent
                    self-absorption
A burning platform for change

               • Harsh financial climate

               • Ageing population

               • £20 billion of efficiency
                 savings required within
                 NHS by 2015
National priorities
•Stemming the increase in emergency
admissions

• Service reconfiguration; making the shift from
hospital to community care; seamless care

• Addressing inappropriate variations in clinical
practice; clinical safety and quality
A pressing need for innovation
                    “We need to radically
                      transform the way we
                      deliver services.
                      Innovation is the only
                      way we can meet these
                      challenges”
“Put simply, we must make innovation a priority.
We know that the NHS can spread new ideas at
pace and scale when it puts its mind to it, and we
need to do more of this.”
Copying is good
“ Innovation ... needs to be replicable – and
   replicated – across similar settings. So
   innovation is as much about applying an
   idea, service or product in a new context, or in
   a new organisation, as it is about creating
   something entirely new. Copying is good.”
Positioning librarians in the workplace
     as catalysts for improvement

•   Aligning with NHS priorities
•   Multidisciplinary working
•   Changing skill mix
•   Role substitution
•   Role enlargement
•   Role enhancement
Enhancing the role of librarians

Role enhancement involves expanding a group
  of workers' skills so they can assume a wider
  and higher range of responsibilities through
  innovative and non-traditional roles
Bringing knowledge to bear
 in a cold climate: an ABC
A practical approach to ‘KM’

• Applying knowledge

• Building know-how

• Continuing to learn
A = Applying knowledge
around the commissioning cycle
Milton Keynes CCG...
• CCG is responsible for £268 million

• CCG must be innovative and effective if we are
  to produce better services whilst reducing the
  increasing cost of healthcare
Director of Corporate
                                     Affairs & Partnerships




                        Corporate Affairs PA




            Team Administrator




                         Organisational &                               Infrastructure &
                                                       Comms and
Knowledge Officer            Workforce                                   Commissioning
                                                   Engagement Manager
                       Development Manager                                Support Lead




                                                                             Project Manager
The intelligent commissioner
Knowledge service                 Business intelligence

• Searches -                      • Monitor, analyse, interpret,
• clinical & cost effectiveness     report on
  best practice”; models of         cost, activity, outcomes, qua
  service                           lity ref contract
• Horizon scanning; alerting
• Website                         • Clinical analytics
• Disseminate best evidence
                                  • Public health intelligence
Role of Knowledge Officer
Role of KO                    • Lead website steering
• Search & summarise info:      group
   – models of service        • Commissioning Manual
   – clinical effectiveness   • Innovation action plan
   – Clinical effectiveness   • Promote R&D
• Support pathway review      • In house: CCG Telephone
  and service redesign as a     directory; Desk pack
  member of the team
                              • Ensure access
• Profile knowledge needs
                              • Information skills &
• Targeted and tailored         resources
  Knowledge@lerts
Improving Medical
Practice by Assessing
CurrenT Evidence
B = Building Know-How
to improve performance
Mainstreaming systematic approach
Tools
•   MK CCG Information pack
•   Opportunity Locator (NIII)
•   NHS Atlas of Variation (Right Care programme)
•   National Benchmarker (Audit Commission)
•   NHS Comparators
•   ACGs
•   JSNA
C= Continuing to learn
      • Evidence-based practice skills
      • Effective meetings practice

      • Learning sets to support
        model of improvement

      • Metrics; outcome measures
      • Mosaic

      • Lessons learned events
The library as a platform for change
Understanding the environment
• The context in which health & medical
  information is needed, managers reach
  decisions about models of care, patients are
  asked to enter into shared decision-making
• Changing healthcare environment:
  policy, economic, legal issues, education &
  training patterns, workforce
• Changing information environment:
  virtual learning environments, social
  networking, the creative cloud, open access
  access scientific publishing
Preparing for today and tomorrow
• Health sciences librarians must prepare to
  meet the needs of today's and tomorrow's
  health sciences environment

• Multi-disciplinary, life-long learning - to serve
  the needs of health providers and consumers

See Platform for Change, MLA, 1992
The Evolving Librarian

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The evolving librarian - health and medical librarians in a changing environment

  • 1. The evolving librarian – health and medical librarians in a changing environment Sue Lacey Bryant Health Education in Transition UHMLG Spring Forum, 4th Feb 2013
  • 2. The Evolving Librarian Source: A visualização da imagem anterior desperta para a leitura do artigo: "Evolving Web, evolving librarian" de Amy and Robert Favini balcaodebiblioteca.blogspot.com
  • 3. 1. Introduction 2. A burning platform for change 3. The pressing need for innovation 4. Positioning librarians as catalysts for change 5. Bringing knowledge to bear 6. The library as a platform for change
  • 5.
  • 6.
  • 7. DH NCB NIHR LETB HEE PHE The new NHS infrastructure NICE
  • 8. Fire fighting The practice of dealing with problems as they arise rather than planning strategically to avoid them
  • 9. Omphaloskepsis The contemplation of one's navel which is an idiom usually meaning complacent self-absorption
  • 10. A burning platform for change • Harsh financial climate • Ageing population • £20 billion of efficiency savings required within NHS by 2015
  • 11. National priorities •Stemming the increase in emergency admissions • Service reconfiguration; making the shift from hospital to community care; seamless care • Addressing inappropriate variations in clinical practice; clinical safety and quality
  • 12. A pressing need for innovation “We need to radically transform the way we deliver services. Innovation is the only way we can meet these challenges” “Put simply, we must make innovation a priority. We know that the NHS can spread new ideas at pace and scale when it puts its mind to it, and we need to do more of this.”
  • 13. Copying is good “ Innovation ... needs to be replicable – and replicated – across similar settings. So innovation is as much about applying an idea, service or product in a new context, or in a new organisation, as it is about creating something entirely new. Copying is good.”
  • 14. Positioning librarians in the workplace as catalysts for improvement • Aligning with NHS priorities • Multidisciplinary working • Changing skill mix • Role substitution • Role enlargement • Role enhancement
  • 15. Enhancing the role of librarians Role enhancement involves expanding a group of workers' skills so they can assume a wider and higher range of responsibilities through innovative and non-traditional roles
  • 16. Bringing knowledge to bear in a cold climate: an ABC
  • 17. A practical approach to ‘KM’ • Applying knowledge • Building know-how • Continuing to learn
  • 18. A = Applying knowledge around the commissioning cycle
  • 19. Milton Keynes CCG... • CCG is responsible for £268 million • CCG must be innovative and effective if we are to produce better services whilst reducing the increasing cost of healthcare
  • 20. Director of Corporate Affairs & Partnerships Corporate Affairs PA Team Administrator Organisational & Infrastructure & Comms and Knowledge Officer Workforce Commissioning Engagement Manager Development Manager Support Lead Project Manager
  • 21. The intelligent commissioner Knowledge service Business intelligence • Searches - • Monitor, analyse, interpret, • clinical & cost effectiveness report on best practice”; models of cost, activity, outcomes, qua service lity ref contract • Horizon scanning; alerting • Website • Clinical analytics • Disseminate best evidence • Public health intelligence
  • 22. Role of Knowledge Officer Role of KO • Lead website steering • Search & summarise info: group – models of service • Commissioning Manual – clinical effectiveness • Innovation action plan – Clinical effectiveness • Promote R&D • Support pathway review • In house: CCG Telephone and service redesign as a directory; Desk pack member of the team • Ensure access • Profile knowledge needs • Information skills & • Targeted and tailored resources Knowledge@lerts
  • 23. Improving Medical Practice by Assessing CurrenT Evidence
  • 24. B = Building Know-How to improve performance
  • 26. Tools • MK CCG Information pack • Opportunity Locator (NIII) • NHS Atlas of Variation (Right Care programme) • National Benchmarker (Audit Commission) • NHS Comparators • ACGs • JSNA
  • 27. C= Continuing to learn • Evidence-based practice skills • Effective meetings practice • Learning sets to support model of improvement • Metrics; outcome measures • Mosaic • Lessons learned events
  • 28. The library as a platform for change
  • 29. Understanding the environment • The context in which health & medical information is needed, managers reach decisions about models of care, patients are asked to enter into shared decision-making • Changing healthcare environment: policy, economic, legal issues, education & training patterns, workforce • Changing information environment: virtual learning environments, social networking, the creative cloud, open access access scientific publishing
  • 30. Preparing for today and tomorrow • Health sciences librarians must prepare to meet the needs of today's and tomorrow's health sciences environment • Multi-disciplinary, life-long learning - to serve the needs of health providers and consumers See Platform for Change, MLA, 1992

Editor's Notes

  1. Our theme this year is Health Education in Transition at a time when both medical/health education, and the NHS, and indeed the wider landscape of health and social care in the UK, is in a state of change.
  2. Concept of Evolution - Develop gradually, esp. from a simple to a more complex formDevelop over successive generations, esp. as a result of natural selection.
  3. Already a much changed environment since I headed into academic libraries as a young graduateStarted out here in the Current Periodicals Room at Birmingham UniversityAnd then after completing “Library school” went onto my first professional post at Newcastle Poly; where I worked on a User Education project funded by the BL, known as The Travelling Workshops Experiment
  4. Dir Corporate affairs and partnershipsMK: a young, AND an ageing AND a growing population
  5. A time of enormous change in the NHS
  6. http://healthandcare.dh.gov.uk/the-health-and-care-system-in-april-2013-infographic/
  7. Effectively flat real terms funding for the next four years; against backdrop of wider economic recessionThe rich world is ageing; more people living longer - at 2030 22% of the people on the planet 65+; Elderly people who are chronically unwell rather than seriously ill can be maintained with nursing rather than medical care in their own homes. Never let a good crisis go to wasteTake the opportunity to do things you think you could not do beforeThe Burning Platform – explosion the Piper Alpha oil-drilling platform in the North Sea in 1988One of the survivors,a superintendent on the rig, jumped 15 stories from the platform to the water – where he knew he could only survive for 20 mins. Why? “It was either jump or fry.” He chose possible death over certain death; the price of staying on the platform was too high.
  8. Demand continues to rise, especially for unplanned and emergency care; rise in levels of chronic conditions and obesityWith 4 hospitals within 30 mins driving distance, - we might expect to see some reconfiguration of health services to offer patients the very best specialist care where availableBetter drugs and improved surgical techniques, along with the advent of day surgery, have meant good after-care, rather than medical intervention, is what increasingly determines a full recoveryA whole year's care by a GP costs about one tenth of a day in hospital. Dealing with the duplication and fragmentation that occurs in care that crosses provider and budgetary boundariesUsing data to illuminate unexplained / inappropriate variation to drive up quality.
  9. The status quo is not an optionInnovation not necessarily invention
  10. Health is a knowledge-based industry Innovation Health and Wealth, p.9
  11. So this is the challenge for us today –
  12. Carl-Ardy Dubois and Debbie Singh. From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management. Human Resources for Health 2009, 7:87 http://www.human-resources-health.com/content/7/1/87
  13. Healthcare is a knowledge based industry;Harsh financial climate
  14. Where can knowledge have the most impact?How can we improve business performance by building know-how?How can we share and spread good practice & embed lessons learned?What do we need in the way of information products and services?
  15. Developing as a high performing organisationand alongside enabling our day to day business, my role is fundamentally about transformation and supporting system reformInnovation, Knowledge Management, Quality ImprovementBuilding organisational delivery capability; staff and leadership developmentForming successful partnerships, member practice engagement,public & patient involvement Infrastructure planning, management and development – commissioning support arrangements; PH MoU; IT system integration; using estates V small directorate; maybe 40-45% of our management costs fund an SLA with GEM as our commissioning support organisation; hold the ring on the service specifications and contract managementMatrix organisation – currently also Exec lead for Commissioning urgent care
  16. BETTER METRICS - Enable systematic challenge of variation –more proactive analytical service (more strategic use of data); Clinical analytics – inc risk stratification
  17. And where can Where can knowledge have the most impact?
  18. Supported by a primary care librarian working in member practices Started in 2007; really about growing clinical involvement & support for innovation at practice level; Challenge is to share & spread
  19. How can CKOs build the Know-How to improve business performance, reduce costs and improve quality?
  20. Whole system approach to service review and pathway developmentEXPLICIT BUSINESS PROCESSES for commissioning & contracting
  21. How can we share and spread good practice and embed lessons learned?How can the CKO build a culture receptive to evidence-based practice, knowledge exchange and learning?Core skills; accessible resourcesBUILDING CAPABILITYPersonal & corporate effectiveness. Learning & networking
  22. Platform for Change: The Educational Policy Statement of the Medical Library Association, The Medical Library Association, 1992http://www.mlanet.org/education/platform/
  23. One of the core areas of knowledge described in the Platform is the health sciences environmentNew kinds of doctor, new kinds of health professionals To help equip new professionals to step onto the burning platform- Do you forsee a shift of budget from libraries to fund free to net publication by researchers?
  24. Platform for Change: The Educational Policy Statement of the Medical Library Association, The Medical Library Association, 1992http://www.mlanet.org/education/platform/One of the core areas of knowledge described in the Platform is the health sciences environment
  25. In the struggle for survival, the fittest win out at the expense of their rivals because they succeed in adapting themselves best to their environmentIt is the expertise of health and medical librarians that can make a difference