This document discusses embedding a Team Knowledge Officer (TKO) role within clinical teams through a pilot clinical librarian service. It provides background on clinical librarian projects and definitions of clinical librarians and their roles. The document outlines recommendations for a TKO from the 'Hill Review' to support teams through knowledge sharing and ensure evidence-based input. A past study where a librarian attended mental health team meetings is described. The document proposes a pilot to embed the TKO role within specific clinical services at Durham and potential benefits like improved skills and awareness of information resources to enhance clinical effectiveness. Issues for consideration include evaluation methods and information needs analyses.
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Embedding the Team Knowledge Officer role within clinical teams via a pilot clinical librarian service
1. Embedding the Team Knowledge Officer role
within clinical teams via a pilot clinical
librarian service
Catherine Ebenezer
Durham CAMHS CPD meeting
West Park Hospital
29/06/2011
2. Clinical librarian projects: 1
Started in USA 1971-
Integrate health sciences library services and literature
searching expertise of health librarians into clinical
settings
Overcome time, cost and expertise barriers to adoption
of evidence-based practice
Enhance educational experience of students and junior
doctors
Enable librarian to gain a better understanding of the
patient care context of information needs
3. Clinical librarian projects: 2
Extensive professional literature, including
several systematic reviews:
Wagner and Byrd (2004)
Brettle et al. (2010)
Weightman and Williamson (2009)
Very few projects in mental health services:
Reid et al. (2008) – Barnet PCT
Urquhart et al. (2007) – North Wales
**Gorring et al. (2010) – Birmingham & Solihull**
4. Clinical librarian: a definition
A clinical librarian seeks “ to provide
quality-assured information to health
professionals at the point of need to
support clinical decision making”
(Hill, 2008)
5. Role of the clinical librarian
• Attendance at clinical meetings
• Attendance at / support for journal clubs
• Undertaking literature searches
• Evaluating information / critical
appraisal / clinical question answering
• Facilitating clinical guideline development
• Service promotion and outreach
• User education and training
6. Models of clinical librarian service
Question and answer service
requests submitted to CL – literature search results provided to user
Outreach
CL uses a range of means and methods of providing information to users
– tries to engage them with library services
Question and answer service plus critical
appraisal
response to user’s enquiry contains a critically appraised summary of
results
Outreach plus critical appraisal and synthesis
Results of queries include a synthesised critical appraisal
(Brettle et al. 2010, p. 12)
7. ‘Hill review’
Hill, Peter (2008)
National Review of NHS Health Library Services in E
. London: DH
Important high-level recommendations re:
Knowledge management within the NHS
NHS library and information services
Never officially endorsed by DH
Overtaken by ‘Darzi’- led to breakup of NLH
Impetus for many clinical librarian projects
8. Chief Knowledge Officer (CKO)
Advocated originally by Muir Gray (1998)
“In every NHS organisation someone at board
level should be entrusted with the role of Chief
Knowledge Officer for that organisation.”
Role: to provide leadership and oversight to
enable all NHS staff to access and apply the
best available evidence in supporting every
aspect of the clinical care of patients.
(Recommendation 11)
9. Team Knowledge Officer (TKO)
“Every clinical or management team in the
NHS should identify someone in the
team as “Team Knowledge Officer” (or
equivalent). The Team Knowledge
Officer will have responsibility for
ensuring the effective input of evidence
to enable the team to function properly.”
(Recommendation 14)
10. Role of the Team Knowledge Officer: 1
Supporting the team through:
ensuring the dissemination of externally and internally generated
evidence, research, information, and data
facilitating knowledge sharing
participating in horizon scanning by anticipating future service needs
Working in partnership with the Chief Knowledge
Officer by informing him/her about the team’s issues in
managing knowledge
Identifying and participating in relevant networks
across the health community in order to make best use
of all available information resources
11. Role of the Team Knowledge Officer: 2
Has an enabling role in supporting excellence by
improving:
awareness of the evidence
access to the evidence
Identifies relevant colleagues for liaison within and
outside the organisation, e.g.
education and training
library and knowledge services
information departments
other providers of knowledge
Maintains an awareness of relevant developments in
health care e.g. within their speciality, within health
information / health informatics services
12. Role of the Team Knowledge Officer: 3
‘Clinical team’ is not defined
‘Nature of ‘Team Knowledge Officer’ role is
unclear:
Hill – a synonym for ‘clinical librarian’ – advocated
an expansion in the number of clinical librarians
serving the needs of a limited range of specialties
within acute trusts
NLH - an extra responsibility taken on by a clinician
within a team
Wrangling within directorate!
13. Gorring et al.
Four-month pilot project; librarian attended weekly
team meetings in two community MH teams to help
generate clinical questions
Senior medical or nursing lead was present to facilitate
discussion and clinical question formulation
A summary of the evidence on each topic was
presented the following week
Evaluation was conducted using a questionnaire
survey, focus groups and interviews
14. Gorring et al. – reported benefits
Librarian – built up clinical expertise – clinical context provided
important background information
Consultant psychiatrists – having an external person from a
different professional background attending team meetings was
beneficial – contributions from librarian were ‘unbiased,
unemotional and informed’
All clinicians – librarian input a useful training tool – ‘broadened
the knowledge base’ – better understood ‘the librarian’s potential
role in enhancing learning’
Team member – broke down barriers to visiting and using the
library
Substance misuse team - improved ability to formulate clinical
questions
15. Embedding the TKO role
Working with each team to develop an agreed Team
Knowledge Officer role to be adopted by one or more
of the members under the direction of the appropriate
clinical lead
Four services participating:
Durham CAMHS
Durham AHP
Durham LD (TBC)
Clinical psychology research structure – Barry Speak
16. Deliverables
Enhanced information literacy among
clinicians within the participating services
leading to:
Better quality clinician information seeking
A detailed specification for the role of Team
Knowledge Officer which could in principle be
replicated across other services
Professional publications giving an account of
the project
17. Benefits
Improved skills in question formulation,
information seeking and critical appraisal on
the part of clinicians
Improved awareness of information resources
leading to:
Improved clinical effectiveness, patient safety
and patient service quality
An enhanced reputation for the trust for
forward thinking as an early adopter of the TKO
role
18. Issues to consider
Evaluation methodologies? – to be determined
Information needs analyses – required in detail
for each participating service
Tie-in with Professor Joe Reilly’s work on
current awareness for the CEO
Possible scenario = a network of TKOs across
the trust facilitating research awareness,
supported by a (permanent) clinical librarian?