Library and Knowledge Services Annual Report

Library and Knowledge Services Annual Report 2016-2017 West Hertfordshire Hospitals NHS Trust Katherine Teal

Annual Report 2016-2017 Foreword This year has seen significant changes in the Library and Knowledge Services at West Hertfordshire Hospitals NHS Trust as the changes implemented during phase 3 of the management of change process were implemented. This has led to interesting opportunities and greater capacity to build on the work of the existing LKS team to develop the service in line with the Knowledge for Healthcare framework and to cement greater alignment with the workforce development activities in the Trust. Following the reorganisation of the education and training function the existing part time LKS staff now work as part of the education and training team. From Autumn 2016 a new team of full time LKS staff was employed at St Albans with a Library and Knowledge Services Manager with responsibility for managing the overall service across the Trust who started in October. The final two quarters of 2016/17 were very much focused on induction and training of the new team supported by Janet Reynolds, the existing Library and Knowledge Service manager, who had been seconded into the role which had been vacant long term. Special thanks to Janet for this ongoing support and training as the team reach the end of their probationary period. This has not been a year without challenges particularly in relation to the staffing changes above. In addition financial pressures following the change to collaborative purchasing arrangements across the region and the breakdown in Trust IT systems preceding the Cyber Attack left many unable to access educational resources or use systems vital to performing their role for many weeks. On a positive note we are well on the road to embedding and developing many of the strategic aims outlined in our Library and Knowledge Services Strategy 2015-2020 and the Knowledge for Healthcare framework. We are starting to see the rewards of a drive towards raising awareness of the service and greater integration with education and training and the Trust educational governance structures and an emphasis on partnership working across the Trust and the local health community. I look forward to working with the current team to realise the vision of a Trust underpinned by a strong exemplary knowledge and evidence base at all levels to provide safe patient care of the highest quality and improve the health outcomes for the wider community. Katherine Teal Library and Knowledge Services Manager

Introduction This annual report covers the period from April 2016 to April 2017 with some reference to the period immediately following this in May and June where this is relevant. The key focus is on the Library and Knowledge Services for the first two quarters while the second two quarters also report on education centre activity for St Albans as the changes in staffing meant that Senior Library Assistant and Library Administrator are also responsible for running the education centre on this site. Background Information WHHT Library and Knowledge Services has libraries on 3 sites; Watford, St Albans and Hemel Hempstead. Dedicated professional staff are present at Watford and St Albans to provide a full service while Hemel Hempstead users can access professional support via phone or email. The service supports all staff and students on placement at WHHT - many from UCL, UH, St Georges University and University of Bedford. Mission Our mission is to make a difference, to work in partnership to provide a consistently high quality service, informing and informed by world class research and education and driven by national and local drivers to meet the needs of health care professionals to support delivery of the very best care for every patient, every day by: Making knowledge accessible Staff and patients can access the right information at the right time and place to have a positive impact upon healthcare Informing professional decisions Staff can access evidence to support high-quality decision-making at all levels whatever their role Supplying the evidence base to enable outstanding healthcare and reduce risk We will identify high - quality evidence by undertaking effective research and providing authoritative up-to-date resources for research Promoting innovation, quality improvement and keeping staff updated Proactively helping to create a well-informed workforce that is knowledgeable in the latest developments, theories and practices Saving valuable staff time Our professionally qualified, experienced staff provide responsive research and enquiry services to help you find the best information, leaving you free to focus on other priorities Building stronger partnerships across organisations, regional health networks and within the Trust - to create better health outcomes for our region Developing a culture of knowledge sharing and utilisation within the Trust to improve business performance Library and Knowledge Services

are business critical and fully integrated into all aspects and levels of Trust activity. Key Activities and Achievements The year has seen significant changes in Library and Knowledge Service staffing due to Management of Change Phase 3 and much of the focus has been on managing the change process for the existing staff, induction and training and development of the new staff and integration of new staff with established team members. The transition process has been challenging particularly for existing team members however their support has facilitated the successful completion of probationary periods for the new roles. Moving forward the focus will be on cementing team relationships across the sites and ensuring cross site working practices are effectively meeting service needs. A key focus for this year has been the work that the team have been doing to raise awareness and build partnerships within the Trust. Throughout the year we have set up meetings with the Research and Development Team, Patient Information Team, Dementia Team, Clinical Audit Team and Corporate Nursing to explore opportunities for working together and to break down silos for the benefit of patients and achieving Trust goals. These meetings have proved to be useful starting points for knowledge exchange and now work is underway to build on the potential for closer working. Also very valuable was a meeting with Dr Knight, a clinical tutor, who provided some very helpful ideas about how the Library Service could be developed to meet junior doctor s needs and continues to be an excellent advocate for library services within the Trust. We are developing several work streams as a result of this input. These ad hoc meetings took place on top of the existing regular educational governance and workforce development meetings which are an excellent vehicle to share best practise, raise awareness of the service, discuss any issues or opportunities for improvement. It is encouraging that WHHT involves the Library and Knowledge Services so closely in educational governance and there is much that the LKS can do to support evidence- based practise and quality improvement. A particular highlight was the mention of the valuable support provided by Library and Knowledge Services at the school of medicine visit in March. The challenge is now to raise awareness of the benefits of LKS in supporting wider workforce development and evidence based quality improvement in the wider Trust and this will be part of the agenda going forward with particular focus on the senior HR meetings as a vehicle for achieving this recognition at board level. We are have made significant progress in developing a dedicated clinical librarian service and following an intensive period of research and evidence gathering a proposal was sent to the dietetic team for a pilot service. This is currently being followed up and we hope to test this service further during the summer period. Knowledge and awareness raising activity is now firmly embedded in LKS services. Evidence bulletins are now sent out to a growing distribution list on the subject of dementia and palliative care. We have also increased our signups to Knowledge for Healthcare although more needs to be done to promote this tailored alerting service further. Knowledge management is a key focus of the Knowledge for Healthcare framework and LQAF is assessing knowledge management activities as part of the core criteria this year.

This is an area which has great support at WHHT with key members of the Trust proactively encouraging the formal sharing and management of knowledge to create a sound knowledge base for decision making. An example of good practice was where the LKS undertook a mapping exercise to map governance structures for non-medical education as part of an exercise to ensure the right structures are in place to reduce risk and support quality learning in the West Hertfordshire workforce. WHHT LKS have also attended the regular Knowledge Cafés for the regional network of libraries. These Can-do Cafés have provided a great opportunity to focus on very specific challenges with delivering library services and for library staff across the East of England to share their best practice in resolving these challenges. Examples of topics include; how to support external organisations, how to best disseminate information, how to support services with Twitter and how to deliver an effective library induction. WHHT LKS are continuing to attend these knowledge cafés that take place approximately every two months. We have also initiated a series of health information focused knowledge sharing displays on topical health subjects such as diabetes, breast cancer, kidney cancer. The Library and Knowledge Service was heavily involved in supporting Dementia Awareness Week when we worked closely in partnership with East and North Hertfordshire Trust. This activity was a key component of our work towards implementing the Knowledge for Healthcare framework and contributes to several of the requirements for outreach and enhanced access to health information across the health community which will increase our success in the LQAF assessment due in September. The events provided an opportunity to build closer relationships and partnerships with the Dementia team and external support organisations such as the public library service which have a key role to play in promoting self-care and health information and voluntary groups like Dementia Friends. They also helped to raise the profile of the Library and Knowledge Services so that teams across the Trust are more aware of how the service can support their work with evidence, horizon scanning and research and support their education and professional development. The legacy effect of this activity means that we have strong relationships in place to run similar events next year and an additional one focusing on diabetes care. Across the Trust LKS at St Albans and Watford we have established working relationships with the Public Library Health and well-being services to raise awareness to patients of services and information available to promote self- care ultimately with the aim of reducing the need for acute hospital care. This is also a key focus of the Knowledge for Healthcare framework. The LKS has very successful, well established relationships with hospice services in West Hertfordshire and offers training to hospice staff in evidence gathering and information skills to enhance their CPD and patient care. These relationships have continued to grow throughout the year and the same service is now offered to Rennie Grove. Critical appraisal is recognised as a key skill for Trust staff across all disciplines especially with the increasing emphasis on evidence- based care to improve outcomes and patient safety. Following benchmark visits and refresher training via Royal Free and Chelmsford Hospital Library Service and support from several clinical tutors and corporate nursing we have designed and implemented a journal club and critical appraisal support service for the

benefit of the Trust. The aim is to fully embed this service in the education and training programmes across the disciplines. The Library and Knowledge Services Team are closely involved in quality control aspects of mandatory and essential training within the Trust. In addition to supporting e-learning targets the team are active members of the quality control panel for this training. This has led to an increase in compliance rates for this training. The year has seen an increase in visitors to the library and St Albans Education Centre to use the facilities for e-learning and more generally the number of internal and external training and education events taking place at St Albans Centre has increased throughout the year. This increase in usage provides opportunities for increased visibility of library services at St Albans and has led to an increase in library usage on this site. Activity Data The library and knowledge services provide a wide range of services many of which are common across the Health Libraries Network. Statistics are collected regionally on core activities and we also collect statistics locally to help to shape the service. Our monthly report collates data and service information from both staffed sites. During the year the Library and Knowledge service has delivered: 447 loans from stock 163 loans from the regional library network 11 loans from the British Library, BMA and other libraries 438 photocopies of articles were supplied from British Library and NULJ 65 online evidence searches on behalf of staff 533 downloaded articles During the year we have delivered direct services to the following groups of staff. This does not include those who have remotely accessed the service: 387 Junior Doctors 446 Consultants 1 GP 16 Medical Students 183 HCAs 51 Student Nurses 344 Nurses 95 PCT nurses

5 GP nursing staff 113 AHPs 1 Herts Parts AHPs 54 PCT AHPs 35 Administrative Staff 25 others There were 367 new library registrations during the period which is slightly down on last year. Service Development and Marketing Service development has been a key focus of 2016/2017 and in order to facilitate this benchmarking visits took place to Royal Free, East and North Hertfordshire, Hertfordshire Partnership Trust. These have provided a basis for service development and have led to ideas for improvement which are currently being implemented. All resources and materials are being reviewed and IT challenges permitting the website and the intranet page will be updated to reflect the changes in the service and enhance the library brand in the Trust. This work is ongoing. In addition a Library Benchmark survey was sent out to all Athens users and communicated to non service users. The results of the survey have provided valuable information and statistics about the perceived strengths and weaknesses of the service and will underpin the business planning process for next year. The full survey report is available on request and highlights include impacts attributed to the service such as improved patient care and safety, better collaborative working and service development and delivery. 84.21% of respondents felt that financial effectiveness and saving money were most likely future benefits of evidence and support provided by the library service. The quiet study space and access to computers was ranked highest in terms of physical features respondents valued most highly. Finance and Resources The loss of the collaborative purchasing arrangements across the East of England which had greatly benefitted West Hertfordshire in 2015/16 made a significant difference to the depth and breadth of the resources we were able to offer within the Trust. In particular the loss of journal subscriptions and e-books through Clinical Key and the key Wiley Journals has been felt by users. The staff have worked hard to minimise the impact of this loss by using interlibrary loan agreements across the network to satisfy requests. It is hoped that through ongoing discussions more sustainable arrangements for collaborative purchase will be established locally. We were very grateful for the support of a charitable fund donation to enhance our collection of medical books to include some much needed updates and key text recommended by education leads within the Trust.

Due to support from HEE and Medical Education services within the Trust we successfully negotiated a small increase in budget this year which has meant that we can continue to purchase other key resources to support evidence-based care such as DynamedPlus, clinical skills.net to support CPD, Knowledge Share and BMJ case reports, Ebsco journals and a range of key medical text books to support multi-disciplinary care and education as well as emerging Trust and NHS priorities. We are also helping to support a trial of UptoDate for the Trust as this is a tool which is very popular with many staff and clinical tutors who have previously benefited from personal subscriptions to this product. Much investment is needed to make improvement and repairs to the physical space at Watford and St Albans and a separate budget for this maintenance is being explored so that the impression of the library and education centre is improved, facilities are fit for purpose and users feel valued. A review of stock at the different sites will be a focus next year. The available budget at West Hertfordshire continues to present challenges as it is proportionately smaller when taking into account the size of organisation and the fact that we operate a multi-site service compared to other Health Library services funded by HEE. We will continue to work hard to demonstrate the value and impact of using knowledge and evidence effectively in organisational and professional development and hope that this return on investment will start to be recognised at all levels. Opportunities for efficiencies and enhanced services are being explored in partnership with East and North Hertfordshire Hospitals Trust and this work will also provide a foundation for more collaborative working across the STP footprint. The East of England Health Libraries network continues to be an excellent source of peer learning and innovation. The team regularly attend these meetings at HEE and value the opportunity to keep abreast of developments and lobby for change. Staff Development In July the Library team attended the Midlands and East Summer Conference 2017 where they were able to exchange processes and plans with many other libraries in the NHS network and expand their contacts. This conference also had a positive impact upon supporting continuing professional development. Sessions included how to organise pop-up libraries and the parts of the nurse revalidation process where the support of a library can be most effective. A Technology Jam demonstrated new devices that can be effective in library environments, such as display equipment and the medical and educational applications of virtual reality devices, both of which will be incorporated into WHHT library services in future. More locally the new team have successfully completed probation periods and have undertaken additional management and appraisal training to support their work. This has involved coaching in finance and budgeting and in Library systems and processes. Systems and processes for appraisal and staff development are followed closely in the team. An area for improvement is cross team meetings which have proved challenging on a split site service. This will be addressed during the coming months. Formal training via CILIP will be implemented next year to ensure that the service maintains the required skills and qualified staffing levels and business continuity is managed effectively.

Further information about any of the information contained in this report is available by contacting the Library and Knowledge Services Manager on 01923 217266 or email Katherine.teal@whht.nhs.uk