Strategic Collaborations in Health Sciences Libraries

Jean P. Shipman, M. J. Tooey

• Publisher: Chandos Publishing
• Year: 2018
• Print ISBN: 9780081022580
• eBook ISBN: 9780081022597
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

Health sciences librarians need to optimize collaborating with others in their institutions and beyond. An understanding of what leads to successful collaborations is beneficial and empowering. By using case studies of varieties of collaborations, Strategic Collaborations in Health Sciences Libraries provides a framework and evidence about key factors to consider when thinking about building and sustaining successful collaborations. Readers of this book are encouraged to contact the chapter authors to obtain more details than those provided in the book. This connection between experts with collaboration experience and those seeking to understand successful collaborations is the key impact of this book. - Focusing on the positive aspect of collaboration in health sciences libraries, this book encourages others to form collaborations mutually beneficial to the library and the collaboration partner. - Through case studies, readers are exposed to new ideas and ways to enhance existing collaborations. - By contacting individual authors and learning more about their experiences, readers share ideas and connect with a network of librarians with collaboration expertise.

Chapter 1

CEBIS

Collaborating With Clinicians to Inform Evidence-Based Practice

Amber Dunlop, and Anna Brown CEBIS Specialist, Library and Knowledge Services, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom

Abstract

The Clinical Evidence Based Information Service (CEBIS) is a team of information specialists based within the Library at University Hospital in Coventry, England. CEBIS specialists collaborate with clinical teams, attending clinics, meetings, and ward rounds. They provide a search and summary of the evidence in response to queries raised by clinicians and patients. CEBIS facilitates evidence in practice groups for discussion of the evidence and its application.

Questions submitted to CEBIS are called “referrals.” This, along with the ability to submit referrals via the patient record system, contributes to CEBIS being as integrated into the patient care process as the skills and work of microbiologists or radiologists. Having dedicated CEBIS specialists has enabled integration with clinical teams. The information professional develops subject knowledge and builds working relationships. Clinicians recognize specialist skills and the integral part they play in evidence-based practice. Both parties thus benefit from the collaboration.

Keywords

Clinicians; Collaboration; Embedded; Evidence-based health care; Information professionals; Multidisciplinary working; National Health Service; United Kingdom

Introduction

Evidence-Based Health Care

The evidence-based health-care movement has from the beginning identified itself as the integration of the best available research evidence with individual clinical expertise, including the “thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care,” ¹ as illustrated in Fig. 1.1. In many health-care settings, librarians or information professionals use their discovery and appraisal skills to identify the best available evidence. The clinician and the patient must not be forgotten. To best support the clinical decision-making process, evidence reviews need to be provided in a timely manner at the point of care, should take into account the complexity and concerns of individual patients, and encourage clinical input and questioning of the evidence with regard to its applicability to the situation at hand. Through close collaboration with clinical staff, information professionals can better understand and meet the needs of clinicians and their patients.

Figure 1.1 The essential components of evidence-based health care.

Setting

The National Health Service (NHS) in England is one of the four publicly funded national health-care services of the United Kingdom (NHS England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland). Established together in 1948, they provide comprehensive health services, free at the point of delivery, for residents of the United Kingdom. NHS England is a vast public body, comprising many different smaller organizations serving specific geographical areas and/or functions (e.g., acute care, primary care, mental health care, or ambulance services).

University Hospital in Coventry, central England, is an acute teaching hospital, and one of the largest such hospitals in the country. The hospital serves a population of over 1,000,000 people, employs over 8000 members of staff delivering care to 1100 patient beds, and has 26 operating theaters on site. ²

The library at University Hospital, staffed by a mix of professional and paraprofessional staff, provides access to thousands of print and electronic books and journals, searchable electronic databases, physical space with computers, professional expertise, and information skills training. These services are available to all hospital employees, as well as affiliated students, supporting them in all areas of their work or study, including research, evidence-based practice, teaching, and learning.

Development of Clinical Evidence Based Information Service

History of Clinical Evidence Based Information Service

In 2004, a Clinical Librarian (CL) service, consisting of one librarian, was implemented at the University Hospital. The CL developed the Evidence in Practice Group (EPG) model of delivering the best available evidence. EPGs involved the CL working collaboratively with a clinician to enable unbiased critical appraisal of evidence to be applied at a local level, then presenting this to the relevant clinical team to stimulate clinical discussion and the implementation of the evidence into practice. The role of the CL was to use critical appraisal skills and neutral viewpoint to present the evidence in an unbiased way in an environment where clinicians may be happier to practice based on the opinion that they have “been doing it that way for years.” Working closely with a clinician ensured the request for evidence had been properly understood and the evidence was applicable to the local setting/population. The CL also worked with a member of the Information Technology (IT) department to develop a pilot IT system.

In 2006, a business case was presented for additional CL posts, alongside further development of the IT system. The case was presented by the Head of Knowledge Services, as the manager with responsibility for the hospital library, its services, and staff. At that time the hospital's board of executives declined the request. By 2009, the case showing the need for further investment grew based on the success of the CL service. A second business case was presented for the service now named the Clinical Evidence Based Information Service (CEBIS). On this occasion, the Head of Knowledge Services was successful in securing funding from three of the five clinical divisions for three full-time equivalent CEBIS specialists to work within the specialties covered by those divisions. Three CEBIS specialist posts have been in place since 2010. In 2012, as a result of the reorganization of clinical divisions into smaller groups of specialties, the CEBIS specialists are now centrally funded and free to work with staff from across the hospital. The 2009 business case also secured funding for the in-house development of an IT system with the capability to link directly to the electronic patient record.

Purpose and Aims of the Clinical Evidence Based Information Service

CEBIS builds on the CL model of delivering evidence at the point of care. CEBIS promotes the use of research evidence in practice by providing the information to facilitate evidence-based decision-making in a timely and effective manner. The primary aim of CEBIS is to collaborate with clinical staff to support quality patient care, either by aiding decision making about an individual patient's care, or improving evidence-based practice more broadly by working on research and audit projects, development of local guidelines or through advancement of professional knowledge. CEBIS is staffed by three qualified and experienced information specialists and supported by an IT system linked directly to the electronic patient health record. This enables colleagues to make requests for evidence as routinely as if making a referral for a blood test or X-ray. Requests to CEBIS are therefore termed “referrals,” embodying the integration of an evidence search and discussion in the patient care process.

The Service and How It Works

CEBIS referrals may be submitted via a web form linked to the dedicated IT system, in person to the CEBIS specialist, by phone or email, or via the electronic patient record. For referrals relating to an individual patient, the latter option allows the CEBIS specialists to identify the patient and read relevant clinical notes shedding more light onto the clinical problem, as well as providing documentation of consultation of the research evidence alongside that patient's notes. CEBIS specialists, regarded as a member of a patient's clinical team, attend the same training and agree to the same policies as clinical staff regarding access to the patient record. They are trusted to access information about patients in accordance with information governance policies and data protection regulations. Search results, evidence summaries, presentations, and any discussion associated with each referral are stored on the searchable IT system.

The three CEBIS specialists are each aligned with specialty groups with whom they work particularly closely. The aim is to work in an embedded way as a member of the clinical team, attending ward rounds, clinics or clinical meetings, thereby contributing information and knowledge to improve day-to-day patient management. Being present in a clinical area also encourages the asking of questions and seeking of evidence by clinicians as uncertainties arise, rather than allowing these to go unanswered as a result of time pressures. The case studies provide examples of embedded working.

CEBIS referrals arising from nonembedded specialties are allocated to team members according to workload. While each specialist manages their own work, the team shares an office and often discusses searches or referrals to obtain advice or suggestions from colleagues. Training and skills development in areas such as critical appraisal and advanced searching are largely undertaken internally. This is a collaborative approach, with much sharing of knowledge and experience between the members of both CEBIS and other staff at the hospital library, including a knowledge skills librarian and electronic resources librarian.

Case Studies

Neonatology

Analysis of Referrals

University Hospital delivers specialist neonatal care to newborn infants from 23 weeks gestational age through the Neonatal Intensive Care Unit (NICU). The NICU multidisciplinary care team was involved in the pilot year of CEBIS development, inviting a CEBIS specialist to attend weekly multidisciplinary team grand rounds on the ward. This working relationship has flourished over time and each week CEBIS provides evidence to inform clinical practice, supporting clinical staff in delivering EPGs and facilitating clinical discussions to enhance evidence-based practice, education, and service development.

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Table of contents

• Cover image
• Title page
• Table of Contents
• Series Page
• Copyright
• Contributors
• Biographies
• Preface
• Chapter 1. CEBIS: Collaborating With Clinicians to Inform Evidence-Based Practice
• Chapter 2. Collaboration is Key: Advancing the Academic Health Sciences Library's Mission Through Campus Partnerships Within Library Spaces
• Chapter 3. Collaborating to Connect the Underserved With Patient Portals
• Chapter 4. Finding the Way Without a Road MAP: Cultivating a UK-Wide Community of Practice
• Chapter 5. Open Collaboration: How Separate Library Systems Harmonized Their Support for Open Access Scholarship
• Chapter 6. Bringing the Evidence to the Table: Librarians Partner With Performance Improvement for High-Quality, Safe, and Cost-Effective Patient Care
• Chapter 7. Successful Collaborations at the Local and National Level Build Teenagers' Skills to Advocate for Improved Health: Project SHARE
• Chapter 8. Strengthening Strategic Planning Through Diverse Collaborations
• Chapter 9. e-channel: A Platform for Disseminating the Scholarly Output of Innovators
• Chapter 10. It Takes a Village: Operating an App Bar Within a Hospital
• Index