Exploiting the Power of Knowledge

in NHS Scotland

Integrating Knowledge with Patient Care

Dr Ann Wales NHS Scotland Library Service Development Coordinator

NHS Education for Scotland

Knowledge - definition

“The property of intelligent agents which helps them to reach their goals effectively”

Allen Newell, 1981

Technology networks facilitate access to knowledge

Human networks translate knowledge into goals.

Knowledge Support for NHS Scotland :

Strategic Goals

Equipping and empowering staff

Partnership – national, local, cross-sectoral

Service Modernisation

Public Involvement

Health Improvement

Quality and Standards

Knowledge Support for

an

Integrated Healthcare

System

Knowledge Support for NHS Scotland :

Strategic Needs

Knowledge Needs of NHS staff

Of Knowledge Sources

Integration

National, Local, Sectoral

Managed Clinical Networks, Community Health Partnerships

Burnett et al, Knowledge needs analysis of NHS Scotland staff. Robert Gordon University, 2003.

Knowledge Needs of NHS staff

With workflow and patient care processes

Staff roles and responsibilities

Focus, Quality, Relevance

All staff grades and disciplines

Integration

Evidence on applying Knowledge to Practice

Linking Knowledge with Case-finding SystemsReminders / prompts linked with patient records

Audit and feedback

Peers and Patients as Knowledge Channels

Communities of Practice

The Need for Change

• Existing Knowledge Services

• Fragmentation

• Inequity

• Under-resourced

• Low strategic / management profile

Vision

E-Library as primary vehicle

Local / national Knowledge Support Infrastructure

With Patient Care Processes

With Staff Roles and Responsibilities

Modernised by technology

Supported by human information and communication skills

Integrated

Integration of Knowledge Sources

Search on e-Library

Is transferred seamlessly to other Knowledge PartnersResource Discovery

NetworkHealth Scotland

Database of Guidelines and Systematic Reviews (TRIP)

Scottish Executive database of policy documents

Also cross-searches:

Integrated access to Knowledge Sources

depends on

international standards for data exchange

Same standards can facilitate

integrated access

to other national and local knowledge sources.

Advanced Search Technologies

Focused Subject Search

Focusing Knowledge Support

Subject

Indexing

At detailed level

MESH

GCL

Caredata

Natural Language

Portals:

Cancer, Coronary Heart Disease, Mental HealthPortals planned for:

Health Care Associated Infections

Remote and Rural Healthcare

Stroke Therapy

Knowledge Exchanges

Cancer Portal

Login to create Personal Knowledge Space

Expert Searches

Updating Services

My Knowledge Space

Tools to manage information overload

Create your own knowledge profile

Create portable Favourites

Create your own Specialist Homepage

Receive Alerts on new Knowledge in field of interest

Knowledge Content

Biomedicine

Nursing, midwifery

Allied Health Professions

Science and Technology

Pharmacy

Estates and Facilities

Health Improvement

4000 ejournals

200 ebooks

100 databases

1500 free evaluated Internet resources

Roadmap: Linking Knowledge to Patient Care

1. Consolidation of e-Library

2. Integration of Knowledge Sources

3. Linking Knowledge to Human Behaviour

4. Information Skills Training

5. Development of NHS Librarian role

6. Ensuring Quality and Continuous Improvement

Cost of preventable adverse events

•Additional bed days:

•£1 billion per year UK-wide

•Costs of litigation

The Cost of Ignorance

Scenario 1:

A Public Health Consultant on-call used the e-Library to look up changes in Haemophilus influenza B (Hib) as a cause of acute epiglottis.

“The textbooks were way out of date. What I found influenced the management of a child with acute epiglottitis admitted to the local teaching hospital.”

Benefits of integrated knowledge support

Scenario 2:

Benefits of integrated knowledge support

A GP on a house-call to visit a child with croup was unsure about the application of dexamethasone.

A 5 minute search of the e-Library gives up- to-date evidence and guidance.

Today’s Seminar

Define milestones on roadmap

Recognise shared responsibility

Understand extended role of e-Library