Eahil Dublin 2009 Workshop

Evidence Based Practice Parallel Paper Session (Thursday 4 June 14.00-15.30)

The InterTASC Information Specialists’ Sub-Group: collaboration to improve access to and evidence-based use of search filters 

Presenter: Julie Glanville
Authors: Julie Glanville, York Health Economics Consortium Ltd, University of York, and  Carol Lefebvre,  UK Cochrane Centre, Oxford, UK.

The InterTASC Information Specialists' Sub-Group (ISSG) is the group of information professionals supporting research groups within England and Scotland which provide health technology assessments to the National Institute for Health and Clinical Excellence (NICE).

The ISSG focuses on the professional development of its members. It also seeks to identify, share and promote best practice in information retrieval in the area of health technology assessments and systematic reviews. One major focus of its collaborative efforts has been to set up a web site to help identify and summarise search filters and evaluate them through critical appraisal techniques. Search filters can be useful tools for all health information professionals seeking to search databases efficiently for research evidence. As filters proliferate, however, choosing between them becomes more challenging. This paper will describe how the members of the ISSG have collaborated to produce a web site which not only lists but also evaluates search filters for research methods and designs, such as systematic reviews or randomized controlled trials, to promote evidence-based use of these filters. In addition the ISSG’s experience of developing, implementing and publishing a Search Filter Appraisal Checklist by consensus methods will be explored.

The ISSG is a successful collaboration of research-oriented information professionals across England and Scotland who have high levels of common interests and motivation with respect to skill-sharing. The group has produced an information resource which benefits not only its own members but also a much wider audience of health care information professionals and researchers.

Collaborating to improve healthcare outcomes: the introduction of a Clinical Informationist service to Ireland

Presenters: Beatrice Doran and Maura Flynn

Authors: Beatrice M. Doran, Hon. Senior Research Fellow, Department of Medicine, Royal College of Surgeons in Ireland & Maura Flynn, Clinical Informationist, Department of Medicine, Beaumont Hospital, Dublin.

The Irish Department of Health's Information Strategy  (2004) states that "high quality care requires the availability and use of evidence tailored to the needs of health professionals at the point of decision making".  We report on a pilot study to introduce the concept of a Clinical Informationist Service to Ireland which supports the Department of Health's Information Strategy. Our Clinical Informationist service also supports clinical staff as they practise evidence-based medicine which leads to improved efficiency and safety in the delivery of healthcare.

Research evidence has proved that providing easy access for clinical staff to the evidence base of healthcare (research literature, clinical guidelines and treatment protocols etc.), helps to improve clinical decision making, influence the cost of drugs prescribed and  length of hospital stay, thus reducing overall hospital costs.  A Clinical Informationist service is also part of the Translational Medicine agenda to bring research from bench to bedside quickly and efficiently.

Based in the Department of Medicine at Beaumont Hospital, Dublin the Clinical Informationist is a member of the Medical Team and attends ward rounds, multidisciplinary team meetings and journal clubs. Her main roles include: searching the research literature and providing team members with answers to their clinical questions in a timely fashion, assisting with research projects, and providing information skills training to members of the clinical team. She also seeks to improve awareness and utilisation of the information resources, by clinical staff,  particularly evidence-based resources. This is a one year research project which aims to implement, test, model and evaluate the contribution of a Clinical Informationist service to healthcare outcomes, research dissemination and health gain at a tertiary Irish teaching Hospital (Beaumont Hospital).  We also aim to evaluate the potential care and economic benefits of extending this model to the rest of the Irish healthcare system.

Collaboration, partnership and interoperability aim to provide easy access to the best evidence for public health practitioners

Presenter: Gordon Watson (UK) Collaboration, partnership and interoperability aim to provide easy access to the best evidence for public health practitioners

Authors: Gordan Watson and Shannon Robalino, County Durham Primary Care Trust (PCT) and Darlington PCT Health Promotion Library, United Kingdom,

This paper examines whether linking high quality national public health evidence and guidance with locally held physical resources and user-generated knowledge within an open-source web-based library management system (HPAC LMS) could encourage more use of the evidence-based in public health interventions. 

Setting, Participants and Resources: County Durham Primary Care Trust (PCT) and Darlington PCT Health Promotion Library, together with technical partners Derwentside District Council and the NHS National Library for Public Health. Resources were mainly in the form of staff time. 

Brief Description: This project has enabled the County Durham and Darlington Health Promotion Library to progress from Web 1.0 – the traditional library catalogue – content created by librarians, through Web 2.0 - users sharing knowledge about how they use local resources in health interventions (the wisdom of the user), to Web 3.0 – metadata harvesting of critically appraised evidence (the wisdom of the expert). The project grew out of a desire by the Health Promotion Library to provide high quality evidence to its library users in the same virtual space they use to search for and reserve local physical resources for use in health intervention work - the library catalogue.

The library service is offered to partners outside the NHS, most importantly to those organisations which are working in partnership with public health to narrow the gap in health inequalities. The library has neither the capacity nor the skills to critically appraise the growing volume of public health evidence and add it to the library catalogue. However, critically appraised evidence and guidance is stored in the National Library for Health metadata repository. Using a metadata harvester the National Library for Public Health (NLPH) data is automatically extracted and indexed by the HPAC LMS. The national evidence is easy to access for users because hyper links are automatically created between locally held physical resources and related national evidence and guidance. Both the national and local library use terms from the Public Health Language to facilitate interoperability.  

Results/Outcome: More than 90 percent of the 30,000 issues of physical resources each year are reserved online. The aim is to exploit this high percentage of online access to encourage better use of evidence-based interventions by front line public health practitioners. Formal evaluations from users and data from web logs are being planned and by implementing the principle of “do once and share” this interoperability project will make the national evidence available to the 18 other health libraries using the HPAC LMS.

Finding the Evidence for Public Health Professionals

Presenter: Richard Crookes

Authors: Richard Crookes, Rod Campbell, Knowledge Resources, Nottingham City PCT, Nottingham, United Kingdom

Summary: The UK-wide Public Health Skills and Career Framework (2008) sets out the public health workforce competencies and the knowledge base which underpins it. Thus within this framework the core competency “Assessing the Evidence” and the defined competence “Public Health Intelligence” are cited. The framework highlights the importance of the awareness of evidence, the sources of evidence and the knowledge of literature-search techniques and the subsequent appraisal of primary and secondary research. The aim of the initial 8-day Public Health Intelligence (PHI) workshops piloted by the East Midlands Public Health Observatory (EMPHO) was to try and build a course that fitted into the skills and careers’ framework, the material for which could then be picked up and used by other regional Public Health Observatories (PHO). 

A request was made for a collaborative partnership with East Midlands’ healthcare librarians to develop a “Day-9 workshop” on “Finding the Evidence” to compliment the preceding workshops. Consequently, five members of the East Midlands’ Library Trainers’ Forum (EMLTF) - in collaboration with EMPHO agreed to design, prepare and deliver an interactive information literacy session to Public Health professionals in September 2008 at a regional venue, with a view to the workshop, piloted in the East Midlands, becoming a national model. The session covered: an introduction to the hierarchy of evidence and protocols for searching; the National Library for Health (NLH) and the Public Health specialist library; The Cochrane Library; NLH Search 2.0; critical appraisal skills and Web 2.0 applications. The training featured a mixture of PowerPoint presentations, demonstration and hands-on practice with time for questions. The trainers were on-hand to assist delegates when needed. An information pack was also provided to support the sessions and for future reference, including the contact details of library trainers and knowledge services.

The subsequent evaluation of this workshop indicated the success of the course with participants commenting on “greater understanding” in how to access the literature using the resources covered and appraise the literature. Furthermore, the interactive nature of the course was well-received, although more time and detail on each aspect was encouraged for future training. The collaborative nature of the work between the EMLTF librarians and EMPHO also proved beneficial in being able to share expertise according to the needs of today’s public health workforce.