Knowledge Mobilisation Forum 2018: All you need is love

Attending the UK Knowledge Mobilisation Forum in Bristol last week was an opportunity for me to connect with a new network and explore its alignment with the work of NHS library services and Knowledge for Healthcare.

I came away with a much greater understanding of the theoretical basis underpinning the knowledge management techniques employed by NHS librarians. At times the language used by those working in knowledge mobilisation research felt impenetrable, however, it dawned on me later that a lot of the jargon that is used has cross-over with “library speak”.  For example, “co-production” is a current buzzword in knowledge mobilisation and describes a method of extracting practical and tacit knowledge equitably to create a synthesis of shared knowledge across hierarchies or disciplines.  Applying this concept to the work of NHS libraries, any time we undertake an assisted evidence search or contribute expertise to a multidisciplinary meeting, we are co-producing new knowledge.  I think it could only benefit our networks if knowledge mobilisation researchers and librarians were able to connect more regularly to discuss shared areas of interest.

A presentation that particularly struck a chord with me was the keynote from Dez Holmes, Director of Research in Practice, an organisation that helps organisations and individuals to access, understand and apply evidence in their work with children, young people and families.  Dez observed that producing robust evidence and making it available is only part of the struggle to implementing evidence into practice; often people don’t follow instruction, even if it’s evidence based.

Credit: https://www.askideas.com/do-not-climb-play-on-and-around-pipe-funny-warning-sign-board-on-beach/

Why?  Maybe because it’s more fun, everyone else is doing it, it’s what they’ve always done, or because they’ve been told not to.  Using evidence is a personal thing; there are emotional reasons why people do or don’t use it.  So, in addition to some of the barriers to evidence based practice identified by Wiggins, 2012, applying evidence in practice can sometimes be for personal or emotional reasons.  This led my thinking to the attributes that NHS librarians may require to be an effective knowledge broker.  Rather than focusing on technical and professionals skills (summarising evidence, creating databases), shouldn’t we also then equip ourselves with the necessary emotional and personal skills?  As librarians do we focus too much on bridging the evidence-practice gap with hard, technical skills? Should we be focusing instead on speaking to people’s sense of “ikigai” (a Japanese word for “reason for being”)?  To overcome this barrier we need to tap into the motivation, passions, desires and hopes of the people we work alongside when we’re communicating evidence.  Or, in Dez’s words: as knowledge brokers working in complex systems we need to be “creative, courageous and not scared of mess”.

 

In the face of multiple barriers, how then do we get people to do things differently? Dez suggested that perhaps we can take inspiration from the Unilever approach: the 5 levers of change:

1. Make it understood
2. Make it easy
3. Make it desirable
4. Make it rewarding
5. Make it a habit

Ultimately, a person’s relationship with evidence is crucial. So, our mission as knowledge brokers in the NHS is surely simple: to get people to love evidence!

 

In addition to the reflections above, I came away with several ideas for knowledge sharing techniques that I can adapt and apply in my workplace, including a creative approach to co-production: using the principles of Lego Serious Play to share tacit knowledge.  I took part in the event’s Randomised Coffee Trial which provide to be a great way to meet another delegate for lunch at random.

I also returned from the event with some useful learning from facilitating my own knowledge sharing activity alongside Tracey Pratchett (@TraceyPratchett): a fishbowl conversation.  Each time I’ve facilitated a fishbowl conversation it has been completely different and there’s always learning I can take away.  This time Tracey and I reflected with participants on the potential for the fishbowl as an alternative to a focus group in qualitative research methodology and the pros and cons of such an approach.  On a practical note, we also reflected that we need to ensure that the question under discussion is visible to participants at all times.  Also something to think about for next time is introducing a mechanism for observers to submit questions anonymously to which those conversing can then respond.

Overall, I returned to work with a greater understanding of the world of knowledge mobilisation and the role that NHS librarians play as knowledge brokers; perhaps also with some additional insight into what our mission as knowledge brokers should be. For those wanting to learn more about the event, please visit the forum webpage or follow the hashtag #KMb2018 on Twitter.

Positioning LKS at the heart of NHS business

Increasingly health librarians are being asked to support activities in their organisations which are leading us into new territory: transformation, service improvement, business decision-making and the development of whole system pathways.  Those of us working in the NHS have seen this reflected in a rising demand for our services from managers and service leads.  How do we make sure we have the necessary skills to support this work?  And surely this is an ideal opportunity to position NHS Library and Knowledge Services as business critical?

I recently attended two days of training, organised by LIHNN and aimed at equipping librarians with skills in summarising / synthesizing evidence and advocating our position as business critical to the NHS.

On Day 1, Tim Buckley-Owen presented a masterclass in how to harness our summarising and synthesising skills to ensure that the information we provide is easily digestible to the end user.  Gone are the days that our customer has time to read through pages and pages of article citations; of much greater value in today’s fast-paced NHS is an easily digestible summary that extracts the key messages of the results found.

I feel that as a librarian I already possess a lot of the skills required to do this; Tim’s session gave me the tools with which to harness these skills to greatest effect.  One learning point for me is that writing a summary in this context is not the same as writing an abstract or a precis; a summary extracts the key points relevant to the enquirer, and is tailored to their specific needs.

In Tim’s session we talked about adding credibility to our search results by making the format look more polished and professional.  The added effort required to ensure the search report is more focused on the customer’s needs is worth it to provide a truly more satisfying, value-added end product.  I can see how undertaking a summary of search results immerses you in the material and ensures that you can reel off a verbal summary at a Trust meeting or in that much-anticipated elevator conversation.  Accordingly, practising these skills and altering the way that our searching services function can allow us to network more effectively and maintain relationships with the organisation’s movers and shakers.

On Day 2, Anne Gray presented an undeniable argument for the necessity of library and knowledge skills in a modern NHS.  Many of us have a good understanding of the reasons why clinical decisions have to be evidence based; Anne presented the viewpoint of a manager or commissioner in an effort to encourage us to understand our customer.

Perhaps my biggest learning point from the day was an acknowledgement that delivering services to managers doesn’t mean simply providing management-related evidence searches.  It’s clear that managers rely much more heavily on the knowledge and expertise of colleagues, so our challenge as librarians is to become part of their trusted network.  It may be that acting as a broker of knowledge and disseminating ‘golden nuggets’ of useful information to key contacts is all that is required.  It’s not difficult; it simply requires us to build and maintain relationships with those people making the business decisions in our organisations.  As has always been the case: working in libraries is about working with people.

A challenge for me in Anne’s session was to force myself to approach a search topic in a different way.  When faced with a searching for a clinical question, I usually stick to the topic parameters and try not to digress beyond.  However, having a greater understanding of the way that managers use knowledge to ‘think around’ an issue, I felt liberated to include evidence that was perhaps outside the scope of their original search request, but that I felt was important to their understanding.  It sounds obvious but was a breakthrough moment for me.

The finale of Day 2 was a discussion around how librarians could collaborate to support each other in this work, perhaps through networking, buddying, and sharing good practice and useful resources.  The group felt that there was potential to work together on some topics that would be common across organisations: integrated care, discharge planning, Accountable Care Organisations, for example.  My first action will be to share this blog post with the discussion list and perhaps generate some debate.  I’ll be considering how MAP Toolkit, that I lead with Tracey Pratchett, can support this work.  After that I hope to cascade my learning to my team here at Wirral and adjust the way we support managers.  Plus there’s a search request sitting on my desk right now from our transformation team that will allow me to put some of my new found skills into practise!

 

My recipe for a perfect library induction

Last week I attended a course run by LIHNN (Library and Information Health Network Northwest) and facilitated by Deborah Dalley on ‘How to deliver a memorable induction’.  I was asked to help out by delivering an example of a library induction presentation that wasn’t particularly inspiring.  I delivered some very detailed and dreary slides to the group that were service-focused (rather than customer-focused) in a very uninterested way.  What I thought at first was just an amusing exercise actually really helped me to think more deeply about what a meaningful induction might look like.

Our service has always delivered individual and group inductions and these are usually consist of a general run-down of the services and resources that are on offer from the library.  We’re pretty good at customising the content of the induction to the audience, so for a group of nurses we’ll focus on nursing resources for example, but I don’t think we’ve taken full advantage of this crucial ‘touchpoint’ with potential users of our service or thought properly about what they’ll remember about the library as a result.

Last year we did some work on branding our service, so as a team we have a very clear idea about the brand promise that we want to convey to the end user (“Tailored services in the right place at the right time”), but I think we could go further in conveying our brand in inductions, which are our first, and arguably, most important point of contact with a prospective customer.

My learning points from the course are listed below.  On writing these down, a lot of them seem obvious, but please bear with me…

• The 3 words that describe how I’d like my induction session to be are ‘unexpected’, ‘engaging’ and ‘impressive’
• The purpose of my induction is to raise the profile of the library, generate usage, and therefore make a difference to patient care
• The ultimate message that I want people to leave my induction session with is that ‘using the library will make me a better practitioner’

As tempting as it is to fill a 10 minute induction slot with as much practical information as possible, I thought a lot about the lasting message that I wanted to leave people with. I don’t want them to remember that photocopying costs 5p!  My perfect induction session consists of three simple messages:

1. Using the library will make a difference to you (it will ensure you are an informed, innovative, progressive and evidence based practitioner)
2. Using the library will make a difference to the service you deliver (it will ensure you have accurate information on which to base decisions, it will encourage a learning culture and ensure your team is up to date with good practice)
3. Look at these awesome real life examples that demonstrate how the library makes a difference to other individuals and teams in your organisation!

Within this model, I can mention some library services / resources, but they won’t be the driving force of my presentation.  To make the induction more memorable and engaging, I want to tell the story of some of our customers.  So, there’s my recipe for my perfect library induction; I just need to test it out in practice.  Watch this space!

Using Twitter to be a better librarian

Twitter icon, Flickr CC

Twitter has become so integral to my professional identity that it’s perhaps time to pause and reflect on my use of Twitter, in particular how it connects me to librarians and colleagues in other sectors.

I’ve been on Twitter since 2012 (as a result of participating in the CPD23 programme).  I Tweet as @librarianpocket about issues relating to libraries, health care, professional development and other work stuff.

What I love about Twitter is that it allows me to connect with people that I might otherwise feel too wary to approach directly (something that I’m getting better at).  As someone who is naturally cautious, Twitter makes me feel brave.

Twitter comes into its own, for me, at an event where people are tweeting, be it a conference or meeting, social event or workshop.  Twitter has helped me to spark conversations with people that would never have happened under my own steam.  After tweeting one of the speakers at a library conference, we ended up arranging to meet in the break and we had a really interesting discussion about ways we might work together.  At an event to launch a new health care initiative, I tweeted using the official hashtag, and one of the event organisers approached me afterwards after recognising me from the photo on my Twitter account.  Twitter helps me to engage and connect with people.

I use Twitter to keep up to date.  For me, gone are the days of RSS feeds and email discussion lists – Twitter is what I use to stay connected to professional issues.  Tweets from people that I follow signpost me to useful reports, news items and innovation in my areas of interest.  I surround myself on Twitter with news feeds relating to my local community and local health issues, looking for opportunities to work in partnership with people outside my organisation.  I recently used Twitter to promote our Reminiscence Box service to the local community.  Using Twitter means I don’t lose touch with people.  I engage with library colleagues from all sectors, including library contacts I’ve made from visiting libraries and conferences in India, Canada and across the UK.

Twitter has helped me to raise the profile of the Library and Knowledge Service within my own organisation.  Our Communications team has encouraged the use of Twitter in the organisation over the last couple of years, so senior managers and clinicians, who ordinarily I wouldn’t have had the opportunity to speak to, are fellow Tweeters.  It’s a good way to show that the Library and Knowledge Service is at the forefront of social media and technology – that we are librarians who know our stuff!  The official Trust Twitter account often re-tweets me, endorsing what I’ve shared and disseminating it to a much wider range of people.

I’d definitely say that using Twitter helps me to be better at my job – I am more intrepid, I am better connected, gregarious and (arguably*) more interesting!

*Disclaimer: my colleagues may disagree!

Reflection on Week 6 of the LIHNN Literature Searching MOOC

Evaluation scale by  Bill Sodeman (Flickr CC)

The last week of the MOOC is here!  And we finish with arguably the most crucial aspect of literature searching… evaluation.  I thought a lot of the content this week would be really useful to someone who is setting up a literature searching service, after all, evaluation shouldn’t be an afterthought but rather something we should be thinking about from the very beginning, right?

I loved this week’s examination of impact and how we might present and disseminate impact to our stakeholders.  It strikes me that there’s content and learning here that ventures more widely than literature searching and more widely than health libraries (an opportunity for sharing / branching out?).

Within my own service we have, over the last 6 months, piloted and implemented a thorough system to capture impact data via questionnaire.  It took months of planning and it is aligned with our organisational objectives.  However, after completing this week’s MOOC , I think we need to go further and capture some interview data too, so that’s one thing I’ll be taking back into the workplace.

Again this week I’ve found that so much of what I’ve enjoyed in the MOOC has been seeing examples from other services.  I love the posters and reports that present and disseminate impact data – is there a way we can keep these as a repository of good practice?  I’d love to see more of them.  I look forward to next week reflecting back on the MOOC in its entirety and thinking about what I can take away from the wonderful experience of my first ever MOOC!

Reflection on Week 5 of the LIHNN Literature Searching MOOC

Week 5 has been the most mind-blowing week of the MOOC so far!  This week focused on summarising the results of literature searches and presenting them to the customer.  It has led me to reflect a lot about the service that we deliver in my own team and perhaps some adjustments that we could make to improve the customer experience.

Firstly, perhaps the most useful part of this week’s MOOC was looking at the evidence summary examples from other services.  I was blown away by the examples from Mersey Care in particular; they were so clear and engaging and really focused on making it easy for the customer to digest the available evidence.  Kudos to Clare Payne and the team at Mersey Care.  I also liked the way that SENSE described the different levels of searching that they provide, which raises the question of terminology again; is ‘literature searching service’ something that health professionals understand, and should we be calling it something different?

Something I’d be keen to understand from the librarians who provide a synthesising service is how they reached this level of service.  Currently, we provide a limited summary of the evidence, we certainly don’t summarise in depth, and the thought of synthesising every single literature search we get is terrifying.  But if this is the level of service that we are aiming for (which I think it would be, for me, anyway), then how do we move towards that?  Testing out the templates on one or two searches might be a good way to start I suppose.  Perhaps this also depends on organisational culture, and how much evidence base practice is embedded in the Trust.  We still get lots of general requests for things like ‘Give me all the evidence on managing head injury in A&E’, rather than clear, focused questions like the ones used in the examples here.  I’m not sure that all our search requests would be suitable for synthesis.  Any insight from people working in library services where synthesising services are provided would be really helpful.

Additionally, there’s a real issue here, I think, around the skills and confidence of librarians to deliver a service where we synthesise evidence routinely.  My experience is that it’s something that a lot of librarians are apprehensive about.  This MOOC is one way to encourage those skills to be developed, but I think further support in the workplace would be required in order to move us towards delivering this level of service.

Having said that, I’m itching to try out the synthesis templates demonstrated in this week’s MOOC content, and I will try to look out for a ‘real life’ opportunity to do so 🙂

Reflecting on Week 4 of the LIHNN Literature Searching MOOC

Ooh, lots of great tips and tricks in this week’s installment of the LIHNN Literature Searching MOOC!  This week’s REFINE topic covered lots of real-life literature searching dilemmas that I’ve never before seen covered in any formal teaching – only ever discussed in my own team or at LIHNN Clinical Librarians Groups (great stuff, MOOC creators :-))

Filters https://flic.kr/p/iaNB

My own favourite tip was around the use of search filters in HDAS.  I have been using the publication type filter in Medline, when in fact it is not 100% reliable.  There are more watertight search filters, as published on the InterTASC pages, and these can be replicated in HDAS.  As most of these filters are quite detailed (and therefore quite long), the MOOC suggests that you save a search filter as a separate search so you can then re-run it at the end of any searches that you need to apply the filter to.  Genius (why have I never done this before?!)!  This is something I’ll definitely be trying.

Another highlight this week was the quiz.  I have been known to enjoy a good quiz, and I thought the quiz this week was excellent.  It’s something I can see myself using in training sessions with end users, because it really helped me to think about different techniques and the circumstances in which I’d employ them.

Finally, a MOOC tip from me: don’t eat an apple while doing the MOOC, the crunching invariably drowns out Michelle’s lovely narration and means you have to keep winding back to listen to the bits you missed

Reflection on Week 3 of the LIHNN Literature Searching MOOC

This week the MOOC examined the literature search itself.  As a lot of the content was familiar to me, I found this week’s content most useful for helping me to develop a response to some of those tricky questions that I’m asked in training or assisted searches.

I’m always asked, “Why do I need to search for each keyword in a seperate line on HDAS?” and I have to try really hard not to just say “Because that’s just how you do it”!!!   The MOOC has helped me to prepare a more sensible response, that it helps you to identify any spelling errors in your search terms.

Another common question from my users is “How do I know which concept to start searching with?”.  I think this is something that becomes instinctive when you’ve been searching for a while, and as a librarian I find this really difficult to respond to.  However, the MOOC has provided me with a lovely response that it’s best to “start searching with the most well-defined concept first”.

I also learned a couple of other little tips that are new to me.  I’ve never proximity operators so I appreciated the explanation of how these worked.  I also never knew that when truncating terms you could add a number afterwards to indicate the maximum number of characters.  Illuminating!!

So, overall, this week I found the ‘Help’ and ‘Tips’ slides the most useful part of the MOOC, and it just goes to show that there’s always something you can learn 🙂

Reflection on week 2 of the LIHNN Literature Searching MOOC

I’ve found it more difficult this week to get round to doing the Literature Searching MOOC, hence why this blog post is being written on a Friday afternoon 🙂

This week looked at scoping a literature search and I found that a lot of the steps covered I tend to skip during a typical literature search – out of habit, or lack of time.  It’s been useful to look at those in more detail.  I am definitely guilty of “sticking with what you do” and the MOOC this week has highlighted some resources that I use less often, such as QIPP, that I’ll certainly look at again in the future.

The MOOC wiki arranges resources according to type of literature and type of question.  I can see how this will be useful in a practical way when conducting searches.  I was especially pleased to see the 6S model resources list , since here at Wirral we structure the layout of our search results according to the 6S hierarchy.

There was one quiz this week that I found really challenging! Participants were asked to identify the best level of evidence to answer a particular question and the quiz required you to figure out the type of question (e.g. prognosis, etiology) and then the best type of study to answer that question (e.g. RCT, systematic review).  I found this quite difficult as when faced with an incoming literature search request, this isn’t usually the thought process that I’d go through.  It certainly challenged my usual way of thinking!  It got me thinking that the questions that we are asked don’t usually fit very well into a question type, and increasingly aren’t clinical questions at all.  For example, this week I’ve been asked to find examples of leadership programmes for clinicians in Emergency Medicine.  So this way of thinking, although useful from a theoretical point of view, perhaps doesn’t always match the reality of delivering a literature searching service (for me, at least).

Another video featured in the MOOC this week (that I LOVED) was one that demonstrated how to use Boolean operators.  I’d really like to be able to use these videos in training and I wonder if an end-product of the MOOC could be a bank (or, dare I say it, a ‘library’) of training videos that people can use in training their end users.

Overall, this was another thought-provoking week on the MOOC and I look forward to the next!

Producing a promotional video for your library service

There have been several promotional library videos that have caught my attention this year, so I thought I would share some of my favourites and reflect on my own experience of producing one for my own Library and Knowledge Service.

The motivation to produce a short promotional video was inspired in February 2015 by a need to capture the impact of our service, and recognising that a short film might be a good way to do this.

Our inspiration

We were inspired after seeing this excellent offering from Pennine Acute NHS Trust.  We loved the fresh graphics and contemporary feel of the video, but we knew that we didn’t have the resources or expertise to produce similar effects.

More recently this video produced by Lancashire Teaching Hospitals has caught my eye with its slick graphics and clear branding.

We also really like the message of ‘the library everywhere’ that was at the forefront of this video from St Michael’s Hospital in Ontario, Canada.  However, we felt it was important that our video was from a customer perspective, rather than the library staff.

So, what we wanted was a way of demonstrating the impact of the LKS, using the stories of our customers in their own words.

The process

We produced a series of storyboards, liaised with our Communications team to discuss key messages, intended audience and purpose.  We agreed that the core messages we wanted to convey were that we were a service for all staff groups, and could be accessed anywhere, anytime, in any place.

We approached key LKS members that we knew had a story to tell about the impact of our service.  They were customers with whom we had built a good relationship and who indicated they would be happy to be involved.  We arranged a filming schedule over several weeks in April and May 2015 which included interviews these customers as well as some additional footage of the library and departments in the hospital.  We made sure that we filmed in a variety of locations, including Pharmacy, Accident and Emergency, Intensive Care and the Undergraduate Centre.  We were keen to illustrate the wide variety of our customers and access points.

The footage was edited by the Communications team and a first edit presented to us in May 2015.  The first edit was presented to the Workforce and Communications Group as well as the wider HR&OD team for comments and feedback.  Following some minor changes (captions illustrating name/role of interviewees and additional graphics) we launched the final edit on the Trust’s YouTube channel on 1^st July 2015.

So, what worked?

We had an extremely good working relationship with the Communications team who prioritised the project and worked to our deadlines.

We filmed in various locations (inside and outside the library) to illustrate the accessibility and flexibility of the service.

We identified people from different staff groups to film so that the video featured a diverse customer base.

Each person being filmed was interviewed in a very informal style and we didn’t use any scripts.  This put them at ease and the end result is a very natural and meaningful series of statements from the customer.

And what didn’t work?

We originally intended to have more graphics – however no resources or expertise were available within our Trust.

Filming took longer than expected due to availability of the people we wanted to film so our timeframe slipped slightly.

Some locations were not suitable filming locations due to technical or logistical issues (lighting, shared offices, patients in background).

Feedback

The video was promoted on Twitter via the Trust’s official Twitter feed which has over 2000 followers.  It was re-tweeted by many people including other librarians and senior managers from within the organisation.

We got some feedback from people who viewed the video:

“That’s really good, I like how you got interviews with people we’ll have to do that!”

“It is fabulous!  It has the right amount of services information and flows very naturally. The narrator captures your attention without sounding boring. I also thought the length is just about right.”

“This is really great!  It’s a really good idea having customers talking about the benefits of the service.”

“Very impressive!”

“Involving the staff of the trust makes this one stand out from the crowd!   Must have been difficult to organise but well worth the time.”

Final reflections

The entire process from drafting storyboards and approaching customers, to arranging the filming schedule and editing, took months.  However, the project was exciting and fun for the LKS team to work on and strengthened our relationships with the customers that were featured in the video.  The project has also improved our relationship with the Communications team, who now have a more in-depth understanding of the services that we provide.  Less than four months following its release the video has been viewed nearly 500 times on YouTube, and we now have a ‘ready made’ video that we can use at events and library inductions.