Delivering Knowledge for Health NHSScotland Knowledge Services: Evolving National Perspectives Dr Ann Wales Programme Director for Knowledge Management Update for Librarians’ Open Meeting 26 November 2007

Delivering Knowledge for Health "It is not the strongest of the species that survives, nor the most intelligent. It is the one that is most adaptable to change." Charles Darwin

Delivering Knowledge for Health Outline Design themes and principles Practical implementation Future directions 2008 onwards – Coordinated National Strategy for Knowledge Services

Delivering Knowledge for Health Design themes and principles (1) Sources: From Knowing to Doing Analysis and reports Literature and policy overview Consultation on Coordinated National Strategy March-October 2007: –Patients ~ Professionals ~ Partners Roadmap for NHSScotland Library Services Better Health Better Care Spending Review

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions – colleagues and organisations Learning, Measurement, Review Implementing change Design themes and principles (2)

Delivering Knowledge for Health Better Health Better Care Patient experience Health inequalities Taking responsibility Partnership Knowledge Services (1) Design for patient journey and patient outcomes Empowerment and equity: Access, skills, values Addressing inequalities Taking responsibility Partnership across boundaries Knowledge Services (2) Integrity – quality and equity Compassion – information sharing Excellence Continuous improvement Values Basics System Patient-Professional Relationship Interactions Learning, Measurement, Review Implementing change

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions Learning, Measurement, Review Implementing change Knowledge Services Design for patient journey and patient outcomes Empowerment and equity: Access, skills, values Addressing inequalities Taking responsibility Partnership across boundaries Better Health Better Care Patient Safety Evidence-based practice Consistent quality Basic information about services Knowledge Services Clinical Decision Support Portal Pathways Guidelines Standards Evidence summaries Search ULMS Introductory and research information levels

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions Learning, Measurement, Review Implementing change Better Health, Better Care Continuity of care: Anticipatory Integrated across NHS- Community boundaries “Best possible start” Knowledge Services Coordination Networks Cross-boundary knowledge services: Social Services e-Library Rehabilitation e-Library Health Inequalities e- Library/MKN Quality Assurance Common standards and guidelines Shared systems

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions Learning, Measurement, Review Implementing change Better Health, Better Care “Humaneness” Competence/Accuracy Shared decision-making Time for patient (Wensing, 1998) Patient as partner Self-management Taking responsibility Shared decision-making Long term conditions Knowledge Services Shared Patient-Professional Online Information Services Clinical Decisions Rehabilitation/Long Term Conditions Midwifery Polish Information Plus Future Health Information Online Partnerships: NES NHS 24 Health Scotland Information literacy Framework

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions – colleagues & organisations Learning Measurement Review Implementing change Better Health, Better Care Team-based and continuous care Partnership for community- based care and long-term conditions Network development Knowledge Services Managed Knowledge Networks Rehabilitation/Long Term Conditions MKN’s Health Inequalities MKN New Social Networking Tools Health Information Access through libraries in partner sectors Sharing resources via ULMS Linking knowledge support with Electronic Health Record Systems

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions –colleagues & organisations Learning, Measurement, Review Implementing change Better Health, Better Care Continuous Improvement in Healthcare: “ Invest in staff skills, training and competencies to drive all aspects of service improvement.” Best value Knowledge Services Information literacy framework Knowledge Services for new staff groups Health Management e- Library/MKN (with Health Management Library) Links with KSF, MMC, e- Learning systems Personal Webspaces Best value: Reuse and sharing of services Quality Assurance Framework

Delivering Knowledge for Health Values Basics System Patient-Professional Relationship Interactions –colleagues & organisations Learning, Measurement, Review Implementing change Potential already in our hands Values, Infrastructure, Systems in place to support organisational and personal action plans. Leading and supporting change Collaboration and sharing Opportunism – continuous and long-term change as well as major initiatives

Delivering Knowledge for Health “In the long history of humankind (and animal kind, too) those who learned to collaborate and improvise most effectively have prevailed.” - Charles Darwin

Delivering Knowledge for Health Quality Assurance Framework for Knowledge Services Supporting NHSScotland From Idea to Actuality

Delivering Knowledge for Health Overview Purpose Structure Monitoring and review process Next steps - implementation

Delivering Knowledge for Health Purpose of Framework Practical and strategic tool Demonstrate the contribution of knowledge services to: –Improving health –Delivering patient care –Improving effectiveness; reducing risk - Clinical Governance Ensure continuous improvement of knowledge services for NHS Scotland

Delivering Knowledge for Health Why is it important? Recognition: “NHS Boards are fully accountable for the quality of the Knowledge Services they provide. This is an integral part of NHS Board responsibility for Clinical Governance and Staff Governance. (page 6, section 5).” Applies to provision of Knowledge Services to NHSScotland by all sectors – NHS, Higher Education, other sectors.

Delivering Knowledge for Health Development Pathway Development during 2005 – working group facilitated by NES Knowledge Services; supported by NHS QIS. External consultation – early 2006 Pilot stage – July 2006-March 2007, linking with NHS QIS review of Clinical Governance and Risk Management Standards Publication – September 2007

Delivering Knowledge for Health Principles “Achievable but stretching” Focused on outcomes rather than processes EFQM model (European Framework for Quality Management) –Based on linked Outcomes and Enablers –Comprehensive –Generic –Widely recognised –Externally validated

Delivering Knowledge for Health Structure (1)

Delivering Knowledge for Health Structure (2) Central reference point: Delivering outcomes – improved services and patient care Strategic cycle (Standard A) - analysis and planning ~ implementation ~ evaluation and review underpin management of: Resources (Standard B) User support (Standard C) Partnership (Standard D) Knowledge Services staff (Standard E)

Delivering Knowledge for Health Structure (3) Five Standards Criteria defined for each standard Evidence and accreditation levels defined for each criterion

Delivering Knowledge for Health Accreditation System Levels 1, 2, 3 (minimum to gold standard) Fulfil 100% of criteria at each level Ability to make case for non-applicability of certain criteria Accreditation lasts for 3 years with interim annual reports Can re-submit at any time during those 3 years

Delivering Knowledge for Health Monitoring and Review (1) 1. Self-assessment 2. Production of Action Plan 3. Review of self-assessment and action plan by QAF Coordinating Group members 4. Submission of evidence portfolio and self- assessment. 5. External evaluation by QAF Evaluation Panel

Delivering Knowledge for Health Monitoring and Review (2) Report and recommendations issued by Evaluation Panel Report and recommendations included in NHS QIS monitoring and review process for Clinical Governance and Risk Management Standards Annual review of framework by NHS QIS

Delivering Knowledge for Health QAF Coordinating Group and Evaluation Panel Representation: NES NHS QIS Clinical Governance eHealth Workforce Development Organisational Development Peer service providers – Scotland or UK

Delivering Knowledge for Health Next steps (1) Establish: –Coordinating Group –Peer Support Network

Delivering Knowledge for Health Next steps (2) Implementation from November 2007 Link with next round of monitoring for Clinical Governance and Risk Management Standards – Submit Self-Assessments and Action Plans to Coordinating Group by May-July 2008 Implement Action Plans August 2008-September 2009 Compile reports and evidence portfolios October 2009-March 2010

Delivering Knowledge for Health Quality Assurance Framework for Knowledge Services Supporting NHSScotland From Idea to Actuality

Delivering Knowledge for Health

QAF – NHS 24 Background NHS 24 Two submissions NHS 24 Knowledge Management Team Submission NHS 24’s Health Information Service

Delivering Knowledge for Health QAF – NHS 24 Challenging Time commitment Staffing Thinking out of the box Stretching Made us look at how we impact on patient care

Delivering Knowledge for Health QAF – NHS 24 Lessons Learned Found the action plan central to keeping us on track Used evidence tracker spreadsheet to keep track of evidence invaluable Need to keep up with deadlines Draw on peer support

Delivering Knowledge for Health QAF – NHS 24 QAF/QIS Presents opportunity to be assessed along with clinical services and to be valued as an integral part of patient care Will lead to a minimum standard for Knowledge Services across the NHS

Delivering Knowledge for Health QAF – NHS 24 Reflections QAF powerful ‘catalyst for change’ Powerful ‘bargaining’ tool Encouraged us raise our game! Raises profile of the service Opportunity to be peer reviewed/and quality assured

Delivering Knowledge for Health