Knowledge into Action

Details of suggestions and ideas for tests of change collated from Knowledge into Action event on 30 January

Local activities – suggestions which require a small amount of input or support from the K2A change team

Type of Knowledge into Action activity / Brief description / Partners / Stakeholders / Main contact / Suggested by
Relational use of knowledge / Social Networking – improve integration within board / NHSForthValley
Relational use of knowledge / Lunchtime critical appraisal (journal club) – juniors not really interested due to time. Learning from library staff. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Relational use of knowledge / Peer assist review sessions to gather expert knowledge at start of improvement project.
Discussed possibility of librarians facilitating such review sessions. / ? / ?
Search & Synthesis / Pushing out evidence reviews around specialities – uses BMJ evidence updates. Widen to nursing and AHP colleagues, clinical improvement team. This is sustainable – it gives library assistants a role in managing and moving away from traditional lib assist role. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Search & Synthesis / To have an evidence-based “skin tear box” (containing steristrips etc) and accompanying best practice statement available in all wards and clinical areas to treat patients with skin tears in a standardised way.Need to pilot in one area. / NHS Fife / Lynn Coyne, Specialist nurse, QueenMargaretHospital, Dunfermline.
Search & Synthesis / Ensure the evidence around delayed cord-clamping of the newborn is implemented in practice.
Improve neonatal outcomes.
Potentially reduce requirement for resuscitation of newborns. / NHS Fife / Annette Lobo, clinical midwifery services co-ordinator, VictoriaHospital, Kirkcaldy.
Search & Synthesis / Test search and synthesis service within Physiotherapy. To support physiotherapist staff in answering clinical queries as part of their day to day practice. / NHS Greater Glasgow & Clyde: Knowledge services & Physiotherapy / Fran Harkness, Knowledge Services
Sara Conroy Practice Development, Physiotherapy – initial contact
Search & Synthesis / Clinical effectiveness programme for AHPs cohort. To provide support (Information skills training, searching services) and guidance to AHPs undertaking a 1 yr clinical effectiveness project. / NHS Greater Glasgow & Clyde:
Knowledge services and AHPs / Fran Harkness, Knowledge Sevices
Sara Conroy Practice Development, Physiotherapy – initial contact
Search & Synthesis / Rapid search and synthesis services for Neuroradiologists at SGH. Consultant Neuroradiologists currently as a group carry out Medline search for unusual cases and discuss as a team to reach conclusion. Scope out pilot to see how/if library staff can better support Neuroradiologists in identifying relevant evidence in timely manner for unusual clinical cases. Perception was that the library was for research/education/publication but that the turnaround would be too slow for clinical queries… / NHS Greater Glasgow & Clyde: Consultant Neuroradiologists at SGH / Ravi Jampana, Consultant Neuroradiologist.
Search & Synthesis / Rapid search service for Renal Unit at WIG for questions raised during ward rounds. Could pilot something similar to ICU? / NHS Greater Glasgow & Clyde: Knowledge Services & Renal Unit, WIG / Catherine Stirling, Consultant Nephrologist
Search & Synthesis / Ward round attended by knowledge broker. Pilot to gather answers to clinical queries that occur on ward. For learning but also real clinical need. Could be pre-warned. / NHS Lothian: patients, junior doctors / Sonia Joseph (RHSC/Royal Victoria new build)
GP to try CLEAR and feedback to partners / NHS Tayside / ChristopherWeatherburn, GP
Search & Synthesis; Actionable knowledge / Signpost clinicians developing new guidelines/clinical pathways to local knowledge broker – include in clinical pathway development guide. Ensure adequate support data at the beginning of their work. / NHS Tayside: group clinicians & knowledge broker / Rebecca Locke
Search & Synthesis / Evidence summaries to support change clinical management. Clinicians contracting new or revised guidelines/clinical pathways. / NHS Tayside: knowledge broker led evidence search & group clinicians / Rebecca Locke
Search & Synthesis / AHP physical activity pledge – support pledge to improve clinical practice of AHPs to address Scotland PA challenge. Improve Health. / NHS Tayside: Knowledge broker / Kay Brown, AHP
Search & Synthesis / Diabetes foot disease & use of slipper casting to reduce infection & amputation rates, increase patient comfort and mobility. Knowledge network/broker – look at evidence to support test of change and training to implement. / NHS Tayside: Podiatry, specialist/multi-disciplinary team / Kay Brown, AHP
Search & Synthesis / To use knowledge brokers to support staff projects – encourage evidence-based search prior to starting actions. Sessions with knowledge brokers to develop own skills in searching, question development and measurement / NHS Tayside: AHP managers and staff, knowledge brokers / Nic Richardson
Search & Synthesis; Broker role / Implement a ‘broker’ to support development of a delirium evidence bundle.
Improvement and Implementation unit & Knowledge Management team / Healthcare Improvement Scotland National Delirium Steering Group / Penny Bond
Broker role / Implement brokers to assist with programme development, to embed K2A approaches to make suggestions about K”A and other expertise. / Healthcare Improvement Scotland / June Wylie
Broker role / Supporting implementation of NHS Health Scotland’s Corporate Strategy.
The project will identify, capture and apply the knowledge that exists within Health Scotland to support implementation of its corporate strategy. (Existing test of change) / Health Scotland / Matt Lowther
Broker role / Improve use of CLEAR service by clinicians. (Continuation of test of change) / NHSForthValley / Emily Fotheringham
Broker role / Awareness and perception – of KB services. Needs to be better. Opportunity to engage with Clinical Governance Group – raised the possibility of issuing another questionnaire within board as 4 years since the last. Changing perception of the librarian. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Broker role / FY staff – induction or other opportunities. Impt of embedding in education. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Broker role / Clinical Librarian role – once per week intervention at team meetings (already underway). Having a KB conversation. Feedback from juniors positive. Attending multi-disciplinary meetings. iPad to facilitate discussion. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead

Change team input – Suggestions which require significant input from members of the change team

Type of Knowledge into Action activity / Brief description / Partners / Stakeholders / Main contact / Suggested by
Search & Synthesis; Actionable knowledge / Intranet > Internet – transfer/mirror.
To make searching easier e.g. paediatric guidelines. Easier to link, speed of access, closer to real time. Pilot with advice on indexing and technology. / NHS Lothian: all departments, web master & editors / John Steyn
Search & Synthesis; Actionable knowledge / Develop online technology bundles – clinical decision tools to help staff make decisions. Via iPads and mobile devices. To increase access to high quality resources – to give access to ‘limited’ quality info for speed of access to the best info. / NHS Lanarkshire: Knowledge & library services, OD, IT, PEF/nursing colleagues / Amanda Minns, Knowledge & Library Services
Search & Synthesis; actionable knowledge / How to get clinical guidelines into practice – specifically for Acute Kidney Injury. Identification and management could be improved. Bundle approach – solutions to be defined / NHS Greater Glasgow & Clyde: Knowledge Services & Renal, Medical Receiving / A collaborative approach:
Catherine Stirling, Consultant Nephrologist.
Medical Receiving clinical lead to be identified.
Knowledge Services, Clinical Governance, and Medicines Info group to support.
Actionable knowledge / NHS Dumfries and Galloway producing mobile app – can add to tests of change as basis for transferable learning; incorporate in Knowledge Network mobile knowledge area. (Underway) / NHS Dumfries and Galloway / Anne-Marie Coxon
Actionable knowledge / Pathway publication toolkit – how easy is it to generate, can an individual do this readily? / NHS Tayside / ChristopherWeatherburn, GP
Actionable knowledge / Testing and roll out the publication toolkit. Could be tested as part of the AKI ToC – and /or be part of a test of a Knowledge Services/Clinical Governance support package for Clinical Guidelines. / NHS Greater Glasgow & Clyde - To be finalised – possibly AKI, or other guidelines / Knowledge Services and Clinical Governance (Med Info too?)
In partnership with the clinical guideline owners/areas.
Actionable knowledge / Adopt NES taxonomy and clinical Publication Toolkit. For use with Clinical guidance Intranet / NHS Grampian
CGI steering group
Primary and acute clinicians / Steve Baguley
Actionable knowledge / Use of CDSS browser plug in / NHS Fife
Actionable Knowledge / Potential for development of CDSS browser plug-in for Hospital@Home Team to be used on mobile devices.
Immediate access to relevant information while visiting patients in the community / NHS Fife / Marianne Murdoch, Practice Educator, NES/NHS Fife.
Actionable Knowledge / Developing Apps for dentists to support decision making / NES / TRIADS team
Actionable knowledge / Pathway tool – NES to arrange a workshop. / NHS Ayrshire & Arran & NES / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Actionable knowledge / Mobile awareness, workshop opportunities – NES to arrange an awareness session. Look at how we share. / NHS Ayrshire & Arran & NES / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Actionable Knowledge / Decision Support – embedding Dynamed in trakcare. eHealth as a barrier. Trakcaremove towards this being the system of choice. Need to persuade clinicians beyond use of up-to-date. Browser plug-in also a possibility linking with patient context to Dynamed. Needs clinical buy-in – clinical directors, medical director, medical education. / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Broker role / Develop basic Knowledge Network /Knowledge into Action elearning resource; upload to LearnPro for national use as part of induction.
Provide basic learning and support tailored to the needs of frontline staff. National use by frontline staff. / NHS Dumfries and Galloway & NES / Helen Coles, NHS Dumfries and Galloway.
NES role to produce this resource.
Relational use of knowledge / ‘Roadshow’ style events to spread the word of KIA / NHS Lothian.
NES (presence and marketing materials)
Health promotion / Mairi Simpson

Co-ordinated processes – suggestions which may be delivered locally but would benefit from national co-ordination via the K2A change team

Type of Knowledge into Action activity / Brief description / Partners / Stakeholders / Main contact / Suggested by
Search & Synthesis / Evaluation of impact of literature searches in NHS Borders already underway –suggested including this in portfolio of tests of change; and share learning with other Boards. (Underway) / NHS Borders / Kath Liddington
Search & Synthesis / Provide knowledge into action support to Clinical Advisory Group.
Mainstream knowledge into action support within clinical priorities.
Evidence searching and perhaps other knowledge into action services. / NHS Highland / Anne Gillespie.
Emma Watson
Search & Synthesis / Produce summary of evidence for paramedic topic; include use of clinical knowledge publisher to visualise as pathway. Provide quick and easy access to clinical knowledge for practice tailored to needs of paramedics.
Sourcing and summarising of evidence for paramedic questions in particular clinical topic. Package and present in highly usable format tailored to paramedic needs. Visualisation as pathway likely to be helpful.
Noted that this should be accompanied by training of SAS staff – a) of selected posts to contribute to such developments in future and b) to increase general self-sufficiency among clinical workers in sourcing, sharing and using knowledge. / Scottish Ambulance Service.
Since SAS has no librarian/KM service within the Board, this will require support from the wider knowledge broker network, as well as providing the opportunity to develop roles and skills within SAS. / Christopher Conroy
Search & Synthesis / Expanding uptake of CLEAR service to address capacity limitations in supporting clinical evidence search and synthesis in Boards with low library staffing levels.
Tests of change of use of CLEAR service by clinicians in 4 new Boards.
Noted need to define prioritisation model and scope of appropriate use of CLEAR in each Board – e.g. for StateHospital it is important for librarian to be directly involved in searches specific to corporate needs.
Should be accompanied by programme of training for frontline healthcare staff in sourcing, sharing, using knowledge, so that knowledge brokers are being asked only to conduct searches for the more complex or urgent needs. / NHS Borders
NHS D&G
StateHospital
(Possibly Scottish Ambulance Service and NHS Highland) / Rebecca Hart (StateHospital)
Kath Liddington (NHS Borders).
Anne-Marie Coxon and Audrey Marshall (Dumfries and Galloway).
Possibly – Christopher Conroy (SAS) and Anne Gillespie (NHS Highland/University of Stirling).
Search & Synthesis / Alternative & Augmented Communication project / NES / Susan Shandley , NES
Search & Synthesis / Promoting the CLEAR service to dentists in the community / NES / TRIADS team
Search & Synthesis / Promoting CLEAR service to General Practice Specialists Trainees / NES / Ron McVicar, NES Highland
Search & Synthesis / Guidelines – local v national. Mentioned emerging nurse guidelines (Marie Nimmo) / NHS Ayrshire & Arran / Mhairi McMillan, Head of Knowledge Management
Sally Smith, Executive lead
Capacity & Capability / Investigate how K2A can support education for the new roles associated with health and social care integration in Highland and Orkney / NES / Pam Nicol, RRHEAL,NES
Capacity & Capability / Investigate how K2A can support the changing role in Rural General Hospitals / NES / Pam Nicol, RRHEAL,NES

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For more information contact:

Suzanne Wilson, Improvement Manager (Knowledge into Action)