CILIP Umbrella conference #ub13 in Manchester last Tuesday was Is it a bird? Is it a plane? No, it’s a librarian! from Victoria Treadway, Clinical Librarian, Wirral University Teaching Hospital NHS Foundation Trust & Dr Girendra Sadera, Consultant, Critical Care and Anaesthesia, Wirral University Teaching Hospital NHS Foundation Trust. This was a very popular session, with lots of people tweeting about it.
Treadway is a clinical libararian who, with the championing and support of Sadera, has become part of the critical care team. Being incorporated into the ward round means she can pick up on information needed by the health team on the ward. At first she had to return to the library to search for information, but now she is able to search on an ipad whilst they are doing the rounds. The advantage of being at the patient's bedside with the team is that she can understand the context and contribute to the discussion in a more meaningful way. Having an ipad also means she can pass round the things she finds at once.
They described the way this initiative had developed. Victoria found it daunting at first: apart from anything else there are gruesome procedures and distressing injuries etc. on a critical care ward, and about 40% patients will die.
There was a10 month period as a pilot phase, during that time Victoria did 29 supported ward rounds, and also provided additional services. When asked what impact the information had, the team said that it did improve knowledge and care, and evidence provided by Teadway confirmed or added to their current knowledge. The speakers gave three examples of times when the information had made a difference:
- finding evidence that administering paracetemol made a condition worse;
- finding the latest guidelines for anorexic patients in critical care to prevent refeeding syndrome so a managmeent plan could be formed;
- comiling an evidence summary on use of decompression stickings to respond to a complaint from relatives of a patient who had died.
Treadway mentioned getting confidence and integrating with the clinical team:
- she started each session by explaining to the team why she was there to support them
- it was invaluable to have a champion for the project i.e. her co speaker
- she started to have requests for help outside ward rounds and responded to these questions promptly; she "went the extra mile"
- at the end of each ward round, she stayed for the tea and toast afte the ward round; this social aspect was important
Sadera said that to begin with some of his colleagues were sceptical. Also it took a while to convince IT to lend them an ipad ;-) He stressed that becoming part of the team was a key factor. I also liked something he said later on about convincing senior managers "You keep banging at the doors and at some point they just give in".
The speakers talked about moving the initiative to the wider organisation. A 10 minute video doing a mock ward round, including interviews with the clinical team, was a good marketing tool. The video is at http://www.whnt.nhs.uk/staff/media/itu/wuth_clwr.html
The speakers had talked about the initiative at a critical care conference in Delhi in October last year, giving "an opportunity to communicate clearly". Then Treadway took Sadera to the Canadian Health Libraries conference. Again they got some useful lessons on how to package and describe what they were doing, and they wanted to use this to promote more within the organisation. Finally, Sadera made a nice statement when he said that Treadway was "the secret weapon of our [health services] Trust".
There is a careers profile of Treadway here: http://www.guardian.co.uk/healthcare-network/2013/feb/15/five-minutes-with-clinical-librarian
There is more information on the initiative here: http://www.whnt.nhs.uk/hrod/development/library_services/services/clinical_librarian_service.html