Changing the way we think about impact? by Tracey Pratchett

In the shower this morning I was thinking about a conversation we had at the LIHNN Quality Group about health libraries and demonstrating impact. This idea is embedded within the LQAF framework and no-one questions the need for us to show how we impact on our organisations, but my main question is: “What are we trying to demonstrate impact on?”

There is a lot of out there trying to demonstrate the direct impact of the library service on direct patient care. For example, many of our user surveys include questions like “did our service impact upon your decisions regarding treatment choice or diagnosis?” Obviously patient care is what everyone working in the NHS is about, but I just can’t get away from this feeling that we are missing a trick by trying hard to demonstrate a direct link between our services and patient care.

We also need to remember that not all librarians with NHS organisations can easily make the connection between their work and patient care as they do not work with clinicians; take those working with CCGs or CSUs for example. Ultimately, I keep coming back to the feeling that we can’t prove that it was solely our service which made the difference, as opposed to other factors such as the discussion with the patient or advice from colleagues. Whilst our service has definitely contributed, I’m not convinced that you can isolate our direct impact on patient care. We discussed this a lot when we wrote the Clinical Librarian Systematic Review, (watch out for the results of the NW evaluation imminently J).

My view is that we directly impact on NHS staff and their ability to do their job and this is really important. Think back to the Productive Ward and Releasing Time to Care. Surely it makes more sense for a skilled librarian to undertake a thorough search in 2 hours than for a nurse to spend hours going round in circles on Google? The recent project by the NHS Confederation considers the importance of information, evidence and data in the decision making process (as reported by NHS staff) and surely this is where we should be focussing on impact; their infographic makes for very interesting reading.

For me, the most powerful demonstrations of impact on NHS services do not come from the high level research literature but from some of the case studies. I still remember how inspired I felt when I went to the LondonLinks alignment toolkit launch event and saw 6 people present very different case studies about library services which had made a very tangible impact on a single patient, a group of staff members or organisational decision-making which saved 1000s of £s. This was the Eureka moment which made me really think differently about impact and initiate what became the MAP toolkit.

Recently, I was reading the MerseyCare Annual Report 2013-14 before adding it to the toolkit and the bit that resonated for me was the case study in the appendices. I loved it and it made me think – yep that’s what we do. Also, if you’re interested, read my article published with a colleague which talks about our experience of being the searcher and searchee. It includes three reflective case studies on impact which are not scientific I know, but felt real to me.

The Impact Toolkit includes some really useful tools for librarians who want to demonstrate impact on patient care. I’ve heard on the grapevine that it’s likely to be updated and I’m hoping that this will include resources for those who don’t work directly with clinicians, but want to demonstrate their impact on individuals and organisations abilities to fulfil their roles, regardless of whether they treat patients or not.

I’d be really interested in other people’s views on impact and of course, if you want to submit a case study to the MAP Toolkit on any aspect of impact, please get in touch.

Tracey Pratchett – Clinical Librarian
Library and Knowledge Service
Knowledge, Education, Learning & Development Division
University Hospitals of Morecambe Bay NHS Foundation Trust
Tel: (01524) 516224
Intranet: http://uhmb/cd/libknoman/lib/Pages/default.aspx
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