The impact of INCDocs
About the quantitative impact of INCDocs August 2023-September 2024.
Knowledge for Healthcare 2021-26 seeks to make optimal use of high quality knowledge resources at the point of need. These resources should be quickly and easily discoverable through a robust infrastructure and streamlined systems and processes. Streamlining document requesting and supply services is a specific intervention.
Before, document supply depended on searching many different catalogues for the availability of books and articles at NHS libraries. Open access articles had to be located on the web. Access to full-text articles was generally not straightforward.
The Inter-Network Collaboration (INC) scheme, set up to enable reciprocal interlibrary loans and document supply, introduced 6 regional catalogues. However, there was no standard process for requesting articles from other libraries, managing the request, or recording the activity. It was a highly manual and time-consuming process.
With the introduction of the ESBCO Discovery System, branded as the NHS Knowledge and Library Hub, to all NHS organisations in England, augmented by Third Iron’s LibKey link enhancement technology, and the establishment of regional library management systems in all NHS regions, the national KLS team was able to reimagine document supply.
Having improved the user experience of linking to the full-text of articles, we commissioned Third Iron to develop INCDocs. It uses the data about NHS libraries’ e-journal access from the national link resolver, and Third Iron’s data about open access articles to give KLS staff an easy way of sourcing open access articles as well as those available from NHS libraries’ e-journal collections.
Using DOIs, KLS staff can access open access articles and the full-text of articles from their own library’s e-journal collection, far more easily, within just a couple of clicks. If an article is not available as open access or in a local e-journal collection, INCDocs randomly selects a library from a pool of those who can supply that article. The selected library sends the full-text of the article via email to the requesting library.
Before INCDocs this would have necessitated searching multiple catalogues. While the INC scheme reduced the number of catalogues, electronic journal holdings were not necessarily included, and if they were, did not represent all of a library’s holdings[AF1] . The holdings may also have been listed in the catalogue incorrectly. This led to delays as the contacted libraries found they did not have access to the article after all and could not supply. Another library with availability would then need to be found.
As long as holdings in the link resolver are kept current, INCDocs offers better utilisation of all electronic journal holdings in the NHS using the NHS CLA Licence Plus. Supply to the requesting user was made significantly faster, especially important when required for an urgent decision about the care of a patient.
But how much quicker and what kind of savings could be made to the document supply process?
Using the NHS Core Costing Framework, members of the INCDocs testing group were asked to time the steps in the current document supply process and then do so again once INCDocs went live in May 2023.
Process costing breaks down a process, in this case document supply, into steps and asks staff who undertake the process to record the amount of time each step they use takes them to complete. They do this for all document supply requests in a sample period.
The steps in the document supply process were:
By reconciling DOIs, INCDocs had an impact on steps 1, 2, 4, 5, 7 and 8. The libraries which took part in the pre and post INCDocs process costing work supplied the timings for 290 document supply requests.
Those involved in timing the pre-INCDocs process concentrated in the amount of time spent on sourcing journal articles or steps 4 and 5.
For those requests which could be sourced from their own library, the average time was 1.28 minutes. For sourcing from other libraries, the average time was 3.7 minutes.
Post-INCDocs timings showed that sourcing using INCDocs averaged 0.45 minutes, a saving of between 0.87 and 3.29 minutes/request, depending on whether the article was available locally or as open access, or needed to be obtained from another NHS library.
Between August 2023 and September 2024, there were 26,799 lookups for articles available from libraries’ own e-journal holdings or as open access. With the saving in time of 0.87 minutes/request, the saving in time for this activity is 23,315 minutes or 388.59 hours.
The number of articles requested from other NHS libraries, and completed, during the same period was 87,874. The 3.29 minutes saving of time for articles requested from another library equates to 289,105 minutes or 4,818 hours.
More widely INCDocs also saves time in steps 1, 2, 7 and 8. This is estimated to be an additional 7.49 minutes/request.
This releases 14,315 in additional saved hours. Added together, the total saving is 19,522 hours, equivalent to 2,603 days or 521 weeks of staff time.
The Value Proposition: the Gift of Time states that knowledge and library services take the ‘heavy lifting’ out of getting evidence into practice and give the ‘gift of time’ to healthcare professionals.
This enables the NHS to meet its statutory obligations to utilise evidence from research and healthcare professionals to use their time more effectively.
Th time saved can be directed towards the activities which are effective in getting evidence into practice.