Further information on RBHT multi-disciplinary clinical innovations database

Top three winner of the 2017 Sally Hernando Innovations Award

Creating an Innovations Database @ RBHT

Having attended the first workshop of the Knowledge for Healthcare Leadership Programme in March 2016 and being allocated there to our group project – Identifying the skills base for Innovators: a knowledge management initiative for LKS staff to enable knowledge sharing to drive innovation at Trust level, I realised that this was a project that would be beneficial to clinicians in my Trust. The reason for this was that as a result of attending meetings with the medical education committee and the medical education board at my Trust I realised that there was already a lot of knowledge created sitting in silos. A week later I spoke with our Director of Medical Education about making a database to make this knowledge discoverable and shareable among multidisciplinary clinicians cross-site on two different physical locations, who was interested in hearing more about it and suggested I talk about this at the quarterly medical education committee meeting – which comprised of Clinical Tutors and Medical Education Practitioners - and at the medical education board meeting – which was comprised of the Director of Planning and Strategy and other multi-disciplinary educators - and at both events there was interest and an expectation that I should proceed with this and report back to them on progress. I was also given a few initial leads at these meetings of people who I went on to network with – the Trust’s Lead Clinician in Clinical Risk, the Professional Lead Occupational Therapist & Interim Trust Lead for Older People, an Adult Cystic Fibrosis Nurse Specialist, and a Clinical Psychologist who were also keen to be involved once I explained to them the concept of a database to make in-house innovative clinical knowledge more discoverable. They in turn gave me more leads and so the fledgling network of collaborators and contributors increased.

Networking

By June, largely through networking activities I had gathered interest and material with which to populate a database. I then approached the IT department with a request for permission to create a searchable database which would be hosted on the Trust’s servers and be accessible to staff only via the Trust’s intranet site. Initially there were a few hurdles to overcome with finding the right people within the IT dept. with the skillset required to initially create the database. There was also reluctance that this would mean additional work for them to maintain the database. I overcame this by explaining that once permission was given to create the database it would be the library that would populate, maintain and publicise the database in collaboration with the contributing multi-disciplinary clinicians. The database that was created is simple to manage by members of a library team and is searchable via free text.

The Innovations Database 

At the end of June I was able to demonstrate the database at a meeting of clinical teams engaging with quality improvement, where again there was interest in being involved with the process and contributing to growing the database. The meeting on that day was about a competition to do with quality improvement in the Trust and the fact that there was now a database where such projects could be made available to all staff to browse through was appreciated. In mid-July I attended Trust Research Open day to engage with clinical teams to talk to them about contributing to the Innovations Database. I also connected with key people in the Trust introducing the innovations database to them and asking them to work with us to help to grow and establish it.

Word having spread of the existence of this database, I was approached by the Nurse Education Directorate as well as various consultants via the Medical Education Directorate to populate our database with content created by their teams. The CMT (Core Medical Trainee) curriculum requires that CMTs complete a project during each year of CMT training and the Trust works with the RCN to support the on-going development of band 6 and 7 nurses in relation to their role and responsibilities in the delivery of safe compassionate care via the 6 C’s compassion in practice framework. Nurses on this programme create posters and presentations as method of showcasing service improvement projects undertaken in their clinical areas. Previously content created by a team or dept. was available to share within that team or dept. only, thus creating silos as there was not an effective way of sharing what had been done with multi-professional colleagues within the Trust in other depts. With the new innovations database it is now possible for clinicians to share the results of innovative projects and research to provide information to healthcare professionals across the Trust who are seeking to implement new policies, products or practices, and to build on the ideas and research of others to improve the quality of their work and patient care.

On 18th August the database was officially launched with news of it being given a prominent place on the ‘Need to Know’ column of the intranet home page as well as publicity for it from the Trust’s Communications team in their Sept 2016 issue of ‘What’s New’ which is a news bulletin for staff in paper format which is distributed widely across the hospital.

Foundations through engagement 

The creation and population of the innovations database happened quite quickly once I started on that journey. This was because of the engagement work that happened in previous years as part of my efforts to raise the profile of the library service through the creation of a library user group with monthly meetings. I was supported in this by the medical education director who also asked for a library presence at the quarterly medical education committee meetings (which was to do with issues relating to junior doctors and addressing their CME needs), and in time lead to a request for a library presence on the medical education board (which looks at all things educational relating to all the cme / cpd of multi-disciplinary professions practicing here from the perspective of improving patient care and safety, so some of the members of the medical education board are also members on the Trust board). It took persistent effort on my part to get the library user group organised and being able to engage with MEC and MEB came as a result of that, which in turn was the foundation for the innovations database becoming a reality. We now have a database which is a platform where knowledge created in-house can be shared and used. The library service has a role in managing this knowledge and information by maintaining the database. The library is also perceived as common ground for all the professions here and therefore seen as the natural guardians of this knowledge base.

Creating awareness and knowledge sharing for re-use

I now include details of this knowledge database when I do the monthly junior doctor and nurse induction sessions as well as any training sessions so new members of staff joining the Trust are aware that this exists. During one training session a nurse educator from PICU (paediatric intensive care unit) spotted an innovation adopted by AICU (adult intensive care unit) and thought it would be a good idea to adapt it for implementation in PICU as well. Another instance was where a member of the arts team was thinking about using poetry as a means of exploring difficult issues in paediatric nursing in relation to compassionate and empathetic care and patient interaction and was able to discover via the contents of the database initiatives that are already taking place within some nursing departments which made her decide to try to build on what was happening already. A presentation on Sun Shine Therapy has served as inspiration for making a business case for the creation of a roof-top garden for use by long-term patients. A nurse who is putting together a project in the use of herbs and vitamins to promote faster wound healing now has knowledge of other wound care teams and their work with whom she would like to team up if her project proves beneficial in faster wound healing. Another use this has been put to is being used as a tool to inform the non-executive directors on the Trust board of innovations in the Trust and also for informing CQC inspections. I was also able to share information about this database at an event titled 'Systems Leadership and Communities of Practice - Driving Cross-boundary Change' hosted by the Kent, Surrey and Sussex Leadership Collaborative during a ‘World Café’ session which is a methodology for hosting large group discussion to harvest results.

Technical specifications of the innovations database

The innovations database sits on the RBHT staff intranet network with content stored on RBHT servers. The IT dept. uses a bespoke content management system called Easysite. There was no coding involved in the creating of this database. Our IT dept. configured an Easysite directory module to achieve the desired database requested.

The Web Services Team looked at what information we wanted to capture, how it was to be displayed, and who would be involved in inputting the content. From there they deduced the EasySite directory module would be the best option as it allows us to build extensive and searchable listing database. Easysite has a non-technical web-based and user focused interface which provide an easy to use front end for library staff to input information in situ. As the database grows and the amount of content increases IT can assign Directory Module privileges to contributing departments which would allow them to add their content to the database themselves.