Managing knowledge 
in health services

Edited by
Andrew Booth
Director of Information Resources, School of Health and Related Research, University of Sheffield

Graham Walton
Faculty Librarian (Health, Social Work and Education), University of Northumbria at Newcastle and Assistant Director (Strategy), Information Management Research Institute, University of Northumbria at Newcastle

Library Association Publishing
London
© This compilation: Andrew Booth and Graham Walton 2000
    The articles: the contributors 2000

Published by
Library Association Publishing 
7 Ridgmount Street
London WC1E 7AE

Library Association Publishing is wholly owned by The Library Association.

Except as otherwise permitted under the Copyright Designs and Patents Act 1988 this publication may only be reproduced, stored or transmitted in any form or by any means, with the prior permission of the publisher, or, in the case of reprographic reproduction, in accordance with the terms of a licence issued by The Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to Library Association Publishing, 7 Ridgmount Street, London WC1E 7AE.

First published 2000

British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.

ISBN 1-85604-321-5

Typeset in 11/14pt Elegant Garamond and Castle by Library Association 
Publishing
Printed and made in Great Britain by MPG Books Ltd, Bodmin, Cornwall.

Contents

Contributors	v
Introduction	ix

Part 1
Contextual background to healthcare and health information
services

1	Health services: a contemporary approach	3
	Graham Walton

2	Health service users of information	15
	Christine Urquhart

3	Health service libraries	31
	Jane Mackenzie

4	Health service information providers	53
	John Hewlett

5	Consumer health information	69
	Donald Mackay

Part 2
Health information resources and their organization
and management

6	Providing direction and management for health library 	89
	and information services
	Graham Walton

7	Identifying users’ needs	101
	Andrew Booth

8	Making a case	112
	Andrew Booth

9	Identifying resources	122
	Sharon Dobbins

10	Organizing information resources	137
	Andrew Booth

11	Delivering and accessing resources	151
	Andrew Booth

12	Marketing a service	162
	Andrew Booth

13	Evaluating information services 	173
	Linda Banwell

14	Training the users 	182
	Alison Hicks

Part 3
Skills needed to make effective use of the knowledge base

15	Formulating the question 	197
	Andrew Booth

16	Selecting appropriate sources 	206
	Andrew Booth

17	Searching the databases 	222
	Louise Falzon

18	Searching the Internet 	237
	Andrew Booth

19	Filtering and evaluating the knowledge base 	251
	Suzy Paisley

20	Organizing a personal knowledge base 	268
	Andrew Booth

21	Keeping up to date with the knowledge base 	279
	Andrew Booth

22	Some concluding trends and themes 	289
	Andrew Booth and Graham Walton
References 	295
Index 	345

The contributors

The editors
Andrew Booth BA MSc DipLib ALA is Director of Information Resources, School of Health and Related Research, University of Sheffield. He is an information professional, lecturer and researcher with 15 years’ experience of management in a wide range of health information settings. After working in NHS libraries from 1983 to 1990 he was employed by the King’s Fund Centre, where he managed three national information services. In November 1994 he moved to the School of Health and Related Research, University of Sheffield, where he directs an information resource to support evidence based health-care. Andrew coordinates a module on Systematic Reviews and Critical Appraisal for a Masters in Health Services Research and Technology Assessment, and is an Honorary Lecturer within the Department of Information Studies. Having researched and published extensively on literature searching and critically appraising the evidence, his research outputs include three published systematic reviews for the NHS Health Technology Assessment Programme and a further two in progress. The compiler of the ScHARR Guide to Evidence Based Practice and the world wide web resource, Netting the Evidence – used by the Cochrane Library as an authoritative starting-point for evidence based practice – he sits on the editorial boards of Evidence Based Healthcare (formerly Evidence Based Health Policy and Management) and Journal of Clinical Excellence. Andrew was recently elected Chair of the LINC Health Panel Research Working Party where he is developing methods of systematic review and critical appraisal for health librarianship. 

Graham Walton BSc MA MBA FETC ALA is Faculty Librarian (Health, Social Work and Education) at the University of Northumbria at Newcastle and Assistant Director (Strategy), Information Management Research Institute, University of Northumbria at Newcastle. Graham has been working in health information and librarianship for over 20 years. He originally worked in the NHS Highland Health Sciences Library in Scotland. Most of his professional life has been spent in the higher education sector. His current post includes responsibility for three university libraries and supplying a library and information service to over 5000 health students. He has also been active in research, including managing projects on health professionals’ information needs and the eLib IMPEL2 project. His current interests are the cultural and organizational implications of moving to electronic information delivery and the information needs of community practitioners.
The contributors
Linda Banwell BA MA PhD ALA is Senior Lecturer in the School of Information Studies at the University of Northumbria at Newcastle, and Research and Development Manager of the Information Management Research Institute at the University of Northumbria at Newcastle. A chartered librarian with experience in academic and special libraries, she has a PhD in computer science, specializing in human–computer interaction. She subsequently became a contract researcher and then a lecturer specializing in research methods. Her research interests focus on people-centered issues in information system design and implementation and evaluation in a range of application areas including health, education and public libraries. 

Sharon Dobbins BA ALA is Trust Librarian, City Hospitals Sunderland NHS Trust. She previously worked for the British Council in the UK and Bangladesh, and for Dorset Institute of Higher Education (now Bournemouth University). Professional interests are the development of library and information services, particularly electronic facilities, user education and staff development.

Louise Falzon BA DipInf ALA is Information Officer at the School of Health and Related Research, University of Sheffield. She began her library career in the public sector, working for Berkshire County Council. She then moved to Sheffield Hallam University where she specialized in health and nursing. Her current post combines her other main area of interest, which is training.

John Hewlett MSc (InfSci) ALA MIInfSci is Director, Northern and Yorkshire Regional Library Advisory Service. He was Regional Librarian for North East Thames for the previous 16 years, and is particularly interested in the improvement of library information services by staff training and performance.

Alison Hicks BA MLib ALA MIInfSc is Trust Librarian, Gloucestershire Royal NHS Trust, where she currently manages the library and information service at Gloucestershire Royal NHS Trust. She previously worked at ScHARR, University of Sheffield and the University of Wales College of Medicine. Alison is particularly interested in developing training resources to support evidence based practice and clinical governance.

Donald M Mackay MA MA, ALA became Enquiry Services Manager, Cairns Library, University of Oxford following three years as Librarian at the Health Education Board for Scotland. He recently completed a Masters dissertation on the training needs of CHI providers in Scotland. Current professional interests other than CHI include evidence based healthcare, quality in LIS and the needs of long distance users and community based healthcare workers.

Jane Mackenzie BA MA ALA is Business Development Manager at the Library and Information Development Unit, Thames Postgraduate Medical and Dental Education. After ten years’ working in libraries in Colleges of Further and Higher Education in London and then Central Scotland, she moved to the health sector to manage, initially, the King’s Fund College Library and then the merged College/Centre Libraries, including a move to the Cavendish Square Library. Prior to her current position she spent two years as R&D Information Manager in the Chief Scientist Office in the Scottish Health Department (including close involvement with the SLIC Review of Scottish Health Libraries). Professional interests include quality and performance management, CPD and career development of library staff, move to networked, electronic information delivery and use of evidence base by LIS practitioners.

Suzy Paisley MA ALA is Senior Information Officer at the School of Health and Related Research, University of Sheffield. Her interest in health information began at Sheffield Hallam University, where she specialized in health and social sciences. She joined ScHARR to set up the Trent Institute for Health Services Research Information Service, supporting the research activities of NHS staff in Trent. Her main area of interest is in literature searching to support systematic reviews and evidence based practice.

Christine J Urquhart BSc MSc PhD MIInfSci PGCE is a Senior Lecturer at the University of Wales, Aberystwyth. Her recent posts include librarian at a nursing college, and Principal Researcher on a value project. She has directed several research projects (EVINCE, GIVTS projects) and several systematic reviews.

Introduction

Reading the January 2000 headlines from the front pages of The Times newspaper provides a succinct overview of the agendas and issues facing those involved in healthcare delivery. Political parties are accused of using healthcare issues for their own purposes. Concern is expressed about where the funding will come from to pay for the new ‘super drugs’. Health services have struggled to cope with a flu epidemic to which the older population is more susceptible. The first arm transplant has taken place.
Health library and information service (LIS) providers are not impervious to the effects of this external environment. They have a central role in ensuring that appropriate knowledge is available to health professionals to ensure that the right decisions and actions are taken to address such issues. Providers of health LIS cannot escape from the dramatic changes that are shaping healthcare. In 1995 Michael Carmel assembled the second edition of Health care librarianship and information work. In this snapshot of the then health LIS world the Internet existed, but only justified two pages of coverage. The concept of evidence based practice had emerged but had not had any discernible impact on LIS professionals. End user searching of online databases took place rarely, if at all. In 1995 the same book by Carmel described the high level of change in health services that had taken place across the world in the early 1990s. Since this book’s appearance the rate of change has accelerated, affecting all aspects of healthcare. The radical nature of such change necessitated a new approach to, rather than simply a revisit of, the subject matter of Carmel’s original work.
The purpose of this book is to define and investigate the context, principles and practical skills needed to effectively manage the knowledge base of healthcare. The book identifies and analyses the function and value of information in healthcare. It describes the rapidly evolving role of health information provision and provides a toolkit of practical knowledge for health information providers and users. To facilitate these aims and objectives the book is divided into three sep arate parts. Part 1 provides the contextual background to healthcare and health information services. The wider health environment is described along with an evaluation of the characteristics of health LIS users. The range of health LIS and the providers who work in these services is outlined in all its complexity and diversity. An overview of developments in consumer health information completes this first part.
The focus for Part 2 is on the principles underlying the way health information resources and services are organized and managed. The first chapter in this part examines how health LIS, and the staff who work in them, should be managed. The importance of user needs analysis is discussed, illustrated by different methodological approaches. Subsequent chapters look at how to make and present a case effectively, how to identify resources for the health LIS and how the LIS should be organized. Developments in the delivery of, and access to, resources are allocated a chapter within this part. The final three chapters in Part 2 consider marketing services, evaluating services and training the users.
In Part 3, the skills needed to make effective use of the knowledge base are described. Formulating the question along with establishing the appropriate sources where the answers might be located are examined. Database searching techniques as well as Internet searching skills are briefly outlined. The development of new approaches needed to filter and evaluate the knowledge base are described. Organizing a personal knowledge base and keeping up to date are the topics of the last two chapters. The book then concludes by examining important trends and themes that the contributors believe will occupy the LIS professional agenda in the early part of the 21st century.
Wherever possible Part 1 is written from a global perspective, but many examples are based on practice in the UK. Parts 2 and 3 are relevant to health LIS across the world and draw extensively on the published knowledge base. This book is intended to be of use to all library and information service providers and students in the field. It should also be of great value to the increasing number of healthcare professionals, such as research and development  coordinators and clinical effectiveness/governance facilitators, required to access health information as part of their working roles. 
The editors would like to thank all contributors for the quality of their writing and their adherence to deadlines! Special thanks are extended to two further individuals: Michael Carmel for inspiring the writing of this book and Dr Anne Wales for her early contributions to the book’s structure. Finally the editors would like to acknowledge the considerable advice, assistance and technical support provided by the commissioning editor for the Library Association, Beth Barber, and also the tolerance of our respective wives and families!

Andrew Booth and Graham Walton