A million ways to be Nice: #amilliondecisions
Amy Finnegan and Sue Jennings explain how the skills of
information specialists at the National Institute for Health and Care Excellence (Nice) support high-quality, cost-effective evidence-based healthcare within Nice and the wider healthcare community.
EVERY day across the NHS and healthcare sector, more than a -million decisions are made which -influence the quality and cost of -services, impacting people’s lives.
Under the Health and Social Care Act 2012,1 health services have a responsibility to ensure that evidence is obtained from research. In January last year, CILIP and Health Education England (HEE) called for health services to utilise the skills of health librarians and information specialists to support evidence-based decision-making through their #amilliondecisions campaign.2
Over the past year, health information specialists have provided examples of how they have contributed evidence that has impacted on health services across the country. For instance:
A clinical librarian provided evidence on the clinical and cost effectiveness of nursing supplies, saving one trust £500,000
An NHS Library service provided evidence of psychological interventions in long-term care which reduced costs across primary and acute care services
Inspired by the campaign, as information specialists at the National Institute for Health and Care Excellence (Nice), we have reflected on how our skills support the delivery of high quality, cost effective and evidence-based healthcare within Nice and the wider healthcare community.
Information support is embedded in Nice business processes. We use a range of skills to support evidence-based practice including:
Assessing the validity of online information
Searching databases and websites
Developing methods and techniques to improve searching precision
Critically appraising evidence
These skills are used to help teams across Nice in a variety of ways, including:
Highlighting relevant and related Nice products
Searching for published literature (e.g. randomised controlled trial results and systematic reviews)
Advising analysts on the best approach to updating a search
We aim to retrieve the best available evidence, reduce information overload and save time sifting through database search results.
Impact of information specialists
We asked Steve Sharp, Technical Analyst at Nice, about the impact information specialist support has on his work to develop guidelines. He said:
“The importance of information skills in evidence-based practice cannot be overstated. Information specialists are an invaluable resource in developing and updating health sector guidelines, where the dynamic nature of research evidence poses a constant challenge in keeping recommendations current and accurate. Without their initial literature searching and intelligence gathering support, it would be impossible to manage the high volumes of evidence emerging across a vast range of topics.”
Contributing to committee meetings
As well as liaising with technical analysts when developing and refining search strategies, we also attend guideline development committee meetings. This gives us the opportunity to clarify the database terminology and techniques (e.g. the use of Boolean logic) used to develop the search strategies to a panel of topic experts, lay members and Nice staff. The committee panel is then able to query the strategy and make suggestions based on their knowledge of the topic.
Attending committee meetings is an important part of the role, as it provides information specialists the opportunity to use our professional expertise to support Nice in making evidence-based recommendations. By offering topic experts the chance to assess the strategy, we can be confident that the evidence base underpinning Nice recommendations are based on systematic searches and robust processes from start to finish.
Information skills training
We don’t just stop at supporting evidence-based decisions within the organisation. Just as academic and NHS librarians equip students with information literacy skills, we provide internal and external information skills training.
At Nice, we train staff how to find high quality information across a wide range of resources. Some might not be aware that Nice operates a student champions scheme,3 helping future health professionals to make evidence-based decisions. The scheme provides students with knowledge and skills on how to use Evidence search, which the students are then asked to cascade to their peers. In 2016-17 information specialists trained 313 student champions who, in turn, passed their knowledge to 2,500 students.
Evidence search is a site that helps health and social care professionals, as well as the public, to access health, social care and public health information from one place. It brings together high quality consolidated and synthesised evidence from hundreds of trusted sources. We use our skills to critically evaluate the sources of information for Evidence search including guidance, systematic reviews, evidence summaries and patient information. The information available in Evidence search can be used to support, enhance and complement Nice guidance.
We also use skills in negotiation, procurement and communication to provide access to the following resources:
Ian Saunders, Content & Quality Assurance Programme Manager at Nice, explains how information specialists can enhance a service, such as Evidence search:
“Information specialists are methodical and fairly tenacious. These qualities are essential to systematically interrogate complex bibliographic databases or to keep looking until a key piece of information is found that will answer a particularly tricky question. Evidence search benefits from the involvement of information specialists as they can systematically search for and include relevant content and maintain a collection that is comprehensive without being overwhelming.”
As the campaign highlights, over a million decisions are made across the health sector in England on a daily basis. We are proud that we contribute to these decisions both internally at Nice and externally through Evidence search and the student champions scheme. IP