Empowering healthcare librarians to anticipate and adapt
‘Healthcare relies on knowledge to be successful. It is not enough to have the right teams with the right skills in the right place, working together to deliver high quality and efficient patient care. It is also essential that they use the right knowledge and evidence to make informed decisions about patient healthcare.’1
The National Health Service (NHS) is experiencing a period of unrivalled change. Economies are experiencing a shift from the ‘white heat of technology’ of the mid-20th century into today’s digital age in which ‘information will increasingly become the currency of healthcare’.2
Librarians make a critical contribution to improving quality outcomes and meeting the productivity and performance challenges facing the NHS in England. We can do more. It follows then that all those who work in healthcare libraries and knowledge services require the confidence, opportunities and skills to be successful; to make an impact.
The preface to Knowledge for Healthcare speaks of library and knowledge services as ‘a powerhouse’.3 The aim of the workforce planning and development workstream is to enable our small, specialist workforce to generate, channel and renew their energies to take the right knowledge and evidence to the right place, at the right time – to boardroom and to bedside.
Workforce planning and development
Our goal is to enable effective leadership, planning and development of the healthcare library and knowledge services workforce by:
* providing effective leadership at national, regional and local levels
* redesigning staff roles to meet changing service needs
* developing an appropriately skilled knowledge services workforce
* ensuring effective talent management of the whole knowledge services workforce.
Applying the principles of Knowledge for Healthcare
Knowledge for Healthcare is founded on an explicit set of principles intended to empower staff to look afresh at opportunities to collaborate and streamline existing services to release time and resource to extend the service offer and reach a wider customer base.
In designing and implementing this programme, we have sought to apply our stated principles and values to deliver practical and flexible solutions.
The principle of equity of opportunity (irrespective of postcode) drives our commitment to developing core products and resources that everyone can access to progress their personal and professional development. For high priority areas, such as knowledge management, we have cascaded a consistent approach to skills development across the country.
Health Education England (HEE) is committed to partnership working with CILIP. Collaboration is another key principle to enable the pooling of resources, budgets and staff time to best effect across boundaries. There is an ‘exemplary record of cooperation between healthcare library and knowledge services in England’.3 Regions assist each other through sharing expertise and knowledge, drawing on the experience of local professional networks as we roll out initiatives.
Harnessing the power of individuals
We place importance on providing and signposting resources to support self-directed learning.
The dedication shown by groups of volunteers working collectively to develop new materials to support professional development is impressive. With over 40 people involved in working groups, feedback demonstrates that participants gain much from involvement:
‘Active involvement in a task and finish group has led to numerous professional benefits – greater engagement with the programme, networking opportunities, leadership development and honing remote working skills. My increased confidence and early adoption of tools has also been of great benefit to my organisation.’
– Alison Day, Lead Librarian for NHS East Dorset Library and Knowledge Service
Underpinning workforce transformation
* introduced the Professional Knowledge and Skills Base for Health, jointly developed with CILIP4
* launched the Learning Zone5 – with over 2,300 users in 11 months since May 2016
* cascaded a tailored talent management resource to over 130 librarians6
* initiated a new HEE/Leadership Academy leadership development programme for more senior staff.
* introduced a mid-career leadership development programme as a joint initiative by HEE and CILIP. Abi Alayo, a participant in cohort one wrote:
‘The programme has brought to the forefront of my mind that leading is not just about managing people but also being productive, improving one’s self, reflecting on what you learn, and most of all contributing to the wider profession. It has afforded me the opportunity to foster lasting relationships with colleagues from various geographical locations. I have learnt so much and gained more confidence in my own leadership abilities.’7
Together these have laid solid foundations for workforce planning and development to deliver Knowledge for Healthcare.
Reflecting on our approach
These early initiatives came to fruition in summer 2016 and we took time to reflect and test our thinking with experienced educators. We are especially grateful to Sharon Markless, Senior Lecturer in Higher Education, King’s Learning Institute and Professor John Sandars, Edge Hill University.
These conversations created an opportunity to explore four questions about how we can best equip staff with the skills and confidence to address business-critical priorities:
What are the principal development needs?
Bringing together intelligence from three different sources has informed our priorities:
* strategically Knowledge for Healthcare, published in 2014, articulates the expectation of empowering staff to drive and deliver service transformation and foster innovation.
* HEE has since determined the importance of giving a higher priority to mobilising evidence and organisational knowledge, and to equipping healthcare professionals to provide information about public health and wellbeing.
* finally, we draw on analysis of survey data that expresses the ‘wants’ of our workforce. A survey in January 2017 was completed by 758 people. Analysis is in hand as we write. Early headlines show that the top three ‘wants’ are: demonstrating value and impact; knowledge management (KM); and emerging technologies.
What learning mechanisms should we use?
E-learning offers benefits for a dispersed workforce. Our approach is to signpost from the Learning Zone to e-resources which are not only for health information professionals but can also be used with, and by, other health professionals – for instance demonstrating knowledge management techniques. We are committed to drawing on the learning and experience of colleagues running a literature-searching Mooc (a massive open online course).7 We will build on the learning from this approach to meet the development needs of our workforce and those of a wider audience.
We recognise that facilitated face-to-face learning is the optimum. Participants commit time to something they perceive as valuable. The facilitation is the learning intervention, and the key to enabling people to change their practice. Given travel costs and competing time demands it is essential to consider carefully where to invest in this approach.
In 2016/17 we prioritised rolling out our Talent Management Toolkit8 alongside initiatives to increase the confidence and capability of librarians and knowledge specialists to initiate an active work programme to help mobilise knowledge for healthcare.
We also commissioned a two-day training programme across the country to enhance the skills and confidence of 300 qualified librarians in synthesising and summarising evidence. Facilitated group practice sessions were an integral element of this programme to better mobilise research.
For KM, we developed a guide9 and adopted a ‘train the trainer’ approach. In March 2017, accompanied by nominated local ‘KM facilitators’, our strategic library and knowledge service leads attended a workshop introducing practical tools to better mobilise organisational knowledge, which they will now cascade to colleagues around the regions.
Thinking ahead, we see the potential advantages of blended learning – using online learning to enable individuals to review and build their knowledge prior to face-to-face sessions that allow for dialogue and engagement with that new knowledge to enable changes in practice.
Certainly, one size does not fit all. For individuals, the Learning Zone illustrates that there are many helpful approaches to development.
What sort of learning opportunities do library and knowledge specialists need?
Convinced of the importance of situated learning, which enables individuals to learn by participating, we ensure that group project work is incorporated into our leadership development programmes – both the joint CILIP/ HEE leadership development programme and the HEE/Leadership Academy programme. Collaborating on a project provides opportunities to create meaning from real activities. We are struck, and reassured, by the synergies observed between the educational and KM perspectives: ‘Social interaction and collaboration are essential components of situated learning – learners become involved in a community of practice’.10
Alongside the practical challenges of working across distance and organisational boundaries, the projects allow individuals to appreciate distributed leadership as practice, with an emphasis on interactions rather than leadership as role or responsibility.11
What makes learning ‘stick’?
The concepts of single, double and triple loop learning12 chime well with the greater focus that HEE places on mobilising organisational knowledge. For instance, using a technique like a retrospective,13 which is incorporated into our workshops about KM, assists teams to learn from experience. Rather than focusing on fixing an immediate, presenting problem, a facilitated, structured retrospect enables double-loop learning. It invites participants to ‘own’ mistakes, understand what might have gone better and discuss with others to discover root-causes. It also calls for a willingness to take responsibility for how we might change our actions or methods.
Appreciating how impactful action learning can be, we have invested in training staff from each region as Action Learning Set facilitators. The aim is to enable triple loop (or transformational) learning through which participants can understand more about both their organisation and themselves. This enables an individual to question the work and process and to reflect on personal attitudes and viewpoints.14 The Learning Zone points to ‘Thinking differently’ tools like ‘Breaking the rules’ which can help with the former.15 Each of our leadership programmes offers approaches that allow individuals to gain personal insights.
Laying strong foundations for workforce planning and development
Perhaps some expected us to devise a raft of topic-based continuing professional development activities? Rather, we seek to lay the foundations of a modern workforce planning and development programme that supports the changing roles and service transformation envisioned by Knowledge for Healthcare. Our aim is to empower healthcare librarians and knowledge specialists to anticipate and adapt to a changing environment and to appreciate where we can best add value.
1 NHS Health Education England (HEE), 2016. Our Policy.
2 HEE, 2017. Framework 15: Health Education England strategic framework 2014-2029.
3 NHS HEE, 2016. Knowledge for Healthcare: a development framework.
4 NHS Library and Knowledge Services, 2016. For Information: PKSB for Health.
5 HEE: Library and Knowledge Services (LKS), 2017. The Learning Zone.
6 Maden, M., Young, G. and McLaren, L., 2016. LIHNN Introduction to Literature searching Mooc.
7 Alayo, A., 20 February 2017. ‘Knowledge for Healthcare Leadership programme: one year on.’
8 HEE: LKS, 2016. Talent Management Toolkit.
10 Davey K. Situated Learning Theory (Lave) in Learning Theories, 2007.
11 Harris, A. and DeFlaminis, J. ‘Distributed leadership in practice.’ Management in Education. Vol 30, Issue 4, 2016, pp. 141–146.
12 Organizational Learning Group 9, 2014. Single and double loop learning.
13 HEE: LKS, 2016. Retrospective (Baton Passing).
14 Graybeal, L., 2017. Single-Loop Learning Key Terms.
15 NHS Institute for Innovation and Improvement, 2007. Thinking Differently.