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A million healthcare decisions a day



A Million Decisions - How library and knowledge health services underpin a million healthcare decisions a day

Those working with healthcare library and knowledge services (LKS) have long understood the dramatic outcomes their services can deliver: £500,000 savings, reducing the costs of treating long term conditions, reducing the length of stay and improved care for critically ill patients are just some of the examples captured by the CILIP and Health Education England (HEE) #AMillionDecisions campaign.

CILIP and HEE wanted to celebrate these achievements and use them to highlight to senior stakeholders that having a skilled LKS workforce helps meet statutory obligations and delivers savings. The campaign name reflects the fact that every day across the healthcare sector in England more than a million decisions are made that have a profound effect on patients and impact on the cost and quality of health services. All of these decisions have a statutory obligation under the 2012 Health and Social Care Act to be based in evidence. Health LKS workers are integral to meeting those obligations by providing accurate and timely information when and where it is needed.

The ongoing campaign allows us to unite as a profession and use the powerful messages gathered to influence senior managers.

Case studies:

£500,000 saved: clinical librarian crucial to success of Nursing Supplies Group

"The Nursing Supplies Group works alongside the Trust's procurement team to ensure that nursing products bought to deliver patient care are of the highest quality and that a standardised approach is implemented across the trust where possible. The Group considers the research around the clinical efficacy and safety of clinical items available for use and makes recommendations based on clinical and cost effectiveness.

The attendance of clinicians and a clinical librarian at these meetings has been crucial to its success in delivering cost efficient savings to the Trust whilst maintaining quality. Over the years the group as saved the Trust over £500,000 - it wouldn't have happened without the Library."

University Hospitals of Morecambe Bay NHS Foundation Trust

Reduction in cost of treating long-term conditions within acute & primary healthcare

"As a service we have a lot of expertise in the sphere of psychological interventions into Long Term Conditions and the evidence from our library service is used to steer and guide our approaches to it. Information provided via our library and knowledge service is also invaluable in developing our business cases and securing commissioner commitment.

We needed to present in-depth evidence around options that will reduce costs in both the acute sector and primary care, and to evaluate a range of innovative service models in psychological therapy for long-term conditions. Having access to a dedicated library and knowledge service negated the need for us to spend time on this and ensures we can confidently and competently ensure that those with a long term condition can benefit from a psychological intervention.

We are now providing a range of psychological therapy interventions into services that we run in Brighton and Hove, including Diabetes and Respiratory clinics and we are on the edge of a massive roll out of interventions into long term conditions services across Sussex."

Sussex Community NHS FoundationTrust

Reduced length of stay and improved care for in critically ill patients

"On testing we found that a large number of our critically ill patients were vitamin d deficient. Our library and knowledge services brought evidence showing that vitamin d deficiency is associated with worse outcome for critically ill patients including increased length of stay and mortality; but treating vitamin d deficiency in critical care should help with rehabilitation and can potentially reduce hospital days for this population.

As a result of this evidence, a new protocol was introduced into critical care (based on NICE guidance but slightly adapted for the critical care population). There is now routine testing and supplementation within critical care. The cost of testing and supplementation is relatively low but the potential impact in terms of speed of recovery and reduced length of stay could be significant.”

Gateshead Health NHS Foundation Trust

In 2017 HEE along with CILIP’s Health Libraries Group introduced the campaign to senior health leaders in the NHS and the wider health sector at NHS Confed. This year we will be returning to showcase the results.

The success of the campaign gives CILIP as the health LKS professional body and HEE as the national training arm excellent evidence as to why long term investment in health LKS services really pays off. All the clinical staff, the commissioners and the patients benefit from well-funded services delivered by well trained staff. Being a member of CILIP makes you part of a professional community that understands your role and helps you demonstrate your own impact. Join CILIP to add your voice and to work with us to proudly advocate for our profession.


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Published: 12 June 2018


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