Adapting the 23Things programme for health librarian professional education

In the UK, as elsewhere, continuing professional development is seen to be a necessary professional activity. However resourcing is problematic and funding varies between employing agencies. The 23Things programme has evolved to address these constraints. In particular it reduces the time for staff to be absent from core functions and makes maximum use of peer support. Within a common structure the programme delivers development to personnel at all professional levels. Activities are learner defined and relevant to their personal context. The pace of progress is learner determined. Cambridge University Medical Library (CUML) has designed its own 23Things programme. While conforming to the general model of 23Things, CUML adapted the programme in three ways. 1. to meet the specific learning needs of the library staff 2. to select topics and tasks related to the subject focus of the library 3. to include a new strand of professional development called Follow That.. Follow That... was designed to foster better understanding of each team members role in delivering core services in the library, and to improve the integration and awareness of expertise within a relatively large team This paper will describe the way in which the programme was set up, the selection of tasks and activities, and the pitfalls encountered. Also included will be an overall evaluation of the programme from the perspective of the participants and the programme designers

TeachMeet - librarians learning from each other

Teaching and training skills are a core requirement for many librarians (1)- whether the teaching is delivered to library users or to colleagues. Formal training in education, while included in some librarianship courses, is not yet available in all librarianship curriculums. Gaining teaching qualifications can be a costly and time consuming process, which might be low on the list of priorities for the employing organisation. Learning from colleagues and sharing experiences is a valuable way of improving practice (2). TeachMeet is an informal event in which like-minded practitioners share tools, techniques and tips they have tried themselves (3)Librarians at University of Cambridge have adapted TeachMeet for their own professional setting, sharing experiences and encouraging creative approaches to user education and continuing professional development. This paper will give a brief history of TeachMeet, how librarians adapted the concept, and how one TeachMeet event was evaluated by participants and organisers

Making a virtue out of virtual communities: working electronically with an advisory panel of library users

All libraries need an effective process of governance to guide the planning, development and improvement of resources and services. Library committees must be able to relate both to the high-level strategic policies and vision of their parent organizations and to the day-to-day needs and problems of their users. Combining these requirements in a single library committee can lead to difficulties for three reasons: it may be hard finding members who are equally well qualified to give advice on both strategic and day-to-day questions; the most useful committee members are often also the busiest and therefore those most likely to miss meetings; and in a multi-disciplinary library, a committee that is truly representative by including members drawn from all the various user groups will be far too large to function efficiently. Cambridge University Medical Library, which serves three distinct but inter-related main communities - university, hospital, and government research laboratories - has encountered all these problems. In response it has adopted a different approach, creating a separate policy advisory group for its major stakeholder organizations, and addressing the day-to-day service issues by forming a User Advisory Panel that relies almost exclusively on electronic communication. The Panel has been designed to allow the library's management to hold regular informal two-way discussions with a virtual group drawn from a broad cross-section of users, seeking their views on a wide variety of issues, both urgent and longer-term. In mid-2007 invitations were distributed widely to users and non-users within all three main communities, inviting volunteers to serve on the Panel. Respondents were asked to provide basic information about themselves, and to identify any special interests or concerns. They were told that they would not be expected to attend any meetings; that they were under no obligation to respond to every query sent by the library to the Panel if they were too busy or had no interest in the subject under discussion; and that they would not be expected to act as formal representatives of a particular group of users. This paper describes the process of forming the Panel, analyzing the initial and continuing response from users and reporting on the successes and problems encountered during this period. It also offers general conclusions on the likely benefits and drawbacks to other libraries considering such an approach

TeachMeet: Librarians learning from each other.

In this case study, we present the TeachMeet concept, discuss how we adapted it for use by librarians and consider how this model is spreading beyond Cambridge. In particular, we consider the role social media had in the inspiration for and organisation of these informal peer support events, and in the dissemination of information about the events once they had taken place

Going, going, gone... but not forgotten: lessons from a journal de-selection project

Objectives Cambridge University Medical Library has a strategy of migration from paper-based to e-resources. In 2007 it secured funding for a new IT study area, necessitating the removal of a substantial proportion of the printed journal collection. This paper deals with the process by which journals were proposed for removal, the issues that arose, and the outcomes. Methods (1) We targeted backsets of dead titles and monitored their in-library use, comparing the results with a similar review in 2000, to construct a list of low-use titles. (2) We checked these against electronic subscriptions and the holdings of other local libraries and created two lists: 444 unique titles for relocation to a dark archive, and 118 duplicated titles for disposal. (3) We conducted an extensive consultation exercise with our user community, using a web-based survey form to record their responses. Results 7,700 users were invited to contribute to the consultation, and we received comments from fewer than 2%. Half the respondents were historians who objected in principle to our relocation plans for unique titles. After further investigation of alternative locations we modified our proposals, redirecting 77 titles to an accessible store, while the remainder were dealt with as originally proposed. Conclusions • Preparing consultative lists of journals for disposal in a multi-library university is a complex and time-consuming task • A web-based survey is an effective consultation medium • Most medical library users accept the case for removing old printed journals • Historians have different requirements requiring different solution

Supporting bereavement and complicated grief in primary care: a realist review.

BACKGROUND: Bereavement can have significant impacts on physical and mental health, and a minority of people experience complicated and prolonged grief responses. Primary care is ideally situated to offer bereavement care, yet UK provision remains variable and practitioners feel uncertain how best to support bereaved patients. AIM: To identify what works, how, and for whom, in the management of complicated grief (CG) in primary care. DESIGN & SETTING: A review of evidence on the management of CG and bereavement in UK primary care settings. METHOD: A realist approach was taken that aims to provide causal explanations through the generation and articulation of contexts, mechanisms, and outcomes. RESULTS: Forty-two articles were included. Evidence on the primary care management of complicated or prolonged grief was limited. GPs and nurses view bereavement support as part of their role, yet experience uncertainty over the appropriate extent of their involvement. Patients and clinicians often have differing views on the role of primary care in bereavement. Training in bereavement, local systems for reporting deaths, practitioner time, and resources can assist or hinder bereavement care provision. Practitioners find bereavement care can be emotionally challenging. Understanding patients' needs can encourage a proactive response and help identify appropriate support. CONCLUSION: Bereavement care in primary care remains variable and practitioners feel unprepared to provide appropriate bereavement care. Patients at higher risk of complicated or prolonged grief may fail to receive the support they need from primary care. Further research is required to address the potential unmet needs of bereaved patients

Support needs of patients with COPD: a systematic literature search and narrative review

Introduction: Understanding the breadth of patients’ support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD). Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs); however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care. Methods: We conducted a systematic search and narrative review of the literature. Medline (Ovid), EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted. Results: Thirty-one papers were included in the review, and the following 13 domains (broad areas) of support need were identified: 1) understanding COPD, 2) managing symptoms and medication, 3) healthy lifestyle, 4) managing feelings and worries, 5) living positively with COPD, 6) thinking about the future, 7) anxiety and depression, 8) practical support, 9) finance work and housing, 10) families and close relationships, 11) social and recreational life, 12) independence, and 13) navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need commonly used in relevant national strategy documents (ie, physical, psychological, and social); however, support needs related to the fourth category (spiritual) were notably absent. Conclusion: This review systematically identifies the comprehensive set of domains of support need for patients with COPD. The findings provide the evidence base for a tool to help patients identify and express their support needs, which underpins a proposed intervention to enable the delivery of person-centered care: the Support Needs Approach for Patients (SNAP)

Interventions to increase referral and uptake to pulmonary rehabilitation in people with COPD: a systematic review.

Pulmonary rehabilitation (PR) reduces the number and duration of hospital admissions and readmissions, and improves health-related quality of life in patients with COPD. Despite clinical guideline recommendations, under-referral and limited uptake to PR contribute to poor treatment access. We reviewed published literature on the effectiveness of interventions to improve referral to and uptake of PR in patients with COPD when compared to standard care, alternative interventions, or no intervention. The review followed recognized methods. Search terms included "pulmonary rehabilitation" AND "referral" OR "uptake" applied to MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BNI, Web of Science, and Cochrane Library up to January 2018. Titles, abstracts, and full papers were reviewed independently and quality appraised. The protocol was registered (PROSPERO # 2016:CRD42016043762). We screened 5,328 references. Fourteen papers met the inclusion criteria. Ten assessed referral and five assessed uptake (46,146 patients, 409 clinicians, 82 hospital departments, 122 general practices). One was a systematic review which assessed uptake. Designs, interventions, and scope of studies were diverse, often part of multifaceted evidence-based management of COPD. Examples included computer-based prompts at practice nurse review, patient information, clinician education, and financial incentives. Four studies reported statistically significant improvements in referral (range 3.5%-36%). Two studies reported statistically significant increases in uptake (range 18%-21.5%). Most studies had methodological and reporting limitations. Meta-analysis was not conducted due to heterogeneity of study designs. This review demonstrates the range of approaches aimed at increasing referral and uptake to PR but identifies limited evidence of effectiveness due to the heterogeneity and limitations of study designs. Research using robust methods with clear descriptions of intervention, setting, and target population is required to optimize access to PR across a range of settings

What are the key elements of educational interventions for lay carers of patients with advanced disease? A systematic literature search and narrative review of structural components, processes and modes of delivery

Context: Educating carers about symptom management may help meet patient and carer needs in relation to distressing symptoms in advanced disease. Reviews of the effectiveness of carer interventions exist, but few have focused on educational interventions and none on the key elements that comprise them but which could inform evidence-based design. Objectives: To identify the key elements (structural components, processes, and delivery modes) of educational interventions for carers of patients with advanced disease. Methods: We systematically searched seven databases, applied inclusion and exclusion criteria, conducted quality appraisal, extracted data, and performed a narrative analysis. Results: We included 62 articles related to 49 interventions. Two main delivery modes were identified: personnel-delivered interventions and stand-alone resources. Personnel-delivered interventions targeted individuals or groups, the former conducted at single or multiple time points, and the latter delivered as series. Just more than half targeted carers rather than patient-carer dyads. Most were developed for cancer; few focused purely on symptom management. Stand-alone resources were rare. Methods to evaluate interventions ranged from postintervention evaluations to fully powered randomized controlled trials but of variable quality. Conclusion: Published evaluations of educational interventions for carers in advanced disease are limited, particularly for non-cancer conditions. Key elements for consideration in developing such interventions were identified; however, lack of reporting of reasons for nonparticipation or dropout from interventions limits understanding of the contribution of these elements to interventions' effectiveness. When developing personnel-delivered interventions for carers in advanced disease, consideration of the disease (and, therefore, caring) trajectory, intervention accessibility (timing, location, and transport), and respite provision may be helpful

Do Patients Want to Die at Home? A Systematic Review of the UK Literature, Focused on Missing Preferences for Place of Death.

BACKGROUND: End-of-life care policy has a focus on enabling patients to die in their preferred place; this is believed for most to be home. This review assesses patient preferences for place of death examining: the extent of unreported preferences, the importance of patient factors (place of care and health diagnosis) and who reports preferences. METHODS AND FINDINGS: Systematic literature review of 7 electronic databases, grey literature, backwards citations from included studies and Palliative Medicine hand search. Included studies published between 2000-2015, reporting original, quantifiable results of adult UK preferences for place of death. Of 10826 articles reviewed, 61 met the inclusion criteria. Summary charts present preferences for place of death by health diagnosis, where patients were asked and who reported the preference. These charts are recalculated to include 'missing data,' the views of those whose preferences were not asked, expressed or reported or absent in studies. Missing data were common. Across all health conditions when missing data were excluded the majority preference was for home: when missing data were included, it was not known what proportion of patients with cancer, non-cancer or multiple conditions preferred home. Patients, family proxies and public all expressed a majority preference for home when missing data were excluded: when included, it was not known what proportion of patients or family proxies preferred home. Where patients wished to die was related to where they were asked their preference. Missing data calculations are limited to 'reported' data. CONCLUSIONS: It is unknown what proportion of patients prefers to die at home or elsewhere. Reported preferences for place of death often exclude the views of those with no preference or not asked: when 'missing data' are included, they supress the proportion of preferences for all locations. Caution should be exercised if asserting that most patients prefer to die at home.This is the final version of the article. It was first available from PLOS via http://dx.doi.org/10.1371/journal.pone.014272