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UHDB Library Team shares insights on their latest Quality Improvement Project


Quality Improvement is defined as the application of a systematic approach that uses specific techniques to improve quality. The purpose of Quality Improvement within our hospitals is about making healthcare safer, effective, patient-centred, timely, efficient, and equitable.

Our library team have been working on two Quality Improvement Projects across UHDB. We spoke to Lindsay Snell, Clinical Librarian, to find out more.

Lindsay said, “We currently have two ongoing Quality Improvement Projects taking place across the libraries at UHDB – one is a Literature Search Improvement Project, and the other is an Inter Library Loans Improvement Project.

Tell us more about your Literature Search QI Project

A literature search is a systematic, thorough search of all types of literature (e.g. books, peer reviewed articles, etc.) in a specific requested topic. Our Library team perform between 300-400 literatures searches each year – so it was important for them to review and improve this process.

Lindsay said: “At the start of this project, we discovered our baseline data was flawed. Our documentation was inadequate, so we have already completed a project to improve the accuracy of our documentation.

“The first part of the project was process mapping – this allowed us to understand what our process was step by step – it was really useful to see this written down in front of us see the main steps of a literature search.

“After process mapping the entire literature search process, we timed the different stages of searches using a programme called Clockify. This included stopping and re-starting the timer if we were interrupted and writing off the activity if the timing got messed up. We needed to be precise in timing how long our searches were taking.

“For any activities that we hadn’t thought of we gained consensus before a new tag was created. The system allowed us to record 2 things at the same time. While this makes the data harder to analyse, this does show more accurately how people are spending their time.

“On the advice of a QI specialist, we aimed to record data for about 20 searches per searcher. This is a large amount of data for a QI project; however, we were advised the large variation in literature search times meant this volume of data would be needed.

“When we had collected this baseline data, we started using reference management software for all searches. This is something we had not previously routinely used, so we were interested to see what impact this would have. External circumstances meant we were also required to start using different interfaces for our literature searches at this time. When all searchers were confident with the new systems, we aimed to record data for another 20 searches per searcher.

“We recorded baseline data for 17, 12 and 6 literature searches for 3 individual searchers.

“We tried to wait until we were familiar with the new systems before we started collecting data in the new interfaces. However, we had to start using the new interfaces on a specific date.

After our UHDB searchers were confident with the new systems, we recorded data for 27, 25 and 6 searches respectively.” 

So, what have your improvements and results been from this project?

Lindsay said: “Our primary conclusion was that despite spending longer searching on the new interfaces, we made enough time savings elsewhere in the process, to more than offset this, so the mean average effect was spending 20 minutes less per search.

“Saving this time is really important to me. Within librarianship, there is limited research available, so for us to have this data about how we are spending our time is really useful and it is helping us to work more efficiently as a team.

“We’re really proud of the quality improvement work we are doing and have recently had the opportunity to present our findings on literature searches at the International Clinical Librarian Conference Lite.”