Information Scotland The Journal of the Chartered Institute of Library and Information Professionals in Scotland ISSN 1743-5471 Issue contents | Journal contents | About the online edition of the journal August 2006 Volume 4(4)

Special collections: focus

Knowledge for the community

Information professional Joanna Ptolomey explains how she used her knowledge management skills to help a Glasgow Community Health Partnership team to move one step closer to a new model of mental health services provision.

The NHS in Scotland is currently experiencing great change. The Primary Sector no longer exists in its old format and Community Health Partnerships (CHPs) are the new structures in place. CHPs are designed to bring health and social care more closely together. The aim is that CHPs will deliver more effective community health strategies and services based, as they are, on a social model of health. CHP area teams are made up from a cross-section of health and social professionals with their own areas of speciality and expertise.

The South West Glasgow CHP decided to look at ways in which they could be more responsive to the needs within the community in the area of mental health provision. This included the premise that experiencing inequalities had the most profound effects on mental well-being. These inequalities spring from cultural, social and biological factors.

A project team was formed to explore these inequalities and develop a proposal, “To develop an inequalities-sensitive approach, with an initial focus on gender, with primary care mental health services provision in relation to policy and practice and community bridge-building.”

There were two key areas within this:

Policy and practice
>>Understanding the impacts of inequalities on mental health.
>>Identify the significance of experience of inequalities on the service users.
>>Promote partnership and a coordinated approach in addressing inequalities.
>>Implications for Greater Glasgow Primary Care mental health development and mental health services development in general.

Development of community based preventative work
>>How to address inequalities.
>>Identify ways of developing good mental health.

A recommendation from a previous client suggested that I should be asked to advise the team, in my capacity as an information professional, on how they might move forward.

How I scoped out the search
The team was keen on an “evidence based search”. Not all team members were exactly sure what this meant, so I explained it. I discussed the availability and quality of material from sources such as think tanks, academic centres of excellence and the charity and voluntary sector agencies.

Many of the team members were very keen to have searches done on the large biomedical databases such as Medline as they had used them in the past. I explained that there was a range of databases, what they covered and why some would be very useful for certain areas of the search, but would be poor in others. For example, clinical interventions for mental heath would be well covered in the biomedical databases but for the searches covering inequalities such as deprivation, poverty, social exclusion, education and housing other sources would be more beneficial. It was also important that they understood the best outcome of biomedical database searching would be the use of controlled language (MESH) searching in combination with natural language searching.

There was a great deal of discussion on not only the definition of the key topics, but also their scope. For example, there was much debate when I asked the basic question, “How would you define mental health?”. One of the other key questions I asked was whether they wished to exclude alcohol and drug misuse from the search as they are very much linked to mental health issues.

Sometimes it is easy to forget the importance of the scoping stage of a literature search. It can be time intensive, but it is necessary to pinpoint the exact resources relevant to the project. Asking the very simple questions should also not be ignored. It is worth remembering that team members are the subject specialists and will generally be quite flattered and impressed by your attention to detail.

I realised from the discussions with the team that what they needed was a value-added literature search. The resulting documents would provide “portfolios of knowledge” on each of the key topic areas. These would provide insight into the:
Search strategy: Clear concise and transparent search terms that comprehensively covered their key topic areas.
Search results: Ordered results clearly identified with commentary on the dividends of each of the search
strategies.
Topic ordered documents with abstracts and commentary: The documents would be immediately useable and in a portable format.

Producing my scoping document
In order to deliver such a comprehensive search within a limited period, good planning is paramount. From the initial meeting with the team I produced a short scoping paper bringing together all the important relevant details of the project. This included:

Aim and purpose
>>Identification of topics to be searched.
>>Definition and scope of topics.

Sources to be searched
>>Databases: biomedical, social science and others.
>>Lists of key organisations.

Timetable
>>Key dates and milestones.
>>Monthly update reports.

Delivery
>>Format and style of final documents.

Financial Considerations.
The production of the scoping paper is not a one-off event – there can be several versions. This is the core document that will guide the research and chart progress, so getting it right before the search begins is essential for a successful project. It also ensures that both parties are on the same wavelength, and that as a project team all members are working towards the same outcomes.

Update reports
One of the most important tools to ensuring the success of the literature search is the monthly update report. This was where the ‘reality’ of the search became apparent. The client feels happy that they are getting regular reports and sees the project moving on. They also get the chance to clarify areas, or in some cases to ask for some further work. It also works in the favour of the information
professional as you are able to write up sections of the final document as you go along.

The update report should include:
>>Listing resources found so far.
>>Progress of the project in relation to the overall project plan.
>>What evidence the search was finding or was missing.
>>Topics that needed further clarification and definition.
>>Topics that were highlighted in the search results but not in the original brief.
>>A moving forward section.

I am very keen on the updating process as it increases confidence in the project for both parties and keeps the lines of communication open.

The final product
The knowledge portfolios I produced comprised a series of directory-style documents, each devoted to one of the key topics: race, gender, ethnicity, social exclusion and interventions (clinical and complementary). The final documents included chapters on: Aim; Methodology; Resources searched: databases and “grey areas”; Resource listing with full bibliographic details and abstract; and Commentary on the searches.

Although these documents were all-encompassing for the broad topic areas, they also provided tailored made sub-topics which were easy to access and allowed for the individual professionals within the team to select the most appropriate sections for them.

Outcomes and impact of the search
The aim of the literature search process was for the CHP team to move one step closer to a new model of mental health services provision. The output from the search and the knowledge portfolios would help team members
gather their thoughts and become better acquainted with the evidence ‘out there’. The initial feedback has been very positive. I look forward to hearing from the team in the near future about its impact. IS

Joanna Ptolomey is a qualified librarian and freelance information professional involved in research and consultancy. She has held positions in the business sector and the NHS as a librarian.

Information Scotland Vol. 4(4) August 2006

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