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Spreading journal clubs across primary care The Quality: MK experience LfN 28 November 2008. Anne Gray Outreach Librarian, MK PCT. 1. Milton Keynes. Unitary authority Relatively small geographic footprint One general hospital One PCT (Commissioning and Provider arms)

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spreading journal clubs across primary care the quality mk experience lfn 28 november 2008
Spreading journal clubs across primary care The Quality: MK experienceLfN 28 November 2008

Anne Gray

Outreach Librarian, MK PCT

1

milton keynes
Milton Keynes
  • Unitary authority
  • Relatively small geographic footprint
  • One general hospital
  • One PCT (Commissioning and Provider arms)
  • 28 General practices, all with a number of GPs and nursing staff
quality mk programme
Quality: MK programme

“A whole system approach to improving health care in Milton Keynes driven by primary care, patient engagement and evidence-based practice.”

introducing journal clubs
Introducing Journal Clubs
  • Held in 4 GP practices
  • First meeting led by GP from Centre Evidence Based Medicine (CEBM), Oxford University
  • Rapid critical appraisal methodology examining published controlled trials
  • Written record of meeting to document appraisal, discussion, clinical impact
  • Discussion around next meeting

Aim to use the evidence to improve patient care (not education)

slide6

PCT/ health:mk

Patients

Clinicians

Questions

Specific answerable question

Track down best evidence

Critically appraised articles

NICE guidelines

Map of Medicine pathways

Expert opinion

Review action plans

Evidence based clinical discussion cycle

Evidence based discussion groups

Implement & audit

Action plan

Apply the evidence

track down best evidence
“Track down best evidence”

Quality:MK

  • Primary literature (RCT)
  • Evidence synopses (Evidence Based Medicine journal or OTSeeker)
  • Secondary literature (Cochrane review)
  • NICE guidance
  • Map of Medicine
  • Expert opinion

Journal clubs

 Evidence based discussion groups

evidence based discussion groups
Evidence based discussion groups
  • So what – what are the implications of the evidence?
  • Different forms of evidence add variety and maintain interest
the librarian s role
The Librarian’s role

Quality:MK

Searches to find a suitable publication

Get the articles and distribute them

Prepare ourselves by reading the articles

Participate in the meeting in the practice

Guide the discussions

Write up a draft report of the meeting

Check actions carried out

Be in touch with the feelings of the group

Cajole and persuade to maintain momentum

toolkit
Toolkit

Quality:MK

10

Journal club Leaflet

Core resources for evidence based medicine

Critically appraised topic templates

Search request forms

Search result forms

Attendance record

20/5/2008 Taunton

critically appraised topics cats
Critically Appraised Topics (CATs)
  • Record of the meeting
  • Bibliographic details
  • Study methodology
  • Brief study appraisal
  • Results
  • Record of discussion, clinical impact
  • Follow up actions (if any)
  • Drafted by librarian, signed off by clinician
ebdgs across mk
EBDGs across MK

4 journal clubs in April 2007

As of November 2008

  • 5 GPs
  • Public health staff
  • 4 provider teams (OT, Learning disabilities, CAMH, diabetes specialist nurses)
  • GP VTS trainees
successes so far
Successes so far

Quality:MK

13

Clarification of procedures / protocols within and across practices

Highlighting differences in prescribing practice within surgery and move towards consistency

Increase in knowledge

Changes in practice

Audits of drug use

questions
Questions?

14

  • For further information contact
    • Anne Gray, Outreach Librarian, MKPCT
      • Outreach.librarian@mkpct.nhs.uk

Quality: MK website

http://www.miltonkeynes.nhs.uk/default.asp?ContentID=1359