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There’s lots of really exciting improvement work going on at Taunton and Somerset NHS Foundation Trust. After a history of bringing in ad hoc external consultants and contractors, our Trust decided to invest in internal improvement expertise.

At Taunton and Somerset we’ve invested in a full time dedicated Improvement Librarian to help us on this journey

Our improvement team has grown dramatically over the last 12 months and is made up of Improvement Advisors, Project Managers, Process Analysts, Benefits Realisation and Project Support. Our mission is to accelerate improvement by using tried and tested improvement methodology to improve care for our patients.

Underpinning the improvement projects is what I term ‘evidence based improvement’. This is all about accelerating improvement by signposting and sharing knowledge and evidence that might help the project team.

There are very few projects or initiatives in the NHS that are unique- we all face common challenges. Outpatients, A&E, theatre utilisation, delayed discharges, patient flow are just a few that immediately spring to mind.

There’s no single knowledge repository or ‘go to’ place to find peer reviewed accounts of what a project did or its results

Yet we have a tendency to operate in silos. We reinvent the wheel. We start from scratch. We address a problem as though it was new. It might be new to us, but in our heart of hearts we know someone else somewhere must have done some work on it before. But we don’t know who, or where, or where to start in trying to find them. We wouldn’t prescribe medicine without consulting the evidence, yet, as improvers day in day out we routinely ‘prescribe’ improvement with our improvement projects or ideas without consulting the evidence of what others are doing or have tried.

More than a ‘lessons learned’ document…

Evidence based improvement is about enabling the person with the problem to benefit from the learning and experience of the person who’s faced it before. It’s more than reading a lessons learned document. It’s about understanding the journey that others have taken, what they tried, what they didn’t.  It’s about using and building on their documentation and templates. It’s about doing what they did, better.

It’s also about signposting improvers to resources that might help them on their improvement journey. Helping them stay abreast of what’s going on in their field, and helping them benchmark their own service or work against others doing something similar. We are constantly scanning for anything (from pictures, to videos, to articles and publications) that could help our improvement team in their job. We accept requests from the teams working on projects. This might be to help them get up and running on an unfamiliar area or it could be a detailed technical question about the evidence about a proposed change. We also proactively disseminate improvement related evidence and ‘horizon scanning’.

Support for QI project write-ups

Another string to our bow is in helping write up improvement projects. Our experience is that improvers don’t always have the time or capacity to document their improvement journey. Nor is there a professional requirement to write articles or present at conferences, unlike their clinical counterparts. So there’s no single knowledge repository or ‘go to’ place to find peer reviewed accounts of what a project did or its results. We aim to help our teams by writing up their projects so that their learning can be shared outside of our trust.

At Taunton and Somerset we’ve invested in a full time dedicated Improvement Librarian to help us on this journey. This unique role is all about bridging evidence and translating it into practice. We unite the evidence with those who need it in a form that is easy to digest. The service is in its infancy (our improvement librarian has been in post for less than 3 months) but is proving tremendously popular and receiving fantastic feedback from everyone who benefits from it. We are now receiving requests to share our evidence updates regionally and nationally. We’d love to hear from Q members about whether they have this kind of service.


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