At the start of the week I had the pleasure of presenting at the 2008 Clinical Librarian Study Day. I was tasked with talking about quality standards in Q&A. This was a tough subject to do justice. I’ve worked hard for ten years on Q&A yet had never really thought about ‘standards’. So it took a while to distill my thinking into reasonable standards.
I came up with two types of standards:
Easy standards are the ones I consider self-evident e.g.
- Competency in searching various databases
- Return answers in an agreed time
- Keep responses to a reasonable (brief) length
- Answers should be referenced
But adhering to these standards means very little.
Real standards are the ones I think mean something and are perhaps less obvious and I came up with 7:
- Competency of answerer
- Correctness of answer
- Boundaries of Q&A
- Quality control
Competency of answerer. It’s relatively straightforward to search medline and learn to appraise. However, it’s much harder to understand the clinical context. This involves trying to understand the motive for the question, what it actually means, the sort of evidence required and knowing when the question has been answered.
Transparency. This is not as simply as linking to an article informing users about the process. It’s ensuring that they actually know what the process is and potential shortcomings.
Communication. Linked with transparency this relates to simple things such as using a clear narrative to more interesting challenges – such as explaining uncertainty.
Feedback. Is there easy feedback from the user but also from others viewing the service? We receive a small amount of feedback, we should get more!
Correctness of answer. Is the correct answer given? A tough question to answer..
Boundaries of Q&A. A bit vague this one, but when/where should a ‘quick and dirty’ Q&A service operate. I often worry that we spend too little time on questions, rushing off to answer the next one. Other areas worry me such as high-risk questions – but then we pass them through to our clinical director to check. But every now and then I worry that we’re going beyond what we should be doing.
Quality control. Is there a QC system? We have internal and external systems, I’m pretty sure they’re robust – but an important standard all the same.
With ATTRACT and the NLH Q&A Service we could improve, I’m thinking particularly of transparency and feedback. We’ll be addressing both these issues (and others) with TRIPanswers.
Of the seven I think the two really important standards are Competency of answerer and Transparency.