an eidm journey: help is out there!
TRANSCRIPT
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An EIDM Journey
Help is out there!
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Presenters Today
• Megan Ward, MD MHSc CCFP FRCP(C): Associate Medical Officer of Health, Peel Public Health
• Bev Bryant, BScN, Med: Manager Education and Research, Peel Public Health
• Lori Greco, MHSc: Knowledge Broker, health-evidence.ca
• Jessie McGowan, PhD: Health and Library Consultant, Toronto; Adjunct Professor, Departments of Medicine and Family Medicine, University of Ottawa; Associate Editor, Journal of Clinical Epidemiology
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Peel Public Health
• 1.3 million population
• Mississauga, Brampton and Caledon
• 624 FTE
• Annual growth of 30,000
• Ethnically diverse
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Vision:
Broad application of EIDM processes among Peel Public Health staff at all levels over the next ten years, resulting in the systematic inclusion of research evidence into decision making.
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The REAL VISION
• Striding into Dr Mowat’s Office!
• Peel Public Health reports are a MUST read!
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CHSRF Survey
• Library services lacking profoundly
• Time/skill to follow an evidence informed process
• Question formulation, search, critical appraisal skills, synthesis and applicability
• No consistent requirement for use of evidence
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But:
• Strong support from Senior Management
• Strategic priority
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Missing Components
• Library services, especially reference
• Access to and knowledge of high quality information, especially pre-processed and pre-appraised
• Building workforce capacity and skill
• Process of bringing evidence to practice questions
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For Today
• Our focus is on the first two– with a taste of training!
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Library Needs assessment
• Lack of access to information– Databases– On line and print journals– Search expertise– Low reference service capacity
• Lack of skills • “Work-Arounds”• Low use
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But, there was some awareness:
• Preference and value pre-processed and pre-appraised literature
• Value of evidence-based philosophies• Demand for more training
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Two years later: Library
• Two reference librarians
• Appropriate databases and access
• Improved web-presence
• High demand for service
• Beginning ‘PUSH’ activities
• Library as knowledge hub
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Two (or more) Years Later: EIDM
• Staff to critical appraisal training
• Process for ‘rapid review’ of the evidence
• Increasing access to pre-processed and pre-appraised sites
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One of the helpers along the way:
Health-Evidence.ca
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Pre-processed literature
Examples:• Guidelines• Policy briefs• Overviews• Systematic reviews
Pre-processed
DiCenso, Bayley, & Haynes, 2009
Single studies
Syntheses
Synopses of syntheses
Summaries
Systems
Synopses of single studies
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Synthesized Research Value:
• Summarize the existing best information to give a picture of what is currently known
• Saves time of reading individual studies
• More reliable results than individual studies
• Respond to a large scope of questions to provide guidance in practice
Work has been done for you!
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MethodsRigorous scientific methods:• Develop question • Identify criteria for included studies• Search for literature• Apply inclusion, quality criteria• Analytic synthesis of findings• Draw conclusions• Practice implications (guidelines, policy
briefs)
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Maureen Dobbins
Director
Paula Robeson
Knowledge Broker
Heather Husson Project ManagerKara DeCorby, Project Coordinator
Lori Greco
Knowledge BrokerDaiva Tirilis
Research Assistant
Lyndsey McRae
Research Assistant
Robyn Traynor
Research Assistant /
Coordinator
The Health Evidence Team
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Health-evidence.ca
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Health-evidence.ca
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Health-evidence.ca
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Health-evidence.ca
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Other Health Evidence Services
• Facilitated Evidence Review
• Literature Searching & Instruction
• Mentoring & Brokering Support
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More help along the way:
Library Services Consultation
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6S Hierarchy
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Canadian context
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Here’s the interactive part:
• Anatomy of a systematic review
• Four simple questions
• Example of pre-processed literature
• Where to find pre-appraised literature
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Reflections:
Your organization
• Where are you on the journey?
• Is there a small step you can take?
• Is there help that you can access?
• Some resources for help…
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Help:
• Health evidence.ca:
http://health-evidence.ca/• Canadian Virtual Health Library:
Welcome to the Canadian Virtual Health Library! | CVHL
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More help:
• Donna Ciliska with NCCMT– National Collaborating Centre for Methods an
d Tools
• CHSRF Assessment Tool
Is research working for you? CHSRF - Self-Assessment Tool
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More Help on Pre-appraised:
Sources of pre-appraised evidence– NCCs http://www.nccph.ca/en/home.aspx– CDC comm guide
http://www.thecommunityguide.org/index.html– Public health +
http://www.nccmt.ca/tools/public_health_plus-eng.html– NICE http://www.nice.org.uk/– Cochrane library
http://www.thecochranelibrary.com/view/0/index.html– Campbell collaboration
http://www.campbellcollaboration.org/
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The following links provide help on the steps of bringing evidence to a practice question
Taken from Peel Public Health’s Library Website: Public Health: Peel Health Library
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Conceptual Model
• Worksheet : Peel Health Library: Step 1 – Developing a Conceptual Model
• CDC Community Guide– Every guideline has a framework– The Community Guide - Diabetes Prevention
and Control
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Question and Search
• Plain language and PICOT format:• Sources of pre-appraised evidence
– Health evidence.ca http://health-evidence.ca/– NCCs http://www.nccph.ca/en/home.aspx– CDC comm guide http://www.thecommunityguide.org/index.html– Public health +
http://www.nccmt.ca/tools/public_health_plus-eng.html– NICE http://www.nice.org.uk/– Cochrane library
http://www.thecochranelibrary.com/view/0/index.html– Campbell collaboration http://www.campbellcollaboration.org/
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Critical Appraisal
• Healthevidence.ca review tool http://health-evidence.ca/tools
• CASP tools http://www.sph.nhs.uk/what-we-do/public-health-workforce/resources/critical-appraisals-skills-programme
• AGREE II tool http://www.agreetrust.org/resource-centre/training/introduction/
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Data Extraction
• Peel Public Health Tool• Adapted from NCCMT
– Table, templatePeel Health Library: Tools for Rapid Reviews
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Applicability and Transferability
• NCCMT website http://www.nccmt.ca/
• http://www.nccmt.ca/pubs/2007_12_AT_tool_v_nov2007_ENG.pdf
• Stop a program
• Start a program
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Report Structure
• CHSRF 1:2: 20 (1:3:25)http://www.chsrf.ca/publicationsandresources/pastseries/communicationnotes/10-06-01/d497a465-5398-4ec8-addf-d7cbf86b1e43.aspx
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Manager’s Checklist
• Our tool http://www.peelregion.ca/health/library/manager-checklist.asp
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Contact Information
• Megan Ward: [email protected]
• Jessie McGowan: [email protected]
• Lori Greco: [email protected]
• Bev Bryant: [email protected]