clinical librarianship kimberly hancock, b.a., m.l.s. regional library services western health
TRANSCRIPT
Clinical Librarianship
Kimberly Hancock, B.A., M.L.S.Regional Library ServicesWestern Health
Objectives• Definition• History• Role of Clinical Librarian• Evaluation of Clinical Librarian
Services• Library Services at Western Health
Definition• Clinical Medical Librarian (CML)
services involve placing medical librarians at the point of decision-making within acute care institutions (Sladek 2004)
• “Providing quality filtered information to clinician at the point of need to promote evidence-based health care”(Winning & Beverly, 2003)
Clinical Medical Librarian
• Takes the Library to the user
• Often provides information before they have asked for it
Goals of CML Services• To overcome the time, cost and
expertise barriers that clinicians face when they attempt to incorporate the best current evidence from the literature into their patient care decisions.
• To enhance the educational experience of students and resident physicians in training.
History• Originated in the United states 1970s• Funding from the National Library of
Medicine• University of Missouri - Kansas City
School of Medicine 1971 – Gertrude Lamb
• Hartford Hospital and the University of Connecticut Health Center 1974
History• Four programs by 1974• 23 Programs in 1985• 29 Programs in 1993• (Bull Med Lib Assoc 2000)
United Kingdom Trends• Developing new Clinical
Librarian programs• Adapting or adding to existing
library information services• Response to Clinical
Governance movement and evidence based health care
Clinical Librarian Core Duties• Attendance at ward rounds, case
conferences, other clinical meetings• Clinical guidelines development• Information searching• Information evaluation• Teaching• Service promotion (Sargeant, 2004)
New Profile of the Clinical Librarian• Expert knowledge• Involved with professional team• Attend bedside rounds / clinical meetings• Contribute to continuing education• Impact patient care• Provide quality filtered case specific
information• Provide immediate responses at the “point of
care”• Define the clinical problem
Role of Clinical Librarian• Searching or helping to search for
Evidence• Evidence educators• Dissemination of information• Collaboration• “Infomediaries” between patients and
physicians
Core Competencies / Education • Familiarity with Medline, CINAHL
and other relevant health databases• Hand-held technology• User education• Project management• Medical terminology courses
(Sargeant, 2004)
Who uses Clinical Librarian Services• Medical Staff• Nursing and midwifery• Allied Health Professionals• Clinical Governance and related staff• Other groups i.e. bioengineers and
social workers
How is contact made?• Email• Clinical meetings• Personal / informal contacts• Ward rounds
Clinical Librarians’ Activity• Literature searching 12%• Teaching 11%• Meetings with health professionals
12%• Other information services average 9-
28% (Ward, 2004)
What information is provided• 100% send list of bibliographic
citations• 50% include search strategy• 65% include a digest / summary of the
results found
Challenges• Role definition for Librarians• Budget• Staff development for Clinical
Librarians• Workload stress• Acceptance of Clinical Librarian
services by other health professionals
Evaluation of Clinical Librarian Services• Wagner Review 2004• 35 studies over 30 years using formal
evaluation methods• Mostly descriptive surveys of user
opinions, inconsistent statistics• Comparative quantitative research
methods very rare – only four studies
Evaluation• Cumulative evidence finds the CML
program users find the information resources provided useful and good quality.
• However, no measurement of impact on direct patient care i.e. LOS, mortality, adverse drug effects etc.
Areas for Research• Settings for CML• Impact of changing healthcare landscape• Kind of work schedule• Optimal ratio of CML to healthcare professionals• Training or skill sets• Optimal length of time to evaluate a CML program • Effectiveness of anticipating information requests
versus responding to direct requests• Which evaluation data gathering and analysis
strategies most effective
New Research• Banks 2007• Study on decreased LOS associated
with presentation of cases at morning report with librarian support
• Demonstrated a decreased length of stay for librarian supported cases (3 days versus 5 for controls)
Library Services at Western Health• Regional Library Services• Three full time staff, part time student
staffing• Open 8:00 am to 10:00 pm Monday –
Thursday, Friday 8:00 – 5:00; Saturday 9:00 – 5:00, Sunday 1:00 – 10:00
Locations• WMRH – Level II• STRH – Close to Organizational
Development• Legrow – Off main lobby• Other sites – resource room located in
administration area and close to clinical areas
Overview of Services• All services and resources are available
throughout the region• Main collection in WMRH• Smaller core collections in other sites /
departments
Library Services• Literature Searches• Interlibrary Loans• Document Delivery• Table of Contents• Coin operated Photocopiers• Internet Access• Selected Dissemination of Information• Teaching Sessions
Physical Resources• Books
Medicine Nursing Management Allied Health Consumer Health
Physical Resources• Journals• 200 Titles
• Medicine• Nursing• Allied Health• Management
Physical Resources• Videos / DVD’s
• Medicine• Nursing• Consumer Health
Electronic Resources• Newfoundland & Labrador Health
Knowledge Information Network (NLHKIN)
• Pubmed• CINAHL• Cochrane• PsychInfo• Social Work Abstracts• Biomedicine Reference
Electronic Resources• NLHKIN
1600 full text electronic journals• Links out to the full text from the databases• http://www.med.mun.ca/nlhkin/
Library Marketing• Monthly general staff orientation• Orientation of all new physicians• Orientation of all new students• Brochure• Newsletter articles• Internet and Intranet pages
Library Outreach• Meetings with clinical teams
• Child Protection Unit Stephenville• Child Management Specialists• Psychology Professional Practice Group• Community Support Leadership Team• Maternal Child Unit staff• Psychiatry Unit• Social Workers• Medical Rounds
Library Outreach• Organizational Integration Evaluation
Teams• Population Health staff meetings• Information Management Team• Breastfeeding Action Group
Library Usage Statistics
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200
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1400
LiteratureSearches
2005
2006
2007
2008 Jan - Apr
Library Usage Statistics
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500
1000
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3500
DocumentDelivery
2005
2006
2007
2008 Jan - Apr
Library Services @ Western Health• Combination of models:
• Traditional hospital library services
• Academic Library Services
• Some Clinical Librarian services