Impact of a Six Month Clinical Librarian Trial in a Tertiary Care

Centre: a Controlled Study

Elizabeth Aitken eaitken@ucalgary.ca

International Clinical Librarians ConferenceJune 14, 2011

Beginnings

• Paradigm Shifts

• Clinical Librarian programs

• Intervention pilot in W21C• Hypothesis: Even with information literacy

education and the moving of systems toward easy interfaces, improved access and evidence-based medicine synthesis services, a clinical team can benefit from a clinical librarian intervention.

Health Information Network

Service Points

Rockyview General HospitalKnowledge Centre

Alberta Children’s HospitalKnowledge Centre

Peter Lougheed Knowledge Centre

Women's Health Knowledge Centre

Health Sciences Library(UofC)

Tom Baker Cancer Knowledge Centre

Setting & Subjects

• Ward of the 21st Century

• Yellow & Blue Teams

• Attendings

• Schedules

Intervention

• Morning handover, Intake, Review Patient List• Formal Education opportunities• Being present• Three roles:

– Education & mentorship to encourage independent ebm information retrieval

– Expedited search support and full-text delivery on request

– Anticipatory info provision based on attendance at bedside

Process & Methods• To Provide Clinical Information

– fast turnaround – patients don’t stay long – usually (IM is complex), physician changes often

– aim was ebm at bedside quickly – mixed results

– process – POC tools, clinical queries, medline/embase

• To Measure the Intervention– Pre and post survey

Survey Results

• Figure 1 • Agreement with a statement that clinical librarian

can be helpful in clinical areas

Qualitative comments made by the intervention group participants

• Useful to have someone dedicated to lit searches• We are more likely to use resources as w/o librarian +

resources available, we forget to look things up

• We just don't have the time, [to search] esp @ our clerk stage Finding evidence to help direct clinical decision making

And from the blue team:• Looked like the other team was learning a lot!

Study Characteristics

• Limitations– Single centre, single service, small sample– Self-reported behaviours– Teaching environment– Potential for “contamination” of control team

• What does this study add?– Large tertiary care centre, representative MTU– Controlled study– Impact on diagnosis & treatment plans

Reviewer’s Comments

• Informationist versus Clinical Librarian

Reviewer’s Comments

• Does a change in treatment plan or diagnosis automatically infer better patient care?

Donabedian A. 1980. Methods for deriving criteria for assessing the quality of medical care. Medical Care Review 37(7):653–698.Donabedian A. 1988. The quality of care. How can it be assessed? Journal of the American Medical Association 260(12):1743–1748.

What’s next?

• Article

• Multi- pre-appraised search tool

• How can we create a clinical librarianship program to work across Calgary Zone

Questions