Clinical Librarianship: A Systematic Review

1. Clinical Librarianship: A Systematic Review Alison Winning & Catherine Beverley Information Resources Section, ScHARR Evidence Based Librarianship Conference 3rd September 2001

2. Overview • Background • Aims of our review • Methods • Results to date • Conclusions

3. What is clinical librarianship? • The provision of quality-filtered case-specific information directly to health professionals in acute settings to support clinical decision making (based on Veenstra & Gluck, 1992)

4. Fact or fiction? • Is there evidence for clinical librarian (CL) programmes? • Can CLs have an impact on clinicians’ information skills? • Can an effect on clinical outcomes and interventions be measured? • Do clinicians value this service? • Are they cost-effective?

5. Cimpl’s (1985) review • Historical review 1971–1983 • Reasons to evaluate: • determine the quality of the service • measure cost • measure educational benefit to clinicians • Benefits of clinical librarianship • enhancement of patient care • greater awareness of library resources

6. Aims of our review • To build upon Cimpl’s review • To determine whether a CL service: • Improves patient care • Has an impact on clinicians’ use of the literature in practice

7. Methods • Application of NICE/CRD framework to health information topic • Inclusion and exclusion criteria • Search strategy • Quality assessment • Data extraction

8. Inclusion & exclusion criteria • Types of study • Types of participants • Types of intervention • Types of outcomes • General, relating to service use • Patient care • Clinicians’ use of the literature in practice • Cost

9. Inclusion & exclusion criteria (2) • Excluded studies: • Health science librarians providing a general hospital library service • Outreach librarians involved in education of remote HCPs • Initiatives outside the acute setting • Initiatives aimed at patients • Non-English language papers • Pre-1983 studies

10. Search strategy • Multiple methods: • Major information science, health & social science electronic bibliographic databases • Internet searches • Citation searches • Reference lists checked • Key journals handsearched

11. Quality assessment • CRISTAL checklist for user studies employed for evaluative studies • Checklist comprises three components (based on CASP): • Validity • Reliability • Applicability

12. Data extraction • Pre-determined data extraction form: • General information (e.g. bibliographic details) • Participant characteristics • Details about the intervention • Methods • Results for each outcome • Additional notes

13. Results … to date • Quantity of research: • 215 references retrieved • 166 references ordered • 12 studies met our inclusion criteria for evaluative studies • A further 29 studies met our inclusion criteria for descriptive studies

14. Results … to date (2) • Quality of research: • Poor reporting • Bias • Reliability & validity of approach • Representative sample group? • Failure to acknowledge limitations

15. General outcomes • Description of programmes • Service usage

16. Patient care • Improved patient care? • Impact on factors: • Advice given to patients • Choice of treatment • Choice of tests • Prevention of events • Additional tests/procedures

17. HCPs’ use of the literature • Ability of clinicians to find literature themselves • Utilisation of the literature by clinicians

18. Costs • No cost benefit analysis • Limited applicability

19. Conclusions • Implications for practice and research: • Evaluate CL programmes in practice • Longer follow-up periods to assess impact on patient care • Identification of use of the literature • Future research: • High quality studies with large, representative samples • Examination of clinical outcomes • Assessment of cost-effectiveness

20. Summary • Limited evidence for effectiveness of CL • Outcomes can be measured • Clinicians appear to value service, but this is not adequately explored in the literature • No information regarding cost-effectiveness