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Librarians Improving Health Care :

Librarians Improving Health Care :. Making a Difference. Indiana Health Sciences Library Association April 9, 2013. Holly Ann Burt, MLIS NN/LM Greater Midwest Region. Making a Difference. Traditional Services Literature Searches Evidence Based Research Beyond the library Rounding

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Librarians Improving Health Care :

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  1. Librarians Improving Health Care: Making a Difference Indiana Health Sciences Library Association April 9, 2013 Holly Ann Burt, MLIS NN/LM Greater Midwest Region

  2. Making a Difference • Traditional Services • Literature Searches • Evidence Based Research • Beyond the library • Rounding • Patient Education • Electronic Medical Records • Share the Results • Annual Reports • Articles

  3. Traditional Services

  4. Traditional services 1 • Library Services • References materials – online and in-print • Just in time information • Literature searches – responsive & proactive • Evaluation and synthesis of the literature • Survey of health professionals • 16,122 physicians, residents and nurses in 118 hospitals served by 56 libraries • Health professionals involved in patient care or clinical research • Remember an event in the past six months where they used an information resource

  5. Traditional services2 • Impact of library services • 75% stated they definitely or probably handled some aspect of patient care differently • 48% Changed advice given to patient • Saved an average of 2.5 hours • 19% Eliminated additional tests • 13% Avoided misdiagnosis • 12% Prevented medication errors • 6% Prevented patient mortality Marshall JG, Sollenberger J, Easterby-Gannett S, et al. The value of library and information services in patient care: results of a multisite study. J Med Libr Assoc. 2013 Jan;101(1):38-46. PMID 23418404.

  6. Beyond the Library

  7. Participation at Morning Reports • Morning Report • Case-based conference in which house officers, attending physicians, and the program director or department chair met to discuss the care of newly admitted patients • Librarian attended and offered follow-up literature • Results of a six month case controlled study • Reduced length of stay by an average of 2 days • Reduced costs by nearly $1400 per person Banks DE, Shi R, Timm DF, et al. Decreased hospital length of stay associated with presentation of cases at morning report with librarian support. J Med Libr Assoc. 2007 Oct; 95(4):381-387.

  8. Participation on ICUMultidisciplinary Rounds • Librarian services • Participation on the hospital Intensive Care Unit Multidisciplinary Rounds team • Response to specific requests • Identifying of questions and providing research • Three case reports, selected queries revealed • Patient care processes improved • Outdated patient protocols identified and changed • Evidence-based protocols established Brandes S. Experience and outcomes of medical librarian rounding. Med Ref Serv Q. 2007 Winter; 26(4):85-92. PMID: 18086644.

  9. Participate in the Magnet process • ANCC Magnet Recognition Program® • Accreditation by the American Nurses Credentialing Center (ANCC), American Nurses Association (ANA) • 14 focused areas (“Forces”) to improve quality patient care, nursing excellence and innovations in professional nursing practice • Librarian services • Address six Forces • Include traditional services • Provide evidence-based training and resources • Partner with nursing staff and leadership

  10. Participate in the Magnet process 2 • Results • Renewal of Magnet status • Increased nursing research studies • Increased number of nurse authors • Use of evidence at the bedside addressing fall prevention Rourke DR. The hospital library as a "magnet force" for a research and evidence-based nursing culture: a case study of two magnet hospitals in one health system. Med Ref Serv Q. 2007 Fall;26(3):47-54. PMID: 17915630

  11. Partnering with/for Patients • 18-month program • Patient information requests rose form 3%-30% • 46% requests focused on prognosis or treatment • 21% of in-patients sought information on psychological issues related to their diagnosis • Results • Hospital-wide commitment to patient education • Improved patient satisfaction • Focus on performance improvement Tarby W, Hogan K. Hospital-based patient information services: a model for collaboration. Bull Med Libr Assoc. 1997 Apr;85(2):158–66. PMID: 9160153.

  12. Partnering with EHR/EMR/PHR • MyHealthatVanderbilt • Electronic Health Record (EHR) with a patient portal • Provide appropriate health information for patients • Librarians work closely with healthcare teams • Selected topics are vetted; links connect diseases to patient-oriented information • Results • July 2006, 15% of patients using the portal accessed the library-provided links Koonce TY, Giuse DA, Beauregard JM, Giuse NB. Toward a more informed patient: bridging health care information through an interactive communication portal. J Med Libr Assoc. 2007 Jan; 95(1):77-81. PMID: 17252070. See also: Welton NJ. The University of Washington electronic medical record experience. J Med Libr Assoc. 2010 Jul;98(3):217-219. PMID: 20648254

  13. Partnering to Address Health Literacy • Pilot project at Harvard Medical School (HMS) • Low health literacy is associated with poorer health outcomes and poorer use of health care services • Focus on the importance of plain language communication • Partnership • Librarians provided education on health literacy and information sources • Medical students developed and taught 10-minute courses on specific topics • Adult students from literacy program attended and provided evaluation

  14. Partnering to Address Health Literacy 2 • Results of the 2008 project • 44% of adult learners learned about a specific health topic • 88% of medical students learned how to improve physician/patient communication • An elective course is under development • Library recourses on health literacy are expanded Hess J, Whelan JS. Making health literacy real: adult literacy and medical students teach each other. J Med Libr Assoc. 2009 Jul;97(3):221-224. PMID: 19626149

  15. Supporting an Evidence-Based Database • Family Physicians' Inquiries Network (FPIN) • Database of clinical questions and answers focused for family physician medicine at the point of care • 600+ Clinical Inquiries published in Journal of Family Practice, American Family Physician, and Evidence-Based Practice and available online (inc. PubMed) • Librarian - health professional partnerships • Systematic, evidence-based expert search process • 100 librarians in 21 states Ward D, Meadows SE, Nashelsky JE. Role of expert searching in the Family Physicians' Inquiries Network (FPIN). J Med Libr Assoc. 2005 Jan; 93(1):88-96. PMID: 15685280. Also see: http://www.fpin.org/

  16. Share the Results Annual Reports Articles

  17. Librarians Making a Difference • Dr. Robert Wachter: So, a medical school librarian set off the modern patient safety movement? • Lucian Leape, MD: Ergo, there we go. Wachter R. In conversation with Lucian Leape, MD. WebM&M. 2006 Aug: Perspectives on Safety. http://webmm.ahrq.gov/perspective.aspx?perspectiveID=28

  18. Librarians Improving Health Care In Summary: All of the roles of the library ultimately support Patient Safety - Michelle Eberle, 2007

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