Impact of a Six Month Clinical Librarian Trial in a Tertiary Care Centre: a Controlled Study

1. Impact of a Six Month Clinical Librarian Trial in a Tertiary Care Centre: a Controlled Study Elizabeth Aitken eaitken@ucalgary.ca International Clinical Librarians Conference June 14, 2011

2. 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.

3. Health Information Network

4. Service Points Tom Baker Cancer Knowledge Centre Rockyview General Hospital Knowledge Centre Health Sciences Library (UofC) Alberta Children’s Hospital Knowledge Centre Women's Health Knowledge Centre Peter Lougheed Knowledge Centre

5. Setting & Subjects • Ward of the 21st Century • Yellow & Blue Teams • Attendings • Schedules

6. 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

7. 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

10. Survey Results • Figure 1  • Agreement with a statement that clinical librarian can be helpful in clinical areas

14. 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 stageFinding evidence to help direct clinical decision making And from the blue team: • Looked like the other team was learning a lot!

15. 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

16. Reviewer’s Comments • Informationist versus Clinical Librarian

17. 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.

18. What’s next? • Article • Multi- pre-appraised search tool • How can we create a clinical librarianship program to work across Calgary Zone

19. Questions