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The North Wales Clinical Librarian Project

The North Wales Clinical Librarian Project. Jean Ryan. Background Role Day-to-day features Marketing Progress to date. Evaluation Successes Barriers / dilemmas Future development. Overview. Background. What is a Clinical Librarian?

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The North Wales Clinical Librarian Project

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  1. The North Wales Clinical Librarian Project Jean Ryan

  2. Background Role Day-to-day features Marketing Progress to date Evaluation Successes Barriers / dilemmas Future development Overview

  3. Background • What is a Clinical Librarian? • Originally conceived by Dr. Gertrude Lamb in 1971 at the University of Missouri, Kansas City • “to provide information quickly to physicians and other members of the healthcare teams; to influence the information seeking behaviour of clinicians and to improve their library skills; and to establish the medical librarian’s role as a valid member of the health care team” Cimpl, K. Clinical medical librarianship – a review of the literature. Bulletin of the Medical Library Association 1985, 73, 21-28

  4. Defining the Role • Intermediary – takes the library to the user • Educator • Disseminator • Bridge the literature – practice gap • The evidence-based medicine process parallels the clinical librarianship process and offers opportunities for the CL to empower and educate users

  5. Steps in EBM process • Formulate an answerable question • Track down the best evidence • Critically appraise the evidence • Integrate with clinical expertise and patient values

  6. Advantages • Is part of the Library team & has access to all library resources • Has database and searching expertise • Gets to know about users’ own clinical areas & specialties • Tailored to specific needs of your teams/users • Can ensure questions arising at meetings are answered on the basis of evidence from published literature • Reduce information overload by providing the most clinically relevant material

  7. How It All Started • Long, long ago………… • Idea to pilot a CL service • Feb. 2003 Funding obtained • Sept. 2003 CL starts in post Evaluation Partner Chosen Teams selected • Nov. 2003 CL Project “operational” • June 2004 All baseline information complete • Feb. 2005 Final Report

  8. Teams • The clinical librarian is working with: • Conwy and Denbighshire NHS Trust • NorthWest Wales NHS Trust • North East Wales NHS Trust

  9. Teams

  10. Services On Offer • Information skills training / User Education • Current awareness updates • Expert literature search service • Develop resource lists on requested topics • Provide evidence for development of new guidelines / pathways

  11. Day-to-Day Job • Variety is key • Different Models - adopt to different users • Juggling act - schedules, teams, priorities, locations etc…. • Carefully manage workload & balance time spent on each team • Value of Library Teams’ Support

  12. Sell! Sell! Sell! • Marketing – key to success • Need to have champions • Tailor publicity to specific teams • Overcome ambivalence / resistance • Promotion as key to success • Warning: You will get very tired of hearing your own voice! • If it works it also increases the Library’s visibility & should raise profile

  13. Progress to Date: • Six-monthly report, April 2004 – overview of Project to date and indication of service usage • Survey of UK Clinical Librarianship • University Hospitals of Leicester • Record of work practices for the month of February 2004

  14. Working Time Activities February 2004 • Working Time activities February 2004: • Administrative Activities 20% • Attending Clinical Meetings 16.8% • Other Meetings with health professionals (outside Library) 0.8% • Literature Searching 25.6% • Teaching information skills 17.2% • Teaching critical appraisal 5.6% • Preparing / Editing Presentations 2.4% • Meetings with other Librarians 1.6% • Ethics Committee & Evaluation Project 8.4%

  15. Working Activities Feb. 2004

  16. Training in North West Wales • 109 people trained in Community to date • Two training sessions for GPs • One training session for General Practice staff & LHB staff • Internet searching, database searching, critical appraisal skills are most in demand

  17. Evaluation • Evaluated by a team led by Dr. Christine Urquhart from the Department of Information Studies, University of Wales, Aberystwyth • Final report in March 2005 will recommend whether service should continue and how it should evolve

  18. Evaluation Goals • Indicate whether the service has been successful and if it should continue • How the service has affected clinical practice • Success factors and problem areas • Comparisons between the sites and teams • Recommendations for future development

  19. Research • Research into clinical librarianship has been lacking in the past • Opportunity to produce a seminal piece of work to guide the further development of these services See article by Kay Cimpl Wagner – Evaluating the effectiveness of clinical medical librarian programs : a systematic review of the literature; J Med Libr Assoc 92 (1) January 2004 FOR MORE INFO...

  20. Methodology • Variety of Evaluation methods to be used • Qualitative: • Questionnaires, Interviews, Feedback Forms, Reflective Practice Diary • Quantitative • Statistical data based on ILL requests and time spent on searches will provide an economic analysis of the service

  21. Phase 1 Phase 2 Phase 3 Jan Feb Mar Apr May Jun July Sep Oct Nov Dec Schedule • Three questionnaires will be given to participants at beginning, middle and end of project. Interviews will also be held over the three phases of the project

  22. How CL fits into clinical team Contribution made to clinical work of team How CL supports clinical governance Changes in users’ information seeking behaviour Cost-benefit analysis – time spent searching Users’ awareness of evidence-based resources Information skills – improved searching etc… Is CL service empowering enabling for users? Issues to be Examined

  23. WARNING! • Ethics Committees – a lot of Red Tape • Plan in advance • This takes a lot of time • Can hold up research

  24. Successes • OT Journal Club • Information Outreach Training • Nutrition Team • CAP Team • Psychiatry especially the Nurses’ EBP groups • ICU ????

  25. Impact • New ICU critical care protocol was developed on use of steroids in sepsis • Provided evidence to develop protocol for rapid tranquilisation in psychiatric patients • Evidence used to develop leaflet & questionnaire for Benzodiazepine Service • Literature to support development of audit tool for breathlessness in lung cancer • Data to support update of TPN regimes for Pharmacy • Evidence to support choice of cognitive screening tool in OT • Have identified research gap for OT in CAP team

  26. Dilemmas / Problems • Resistance • Lack of time vs. Lack of priority • Lack of feedback • Scheduling – ICU • Rapid rotation of staff

  27. Future Plans • “Library Clinics” for community • Database of questions and use of CATmaker software at Psychiatry Journal Club • Overhaul of ICU and Psychiatry Journal Clubs • Psychiatry Nurses EBP Group – training • Evaluation

  28. Flexible Patient Optimistic Motivated Good Communicator Teaching Skills Patient Proactive Long Arms! No standard. Innovation is key. Key Characteristics of a CL

  29. Should We All Be Doing It? • Over to you! • Jean Ryan Clinical Librarian Glan Clwyd Hospital Library Ph: (01745) 534729 Email: Jean.Ryan@cd-tr.wales.nhs.uk

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