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Clinical Librarianship

Clinical Librarianship. Kimberly Hancock, B.A., M.L.S. Regional Library Services Western Health. Objectives. Definition History Role of Clinical Librarian Evaluation of Clinical Librarian Services Library Services at Western Health. Definition.

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Clinical Librarianship

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  1. Clinical Librarianship Kimberly Hancock, B.A., M.L.S. Regional Library Services Western Health

  2. Objectives • Definition • History • Role of Clinical Librarian • Evaluation of Clinical Librarian Services • Library Services at Western Health

  3. Definition • Clinical Medical Librarian (CML) services involve placing medical librarians at the point of decision-making within acute care institutions (Sladek 2004) • “Providing quality filtered information to clinician at the point of need to promote evidence-based health care”(Winning & Beverly, 2003)

  4. Clinical Medical Librarian • Takes the Library to the user • Often provides information before they have asked for it

  5. Goals of CML Services • To overcome the time, cost and expertise barriers that clinicians face when they attempt to incorporate the best current evidence from the literature into their patient care decisions. • To enhance the educational experience of students and resident physicians in training.

  6. History • Originated in the United states 1970s • Funding from the National Library of Medicine • University of Missouri - Kansas City School of Medicine 1971 – Gertrude Lamb • Hartford Hospital and the University of Connecticut Health Center 1974

  7. History • Four programs by 1974 • 23 Programs in 1985 • 29 Programs in 1993 • (Bull Med Lib Assoc 2000)

  8. United Kingdom Trends • Developing new Clinical Librarian programs • Adapting or adding to existing library information services • Response to Clinical Governance movement and evidence based health care

  9. Clinical Librarian Core Duties • Attendance at ward rounds, case conferences, other clinical meetings • Clinical guidelines development • Information searching • Information evaluation • Teaching • Service promotion (Sargeant, 2004)

  10. New Profile of the Clinical Librarian • Expert knowledge • Involved with professional team • Attend bedside rounds / clinical meetings • Contribute to continuing education • Impact patient care • Provide quality filtered case specific information • Provide immediate responses at the “point of care” • Define the clinical problem

  11. Role of Clinical Librarian • Searching or helping to search for Evidence • Evidence educators • Dissemination of information • Collaboration • “Infomediaries” between patients and physicians

  12. Core Competencies / Education • Familiarity with Medline, CINAHL and other relevant health databases • Hand-held technology • User education • Project management • Medical terminology courses (Sargeant, 2004)

  13. Who uses Clinical Librarian Services • Medical Staff • Nursing and midwifery • Allied Health Professionals • Clinical Governance and related staff • Other groups i.e. bioengineers and social workers

  14. How is contact made? • Email • Clinical meetings • Personal / informal contacts • Ward rounds

  15. Clinical Librarians’ Activity • Literature searching 12% • Teaching 11% • Meetings with health professionals 12% • Other information services average 9-28% (Ward, 2004)

  16. What information is provided • 100% send list of bibliographic citations • 50% include search strategy • 65% include a digest / summary of the results found

  17. Challenges • Role definition for Librarians • Budget • Staff development for Clinical Librarians • Workload stress • Acceptance of Clinical Librarian services by other health professionals

  18. Evaluation of Clinical Librarian Services • Wagner Review 2004 • 35 studies over 30 years using formal evaluation methods • Mostly descriptive surveys of user opinions, inconsistent statistics • Comparative quantitative research methods very rare – only four studies

  19. Evaluation • Cumulative evidence finds the CML program users find the information resources provided useful and good quality. • However, no measurement of impact on direct patient care i.e. LOS, mortality, adverse drug effects etc.

  20. Areas for Research • Settings for CML • Impact of changing healthcare landscape • Kind of work schedule • Optimal ratio of CML to healthcare professionals • Training or skill sets • Optimal length of time to evaluate a CML program • Effectiveness of anticipating information requests versus responding to direct requests • Which evaluation data gathering and analysis strategies most effective

  21. New Research • Banks 2007 • Study on decreased LOS associated with presentation of cases at morning report with librarian support • Demonstrated a decreased length of stay for librarian supported cases (3 days versus 5 for controls)

  22. Library Services at Western Health • Regional Library Services • Three full time staff, part time student staffing • Open 8:00 am to 10:00 pm Monday – Thursday, Friday 8:00 – 5:00; Saturday 9:00 – 5:00, Sunday 1:00 – 10:00

  23. Locations • WMRH– Level II • STRH– Close to Organizational Development • Legrow– Off main lobby • Other sites– resource room located in administration area and close to clinical areas

  24. Overview of Services • All services and resources are available throughout the region • Main collection in WMRH • Smaller core collections in other sites / departments

  25. Library Services • Literature Searches • Interlibrary Loans • Document Delivery • Table of Contents • Coin operated Photocopiers • Internet Access • Selected Dissemination of Information • Teaching Sessions

  26. Physical Resources • Books • Medicine • Nursing • Management • Allied Health • Consumer Health

  27. Physical Resources • Journals • 200 Titles • Medicine • Nursing • Allied Health • Management

  28. Physical Resources • Videos / DVD’s • Medicine • Nursing • Consumer Health

  29. Electronic Resources • Newfoundland & Labrador Health Knowledge Information Network (NLHKIN) • Pubmed • CINAHL • Cochrane • PsychInfo • Social Work Abstracts • Biomedicine Reference

  30. Electronic Resources • NLHKIN 1600 full text electronic journals • Links out to the full text from the databases • http://www.med.mun.ca/nlhkin/

  31. Library Marketing • Monthly general staff orientation • Orientation of all new physicians • Orientation of all new students • Brochure • Newsletter articles • Internet and Intranet pages

  32. Library Outreach • Meetings with clinical teams • Child Protection Unit Stephenville • Child Management Specialists • Psychology Professional Practice Group • Community Support Leadership Team • Maternal Child Unit staff • Psychiatry Unit • Social Workers • Medical Rounds

  33. Library Outreach • Organizational Integration Evaluation Teams • Population Health staff meetings • Information Management Team • Breastfeeding Action Group

  34. Library Usage Statistics

  35. Library Usage Statistics

  36. Library Services @ Western Health • Combination of models: • Traditional hospital library services • Academic Library Services • Some Clinical Librarian services

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