Helping Pinch Hitters Step Out while Covering Home Base Francesca Allegri, Julia Shaw-Kokot, Kathleen A. McGraw, Karen Crowell Health Sciences Library University of North Carolina at Chapel Hill

Objectives: The Home Run Explore service models that allow us to… 1. Discover and fill unmet clinical info needs 2. Maintain quality and scope of existing services

The Warm Up Five health schools 600-bed teaching hospital Area Health Education Center Program “Everything I need is online” Still foul balls and strikeouts

Bases to Cover Today First Base First Base –Methods –Data sources Second Base Second Base –Covering home Third Base Third Base –Preliminary benefits and findings –Lessons learned Home Home –Next inning

First Base: Methods Short-term intensive involvement Short-term intensive involvement Track time needed to become accepted Track time needed to become accepted Identify client-desired measurable outcomes Identify client-desired measurable outcomes Conduct an environmental scan Conduct an environmental scan Recommend criteria for selecting clients Recommend criteria for selecting clients Establish free/fee structure Establish free/fee structure

First Base: Data Sources Roster of services and costs Written reports Calendar Time log Requests Learning activities Budget report Pediatrics data

Second Base: Covering Home Supporting our Information Associates

Second Base: Covering Home TRAINING Semester-long mentor program of IA or graduate assistant paired with librarian Semester-long mentor program of IA or graduate assistant paired with librarian Demo/training begins most department and IA meetings Demo/training begins most department and IA meetings STAFFING Designated holiday, weekend librarian-on- call/AskLib Salary increases, position reclass Librarian in dugout Shared LOH/phones off desk

Second Base: Covering Home REALLOCATION Use salary of vacant position as “seed” money Use salary of vacant position as “seed” money Redistribute responsibilities Redistribute responsibilities Reduce librarian hours at service desk Reduce librarian hours at service desk Create support tools for users and staff (user aids, expanded intranet) Create support tools for users and staff (user aids, expanded intranet) Make informal liaisons formal Make informal liaisons formal Give department head staff to supervise Give department head staff to supervise

Third Base: Findings Infectious Diseases Expert searches Monthly morbidity & mortality sessions Monthly morbidity & mortality sessions Case discussions during morning report Case discussions during morning report Publication, grant applications, presentations Publication, grant applications, presentations 81% requests generated while librarian on site (13/16)

Third Base: Findings GI Surgery Expert searches Pathophysiology conferences Pathophysiology conferences Journal club Journal club Current awareness Current awareness Research interests Research interests Patients’ questions Patients’ questions Introductions to new chief residents, residents, and fellows Learning objectives, hypothetical questions Grant applications

Third Base: Findings Pediatrics + 44% in searching for clinical info 3-4 times/wk + 44% in searching for clinical info 3-4 times/wk + 250% in searching for clinical info 5 or more times/wk + 250% in searching for clinical info 5 or more times/wk + 57% in use of PubMed to routinely find clinical info + 57% in use of PubMed to routinely find clinical info + 175% in choosing MDConsult when asked where to look for patient info on pediatric vaccinations + 175% in choosing MDConsult when asked where to look for patient info on pediatric vaccinations + 450% in choosing the AAP web site when asked where to look for practice guidelines + 450% in choosing the AAP web site when asked where to look for practice guidelines

Third Base: Findings General Identify department procedures or practices differing from norm Identify department procedures or practices differing from norm Identify and fill gaps in communication systems, knowledge of resources, and technology Identify and fill gaps in communication systems, knowledge of resources, and technology Share currently accepted practice or theory on topics being taught Share currently accepted practice or theory on topics being taught Generate more info requests with 20 listserv posts over 5 months Generate more info requests with 20 listserv posts over 5 months Embed dynamic search strategies in curriculum website ( will spend 86 hours searching for 98 topics) Embed dynamic search strategies in curriculum website ( will spend 86 hours searching for 98 topics)

Lessons Learned: Player Roster Free/Core AskALibrarian AskALibrarian Electronic resources Electronic resources Educational modules Educational modules Education sessions and support Education sessions and support Expert searches Expert searches Help with presentations Help with presentations Attending departmental meetings Attending departmental meetings Fee/Value Added Expert searches with vendor charges Collaborative projects with direct costs Attending teaching rounds Attending patient rounds Drop-in on site help Special projects (e.g., web development, collection building, PDA)

Lessons Learned: Resources One librarian = 4 clinical depts 25% on teaching rounds 25% on patient rounds 19% on site for drop in help 5% marketing services 26% learn culture, domain 20 hours/week of value added service costs $22,000 annually

Lessons Learned: Effective Learning Activities New terms and overviews Increase understanding Medical dictionaries Texts in Stat!Ref, UpToDate Sessions for med students MedLabRef (on PDA) for normal lab values Department seminars and conferences Performing literature searches

Lessons Learned: Effective Learning Activities New developments Publisher notifications (BMJ, JAMA, NEJM) AHRQ web site guidelines, quality tools Serendipity Current articles and news (AIDS Info at a Glance) AMIA newsletters Morbidity & Mortality web site

Next Inning Refine criteria Refine criteria Separate marketing roles Separate marketing roles Choose next clients Choose next clients Build in time or hire subject knowledge Build in time or hire subject knowledge Track requests generated Track requests generated Administer survey Administer survey