1. Mount Sinai Hospital, Toronto Mount Sinai Hospital is a fully accredited health care and teaching facility, affiliated with the University of Toronto. Located in downtown Toronto, Canada, our hospital has approximately 465 beds, servicing a diverse multicultural community.

2. Centres of Excellence The primary centres of excellence include, maternal, fetal and newborn health, surgical oncology, musculoskeletal disease, gastrointestinal disease and molecular sub-specialty medicine.

3. Sidney Liswood Library Sidney Liswood Library serves 6300 staff and students at Mount Sinai Hospital. Our goal is to better meet the information needs of our students, researchers and clinicians, which in turn leads to improvements in education, research and quality of patient care.

4. Assessment The Sidney Liswood Library selected the best clinical decision-making tools for Mount Sinai Hospital’s centres of excellence. Based on these choices, an Intranet-accessible flowchart was designed.

5. Identified Need The EBM Resources Toolkit is a practical complement to our teaching of Evidence-Based Medicine at Mount Sinai Hospital. The resources provided are hyperlinked on the Sidney Liswood Library Intranet. These electronic resources assist in answering clinical questions.

6. Implementation The evidence-based section of the Sidney Liswood Library Intranet integrates additional Evidence-Based Medicine teaching resources. “An answerable clinical question” opens to a PICO format template. The Sidney Liswood Library is in the formative stages of bringing Evidence-Based Medicine to the point of care.

15. UpToDate Subscription-based clinical information resource Comprehensive - designed to provide concise, practical answers Topic reviews written by physicians

16. Search terms may be a disease, a particular symptom, or a drug name

18. It recognizes most medical terms, common abbreviations and word roots

19. Can change this setting

23. When to introduce When to introduce disease modifying antirheumatic drugs

30. Results The EBM Resources Toolkit is a pathway that assists in seeking and searching for best evidence. The toolkit offers a practical guide to resources for clinical questions of therapy, etiology/harm, diagnosis and prognosis. The EBM resources provide an outline of Sidney Liswood Library’s best external evidence for clinicians and allied health professionals.

31. Benefits Effective and efficient use of the researcher’s time. Useful aid for introducing the teaching of Evidence- Based Medicine and Evidence-Based Practice. Considerable added value to having access to resources electronically.

32. Limitations The Sidney Liswood Library does not subscribe to all Evidence-Based Medicine resources. Current site licenses restricts direct access to additional EBM resources at the University of Toronto Libraries.

33. Next Steps Introduction of this flowchart with hyperlinked resources for PDA (Personal Digital Assistant) use. Pursue feedback from our clinicians, allied health professionals and librarians.

34. Please forward all suggestions or comments about this flowchart to: Sandra Kendall, B.A., M.L.S., Director, Library Services Mount Sinai Hospital 600 University Ave. 18th Floor Toronto, ON M5G 1X5 skendall@mtsinai.on.ca (T)416.586.4614 (F)416.586.4998 http://www.mtsinai.on.ca

35. Acknowledgement: Mrs. Jeannine Banack, Vice President Medical Administration and Special Services for her guidance and continuing support of this initiative.

36. Comments? Questions? Feedback?