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 Rockyview General Hospital Knowledge Centre Alberta Children’s Hospital Knowledge Centre Peter Lougheed Knowledge Centre Women's Health Knowledge Centre Health Sciences Library (UofC) Tom Baker Cancer 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 stage Finding 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? StructureProcessOutcome 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