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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
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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.
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Health Information Network
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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
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Setting & Subjects Ward of the 21st Century Yellow & Blue Teams Attendings Schedules
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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
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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
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Survey Results Figure 1 Agreement with a statement that clinical librarian can be helpful in clinical areas
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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!
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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
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Reviewer’s Comments Informationist versus Clinical Librarian
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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.
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What’s next? Article Multi- pre-appraised search tool How can we create a clinical librarianship program to work across Calgary Zone
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Questions
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