1. Outline Slide 1 of 20 Critical Care Literature updates delivered by handheld computer Mount Sinai Hospital & Interdepartmental Division of Critical Care Medicine University of Toronto Background Procedure logs Current project goals Literature reviews Examples Next steps

2. Outline Slide 2 of 20  Increasing use of handhelds by physicians Background CMAJ 2003, 169:952 Background Procedure logs Current project goals Literature reviews Examples Next steps

3. Outline Slide 3 of 20 Background  Increasing use of handhelds by physicians  Critical Care literature overload Large amount of excellent literature Incorporation in clinical practice takes time Difficulty keeping up to date Background Procedure logs Current project goals Literature reviews Examples Next steps

4. Outline Slide 4 of 20  Increasing use of handhelds by physicians  Critical Care literature overload  Critical Care trainees receive a PalmOS handheld device for procedure logging Background Background Procedure logs Current project goals Literature reviews Examples Next steps

5. Outline Slide 5 of 20  Increasing use of handhelds by physicians  Critical Care literature overload  Critical Care trainees receive a PalmOS handheld device for procedure logging  A handheld based procedure log has been implemented for the CCM training program Background Background Procedure logs Current project goals Literature reviews Examples Next steps

6. Outline Slide 6 of 20  Customized handheld procedure log developed to track trainees’ educational experience. Critical Care Procedure Logs Background Procedure logs Current project goals Literature reviews Examples Next steps

7. Outline Slide 7 of 20  Customized handheld procedure log developed to track trainees’ educational experience.  Internet-linked: allows data upload to a central server, accessible to the Program Director and to individual trainees Critical Care Procedure Logs Background Procedure logs Current project goals Literature reviews Examples Next steps

8. Outline Slide 8 of 20 Critical Care Procedure Logs Background Procedure logs Current project goals Literature reviews Examples Next steps

9. Outline Slide 9 of 20 Critical Care Procedure Logs Background Procedure logs Current project goals Literature reviews Examples Next steps infrared telephone line INTERNET

10. Outline Slide 10 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Critical Care Procedure Logs Data accessible via a secure website:

11. Outline Slide 11 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Literature Reviews: WHY?  Increased volume of medical literature  Increase complexity of medical literature  Frequent development of new therapies  Outdated medical texts

12. Outline Slide 12 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps  Implement a Critical Care literature review process  Post literature abstracts on a website and handheld devices  Facilitate “just in time” learning Literature Reviews: GOALS

13. Outline Slide 13 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Literature Reviews Sidney Liswood Library Mount Sinai Hospital Automated literature search based on key words and selected journals Critical Care Division Faculty Manual Literature search Clinically relevant articles selected Abstracts posted on Divisional website Journal club appraisals posted on website Handheld access through Avantgo Critical care trainees Critical care faculty Free access on web

14. Outline Slide 14 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Literature Reviews: METHODS

15. Outline Slide 15 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Web based Literature Reviews

16. Outline Slide 16 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Handheld Literature Reviews

17. Outline Slide 17 of 20 Background Procedure logs Current project goals Literature reviews Technology Next steps Naysayers 5%-10% Silent Majority 80%-90% Zealots 5%-10% It will never work Great idea! Go for it! Handheld Download of Reviews The Problems

18. Outline Slide 18 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps Next steps....  Optimize literature update process  automated search several months behind  manual search inconsistent  Increase users of handheld system  increase awareness  regular Journal Club appraisals  Obtain user feedback

19. Outline Slide 19 of 20 Presented by the Technology Application Unit, Intensive Care Unit, Mount Sinai Hospital Background Procedure logs Current project goals Literature reviews Examples Next steps Project Staff Stephen Lapinsky, Associate Professor, Dept. of Medicine Randy Showalter, Research Manager, TAU, Mount Sinai Hospital Sandra Kendall, Director, Sidney Liswood Library, Mount Sinai David Hallett, Biostatistician, ICU, Mount Sinai Hospital

20. Outline Slide 20 of 20 Background Procedure logs Current project goals Literature reviews Examples Next steps