The North Wales The North Wales Clinical Librarian Clinical Librarian Project Project Jean Ryan Jean Ryan
Dec 30, 2015
The North Wales The North Wales Clinical Librarian Clinical Librarian
ProjectProjectJean RyanJean Ryan
OverviewOverview
BackgroundBackground RoleRole Day-to-day Day-to-day
featuresfeatures MarketingMarketing Progress to dateProgress to date
EvaluationEvaluation SuccessesSuccesses Barriers / Barriers /
dilemmasdilemmas Future Future
developmentdevelopment
BackgroundBackground What is a Clinical Librarian?What is a Clinical Librarian?
Originally conceived by Dr. Gertrude Lamb in Originally conceived by Dr. Gertrude Lamb in 1971 at the University of Missouri, Kansas City1971 at the University of Missouri, Kansas City
““to provide information quickly to physicians and to provide information quickly to physicians and other members of the healthcare teams; to other members of the healthcare teams; to influence the information seeking behaviour of influence the information seeking behaviour of clinicians and to improve their library skills; and clinicians and to improve their library skills; and to establish the medical librarian’s role as a valid to establish the medical librarian’s role as a valid member of the health care team”member of the health care team”
Cimpl, K. Clinical medical librarianship – a review of the Cimpl, K. Clinical medical librarianship – a review of the literature.literature.
Bulletin of the Medical Library Association Bulletin of the Medical Library Association 1985, 1985, 7373, 21-28, 21-28
Defining the RoleDefining the Role
Intermediary – takes the library to the Intermediary – takes the library to the useruser
EducatorEducator DisseminatorDisseminator Bridge the literature – practice gapBridge the literature – practice gap The evidence-based medicine process The evidence-based medicine process
parallels the clinical librarianship parallels the clinical librarianship process and offers opportunities for the process and offers opportunities for the CL to empower and educate usersCL to empower and educate users
Steps in EBM processSteps in EBM process
1.1. Formulate an answerable questionFormulate an answerable question
2.2. Track down the best evidence Track down the best evidence
3.3. Critically appraise the evidenceCritically appraise the evidence
4.4. Integrate with clinical expertise and patient Integrate with clinical expertise and patient valuesvalues
AdvantagesAdvantages Is part of the Library team & has access to all Is part of the Library team & has access to all
library resourceslibrary resources Has database and searching expertiseHas database and searching expertise Gets to know about users’ own clinical areas Gets to know about users’ own clinical areas
& specialties& specialties Tailored to specific needs of your teams/usersTailored to specific needs of your teams/users Can ensure questions arising at meetings are Can ensure questions arising at meetings are
answered on the basis of evidence from answered on the basis of evidence from published literaturepublished literature
Reduce information overload by providing Reduce information overload by providing the most clinically relevant materialthe most clinically relevant material
How It All StartedHow It All Started Long, long ago…………Long, long ago…………
Idea to pilot a CL serviceIdea to pilot a CL service Feb. 2003 Feb. 2003 Funding obtained Funding obtained Sept. 2003 CL starts in postSept. 2003 CL starts in post
Evaluation Partner Evaluation Partner Chosen Chosen Teams selectedTeams selected
Nov. 2003Nov. 2003 CL Project CL Project “operational” “operational”
June 2004June 2004 All baseline information All baseline information complete complete
Feb. 2005Feb. 2005 Final ReportFinal Report
TeamsTeams
The clinical The clinical librarian is librarian is working with:working with:
Conwy and Conwy and Denbighshire Denbighshire NHS TrustNHS Trust
NorthNorth West West Wales NHS TrustWales NHS Trust
North East Wales North East Wales NHS TrustNHS Trust
TeamsTeamsConwy & Conwy &
DenbighshirDenbighshiree
North West North West WalesWales
North East North East WalesWales
ICUICU Information Information Skills Training Skills Training
to Entire to Entire Community Community DirectorateDirectorate
Psychiatry Psychiatry Journal ClubJournal Club
Urology MDTUrology MDT OT Journal ClubOT Journal Club Psychiatry Psychiatry Evidence-Based Evidence-Based Practice GroupsPractice Groups
Lung MDTLung MDT
Nutrition Nutrition Support TeamSupport Team
CAP TeamCAP Team
Services On OfferServices On Offer Information skills Information skills
training / User training / User EducationEducation
Current awareness Current awareness updates updates
Expert literature search Expert literature search serviceservice
Develop resource lists Develop resource lists on requested topicson requested topics
Provide evidence for Provide evidence for development of new development of new guidelines / pathwaysguidelines / pathways
Day-to-Day JobDay-to-Day Job Variety is keyVariety is key Different Models - Different Models -
adopt to different usersadopt to different users Juggling act - Juggling act -
schedules, teams, schedules, teams, priorities, locations priorities, locations etc….etc….
Carefully manage Carefully manage workload & balance workload & balance time spent on each teamtime spent on each team
Value of Library Teams’ Value of Library Teams’ SupportSupport
Sell! Sell! Sell!Sell! Sell! Sell!
Marketing – key to successMarketing – key to success Need to have championsNeed to have champions Tailor publicity to specific teamsTailor publicity to specific teams Overcome ambivalence / resistanceOvercome ambivalence / resistance Promotion as key to successPromotion as key to success Warning: Warning: You will get very tired of hearing You will get very tired of hearing
your own voice!your own voice!
If it works it also increases the Library’s If it works it also increases the Library’s visibility & should raise profile visibility & should raise profile
Progress to Date:Progress to Date:
Six-monthly report, April 2004 – Six-monthly report, April 2004 – overview of Project to date and overview of Project to date and indication of service usageindication of service usage
Survey of UK Clinical Survey of UK Clinical LibrarianshipLibrarianship
University Hospitals of LeicesterUniversity Hospitals of Leicester Record of work practices for the Record of work practices for the
month of February 2004month of February 2004
Working Time Activities Working Time Activities February 2004February 2004
Working Time activities February 2004:Working Time activities February 2004:
Administrative ActivitiesAdministrative Activities 20%20% Attending Clinical MeetingsAttending Clinical Meetings 16.8%16.8% Other Meetings with health professionals (outside Other Meetings with health professionals (outside
Library)Library) 0.8%0.8% Literature SearchingLiterature Searching 25.6%25.6% Teaching information skillsTeaching information skills 17.2%17.2% Teaching critical appraisalTeaching critical appraisal 5.6%5.6% Preparing / Editing PresentationsPreparing / Editing Presentations 2.4%2.4% Meetings with other LibrariansMeetings with other Librarians 1.6%1.6% Ethics Committee & Evaluation Project Ethics Committee & Evaluation Project 8.4%8.4%
Working Activities Feb. Working Activities Feb. 20042004
20%17%
1%
26%
17% 6%
2%
2%
9%
Admin. Activities
Clinical Meetings
Other Meetings with HealthProfessionalsLit. Searching
Teaching Information Skills
Teaching Critical Appraisal
Preparing Presentations
Meetings with Librarians
Ethics Committee &Evaluation
Training in North West Training in North West WalesWales
109 people trained in Community to 109 people trained in Community to datedate
Two training sessions for GPsTwo training sessions for GPs One training session for General One training session for General
Practice staff & LHB staff Practice staff & LHB staff Internet searching, database Internet searching, database
searching, critical appraisal skills searching, critical appraisal skills are most in demandare most in demand
EvaluationEvaluation Evaluated by a team led by Dr. Christine Urquhart from the Evaluated by a team led by Dr. Christine Urquhart from the
Department of Information Studies, University of Wales, Department of Information Studies, University of Wales, AberystwythAberystwyth
Final report in March 2005 will recommendFinal report in March 2005 will recommendwhether service should continue and how it shouldwhether service should continue and how it shouldevolveevolve
Evaluation GoalsEvaluation Goals
Indicate whether the service has been Indicate whether the service has been successful and if it should continuesuccessful and if it should continue
How the service has affected clinical How the service has affected clinical practicepractice
Success factors and problem areasSuccess factors and problem areas Comparisons between the sites and Comparisons between the sites and
teamsteams Recommendations for future Recommendations for future
developmentdevelopment
ResearchResearch
Research into clinical librarianship Research into clinical librarianship has been lacking in the pasthas been lacking in the past
Opportunity to produce a seminal Opportunity to produce a seminal piece of work to guide the further piece of work to guide the further development of these servicesdevelopment of these services
See article by Kay Cimpl Wagner – See article by Kay Cimpl Wagner – Evaluating the Evaluating the effectiveness of clinical medical librarian programs : a effectiveness of clinical medical librarian programs : a systematic review of the literaturesystematic review of the literature; J Med Libr Assoc ; J Med Libr Assoc 92 (1) January 200492 (1) January 2004
FOR MORE INFO...
MethodologyMethodology
Variety of Evaluation methods to be Variety of Evaluation methods to be usedused
Qualitative:Qualitative: Questionnaires, Interviews, Feedback Questionnaires, Interviews, Feedback
Forms, Reflective Practice DiaryForms, Reflective Practice Diary QuantitativeQuantitative
Statistical data based on ILL requests Statistical data based on ILL requests and time spent on searches will provide and time spent on searches will provide an economic analysis of the servicean economic analysis of the service
ScheduleSchedule
Three questionnaires will be given to Three questionnaires will be given to participants at beginning, middle participants at beginning, middle and end of project. Interviews will and end of project. Interviews will also be held over the three phases of also be held over the three phases of the projectthe project
Jan Feb Mar Apr May Jun July Sep Oct Nov Dec
Phase 1Phase 1
Phase 2Phase 2
Phase 3Phase 3
Issues to be ExaminedIssues to be Examined
How CL fits into How CL fits into clinical teamclinical team
Contribution made Contribution made to clinical work of to clinical work of teamteam
How CL supports How CL supports clinical governanceclinical governance
Changes in users’ Changes in users’ information information seeking behaviourseeking behaviour
Cost-benefit analysis Cost-benefit analysis – time spent – time spent searchingsearching
Users’ awareness of Users’ awareness of evidence-based evidence-based resourcesresources
Information skills – Information skills – improved searching improved searching etc…etc…
Is CL service Is CL service empowering empowering enabling for users?enabling for users?
WARNING!WARNING!
Ethics Committees – a lot of Ethics Committees – a lot of Red TapeRed Tape Plan in advancePlan in advance This takes a lot of timeThis takes a lot of time Can hold up researchCan hold up research
SuccessesSuccesses
OT Journal ClubOT Journal Club Information Outreach TrainingInformation Outreach Training Nutrition TeamNutrition Team CAP Team CAP Team Psychiatry especially the Nurses’ Psychiatry especially the Nurses’
EBP groupsEBP groups ICU ???? ICU ????
ImpactImpact New ICU critical care protocol was developed New ICU critical care protocol was developed
on use of steroids in sepsison use of steroids in sepsis Provided evidence to develop protocol for Provided evidence to develop protocol for
rapid tranquilisation in psychiatric patientsrapid tranquilisation in psychiatric patients Evidence used to develop leaflet & Evidence used to develop leaflet &
questionnaire for Benzodiazepine Servicequestionnaire for Benzodiazepine Service Literature to support development of audit Literature to support development of audit
tool for breathlessness in lung cancertool for breathlessness in lung cancer Data to support update of TPN regimes for Data to support update of TPN regimes for
PharmacyPharmacy Evidence to support choice of cognitive Evidence to support choice of cognitive
screening tool in OTscreening tool in OT Have identified research gap for OT in CAP Have identified research gap for OT in CAP
teamteam
Dilemmas / ProblemsDilemmas / Problems
Resistance Resistance Lack of time vs. Lack of time vs.
Lack of priorityLack of priority Lack of feedbackLack of feedback Scheduling – Scheduling –
ICUICU Rapid rotation of Rapid rotation of
staffstaff
Future PlansFuture Plans
““Library Clinics” for communityLibrary Clinics” for community Database of questions and use of Database of questions and use of
CATmaker software at Psychiatry CATmaker software at Psychiatry Journal ClubJournal Club
Overhaul of ICU and Psychiatry Overhaul of ICU and Psychiatry Journal Clubs Journal Clubs
Psychiatry Nurses EBP Group – Psychiatry Nurses EBP Group – training training
EvaluationEvaluation
Key Characteristics of a Key Characteristics of a CLCL
FlexibleFlexible PatientPatient OptimisticOptimistic MotivatedMotivated Good CommunicatorGood Communicator Teaching SkillsTeaching Skills PatientPatient ProactiveProactive Long Arms!Long Arms!
No standard.No standard.
Innovation is keyInnovation is key..
Should We All Be Doing Should We All Be Doing It?It?
Over to you!Over to you!
Jean RyanJean Ryan
Clinical LibrarianClinical Librarian
Glan Clwyd Hospital LibraryGlan Clwyd Hospital Library
Ph: (01745) 534729Ph: (01745) 534729
Email: [email protected]: [email protected]