Panel 3 Informationist and Rounding Services by Libraries

Librarian/informationist rounding was pioneered in the 1970s by Gertrude Lamb.  She would go on rounds, go back to library, conduct searches, and then connect articles to patient charts (LATCh – Literature Attached to Chart service).  R01 grants by NIH provides grants for Administrative Supplements for Informationist Services in NIH-Funded Research Projects.

Blair Anton, MS, MLIS – Johns Hopkins University

  • challenge: are they asking a reason due to clinical-problem that might lead to research or is a research question with clinical implications?
  • Setting: general internal medicine, held monthly, not at patient bedside,
  • residents come up with question about patient they have seen and share question with librarian team –>later debrief comparing/contrasting evidence found by resident vs librarian
  • particular emphasis on study design during discussion
  • Impact of GIM EBM rounds
    • information literacy
    • resource selection
    • efficient use of databases
    • precision searching: high quality, highly relevant information
    • *not only our students are searching for Practice Guidelines by entering guidelines into a search bar
  • WICU Pilot study
    • observational study to record clinical questions and what happens to them
    • ~38% were not answered
    • questions persisted and morphed over the course of the shift
  • Informationist participation impacting clinical practice
    • JHU Hospital Ethics Committee
    • Education Planning Curriculum Committee
    • Nursing Standards of Care Committee
    • Pediatric Staff Development Committee (allied health – social work, speech path, etc)
    • Emergency Medicine EBM Conference
  • Value indicators
    • increased grant proposal submissions
    • increased publication rates and authorship (journal articles, book chapter and updates, guideline development and updates, comprehensive reviews, systematic reviews)
    • 41% of time spent on comp and systematic reviews, writing methods sections, and more

Jonathan Hartmann, MLS – Georgetown University Medical Center

  • starting to use text mining to help with info retrieval
  • using diagnostic tools to help (DXplain, Isabel)
  • rounds are in internal medicine and PICU
  • carry iPad mini now – previously was done with mobile phone
  • NN/LM SEA Express Hospital awards to market the service
  • librarian vs infobuttons: librarian offers greater ability to respond, refine, and re-search

Terrie Wheeler, AMLS – National Institutes of Health

  • NIH Library Informationist program
  • 2011 JAMA article recognizes the contributions of these programs to medicine
  • Activities:
    • Instruction
    • Search/synthesize
    • Participate in clinical rounds (using iPads)
    • Write and edit manuscripts
  • Examples
    • Alicia Livinski, MPH, MA – Expertise: Social Media, Public Health
    • HHS Committee investigating allocation of medical resources after nuclear detonation
    • Info Intervention: literature search and analysis; working editor-in-chief of special journal supplement on topic
    • Impact: first article on this topic
    • Nancy Terry, MLS – Expertise: Public Health
    • NICHD and HHS Office of Disease Prevention and Health Promotion
    • Info Intervention: ID nutrition studies on children for birth-24 months; answering research questions for the Dietary Guidelines for Americans, 2015
    • Impact: 2015 Dietary Guidelines form the basis for federal public health food and nutrition programs – but how much money does this save? how does this impact patient health?
  • Clinical Search: Clinical Information System has links to NIHL bedside tool

Lauren Yaeger, MA, MLIS – St. Louis Children’s Hospital/Washington University

  • Positioned in the hospital
  • Involved with Resident EBM Curriculum/Resident Journal Club
    • iPass created by residents and given to librarian PRIOR to interaction, so librarian knows the context, abbreviations, etc ahead of time
  • Non-clinical rounds (ex: cleft palate and craniofacials rounds) – aim on interdisciplinary care
  • Worked on integrating library resources into EHR
    • Unless someone is standing there with the care provider and showing them how to use it, care providers won’t use EHR-linked resources

Questions

  • How is this role effective when you are a generalist and when you are a subject matter expert?
    • Subject expertise is important to service users, according to NIH project
    • General skill most needed is finding information quickly, but the subject background helps users not have to explain things quite as thoroughly, according to JHU
    • Rounding with residents tends to have questions and conversations at a more accessible level, but knowing the acronyms or nuances are helpful with searching and reviewing results, Georgetown
    • Teaching hospitals are also good environments, since the culture is teaching and introducing people
  • These services are all for the clinicians, not the patients
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