Tuesday, 19 June 2007
Jacqueline Verschuere presented again, this time on how the Clinical Librarian can still make a difference when the evidence base is low. We often expect there to be perfect answers to the questions we're asked by clinicians, and finding a lack of high-level evidence can be disappointing, especially when you're starting out as a new CL. Jacqui wanted to spark a debate about whether guidelines are high evidence - is a NICE guideline that is based on case series as good as a systematic review?
Klara Brunnhuber and Jane McHugh from BMJ publishing group presented the results of some work they had been doing with clinicians on barriers in the EBM process. I'll admit that at this stage, nerves had got the better of me, as I was up shortly after the tea break, and I was frantically scribbling notes on my presentation script.
A CL conference isn't a CL conference with Andrew Booth. Andrew talked about the work that ScHaRR had been asked to do regarding the training of CLs. I have mixed feelings about this, because while I agree that a CL training programme would be an interesting addition to already existing training options, I do think that a lot of clinical librarianship is personality-based and cannot be taught from a curriculum.
Next up was me, so I'll gloss over that. It was a bit of a blur anyway. I talked about the Pharm-assist project we're running using PDAs at Leicester. It's ongoing, but we hope to present preliminary results at the EAHIL workshop in September.
Caroline Storer & Linda Dobrzanska followed, talking about how they have implemented SIGs - Special Interest Groups at Bradford & Airedale tPCT.
A brief presentation from Ovid turned into a lot of praise from our Australian delegates for its QUOSA product - it's on my ever-expanding list of web sites to check out!
After lunch, Sarah Lewis & Nia Wyn Roberts talked about how they've set up & evaluated peer support sessions in Thames Valley & Hampshire. It's something we've tried in Leicester, based on the Vanderbilt "SearchTalk" sessions that Becky Jerome & colleagues told us about at "Lost in Space"in 2006. I found this talk really interesting, and hope we can get back to doing our sessions again soon.
Following on in the peer support/networking theme, Debra Thornton & James Allen talked to us about how they've set up a journal club for librarians in the North West, based on the principles of clinical journal clubs that they've attended. The idea of practising what you preach in terms of evidence-based practice came across loud and clear! This was another inspiring talk - there'll hardly be any time left for the searching once we've done all this.
Brenda Goddard & Helen Williams talked to us about the way they've restructed library services at Winchester & Eastleigh to reflect more outreach work. This was an interesting presentation in that it was recognised that the library assistants pretty much run the library as a physical resource while librarians go out & gatecrash clinical meetings. Some of it did feel to me like preaching to the converted, as I'm quite well practised in the art of gatecrashing! Hopefully it inpsired the more reticent among us to get out there.
Finally, we broke off into three workshop sessions. I attended Sara Clarke's workshop on the way in which NLH Specialist Libraries and CLs can work together. I'd previously been quite wary of Specialist Libraries, thinking that they were attempting to virtually replace CLs, but after some discussion, we realised that there are ways in which we can complement each other. With the potential for personalisation of the Specialist Libraries, there may be ways of promoting CL services to users from the Trusts that have them.
All in all, I found it to be an exhausting & inspiring two days. I find that being a CL can be quite isolating, even in a Trust where there is more than one of us, so it is always reassuring to know that there are more of us out there, all facing very similar problems.
I hope that the presentations will soon be available on the web site. http://www.uhl-library.nhs.uk > Clinical Librarians > Study Days
Thursday, 14 June 2007
Steve Sharp gave us an insight on the Current Awareness methods used by the NLH Specialist Libraries, which was fascinating, as I hadn't realised just how much work goes into keeping the information current & relevant.
After tea, we broke off into parallel sessions, and I attended Veronica Delafosse's presentation on "The Visible Librarian", which was an interesting description of how Veronica had implemented and evaluated a series of training sessions for Occupational Therapists at the Caulfield General Medical Centre in Australia.
Just before lunch, we had a session by Mick Arber from BMJ Clinical Evidence. Mick told us about the process Clinical Evidence use to identify topics for their database, and how articles are appraised before synopses are written. Unfortunately the NHS in England no longer centrally subscribe to Clinical Evidence, which is a shame, as I've often found it to be a really useful resource in my searching.
It was during the morning session that we realised the acoustics in the Maclagen Hall at St. Williams College were not quite the same when full of a bunch of excited information professionals, so we quickly managed to hire in a PA system.
After lunch, at which some of our foreign contingent were mildly confused by the meringues we had for dessert, Andrew Booth chaired, and oversaw Jacqui Verschuere & the team from University Hospitals of Coventry & Warwickshire collect the Evidence in Practice Award prize. The team's submission was a unanimous winner amongst the judges. It followed the process through from the question being asked, to the Clinical Librarian's search to implementation of a wristband to alert patients, care providers and airlines to the risks for patients who have had intraocular gas tamponades.
This was followed by the team from the Netherlands who described to us how Clinical Librarianship has evolved there since the 1990s, which was a very entertaining tour of their work. I was impressed that the library at the Amsterdam Medical Centre commissions artwork!
Sara Sutton followed up on the international theme by telling us all how to blag our way around the world in the name of furthering the profession and our own professional development.
Following on from the much-needed afternoon teabreak, I attended the workshop on RSS feeds run by Heather Gardner of Derby Hospitals Foundation Trust. We discussed the usefulness of different methods of promoting current awareness, and the hindrances we face in trying to do it.
Finally it was back to the main hall for a whistlestop tour of the new features of the Cochrane Library from Nigel Thompson. In this, we learned that South America has moved to Africa (you had to be there!), and that there are a number of elearning resources now available on the site.
It was a packed day, and we still managed to gather a few of us together at 7.30 by the West doors of the Minster to join the Ghost Trail. Having seen last week's Doctor Who, I was unable to turn my back on the statues!
Friday, 8 June 2007
Now there are snippets of each result displayed below the title, and it seems to be running a lot faster too. More details are on the TRIP blog.
TRIP is a resource I use for just about every search I do, as it searches the main features of Cochrane, North American & European Guidelines, PubMed and eMedicine, to name a few.
Thursday, 7 June 2007
Registers submitting data must ensure they meet a minimum quality standard and that all trials are registered before any participants are recruited. Data will not be accepted directly from drug companies. The network of registers, which are required to disclose their ownership, governance structure and for-profit status, will be expanded to make it more comprehensive.
It's an excellent resource for the die-hard searchers among us.
Wednesday, 6 June 2007
The findings of this survey to identify factors that affect the acceptance of clinical decision support (CDS) among primary care physicians, are published in BMC Medical Informatics and Decision Making. 110 out of 225 physicians responded to the survey, and the majority said that CDS "helps them take better care of their patients." The study asked specific questions relating to acceptance of alerts for different situations, eg elderly patients, multiple medications and multiple chronic clinical conditions. Most of the clinicians said that they were often running behind schedule, and if they were running late, they were less likely to accept the alerts. The conclusions were that they do find CDS beneficial to patient care but they would like more time to use CDS.
A survey of factors affecting clinician acceptance of clinical decision support
DF Sittig, MA Krall, RH Dykstra, A Russell, HL Chin
BMC Medical Informatics and Decision Making, 2006, 6:6
This paper highlights the results of an 18-month evaluation of a clinical librarian project, carried out in North Wales. The purpose of the study was to find out the benefits of using clinical librarians to support clinical teams. The results showed that with a clinical librarian on their team, clinicians were "more willing to spend time searching for information related to patient care."
Changes in information behavior in clinical teams after introduction of a clinical librarian service
C Urquhart, J Turner, J Durbin, J Ryan
Journal of the Medical Library Association, 2007, 95(1), pp14-22
This is a new column looking at the challenges of information service provision in health care. There will be case studies from medical librarianship, health informatics, medicine, and research, focusing on a variety of scenarios to help encourage discussion and development in this area. This first scenario focuses on the involvement and importance of a clinical librarian in the treatment of a patient with respiratory failure and hepatic encephalopathy associated with advanced liver failure. Comments can be made on this case online at http://jmlacasestudies.blogspot.com
Expert synthesis of the literature to support critical care decision making
RN Jerome, RA Miller
Journal of the Medical Library Association, 2006, October, 94(4), pp376-381