Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study.

OBJECTIVE: This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care. METHODS: A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another. RESULTS: Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals. CONCLUSIONS: MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

Linking research to practice: the rise of evidence-based health sciences librarianship.

PURPOSE: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. METHODS: FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. RESULTS: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. IMPLICATIONS: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

Library and information services: impact on patient care quality.

PURPOSE: The purpose of this paper is to explore library and information service impact on patient care quality. DESIGN/METHODOLOGY/APPROACH: A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. FINDINGS: Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. ORIGINALITY/VALUE: Electronic collections and services provided by the library and the librarian contribute to patient care quality.

The value of library and information services in patient care: results of a multisite study.

OBJECTIVE: The research conducted a large-scale, multisite study on the value and impact of library and information services on patient care. METHODS: THE STUDY USED: (1) 2 initial focus groups of librarians; (2) a web-based survey of physicians, residents, and nurses at 56 library sites serving 118 hospitals; and (3) 24 follow-up telephone interviews. Survey respondents were asked to base their responses on a recent incident in which they had sought information for patient care. RESULTS: Of the 16,122 survey respondents, 3/4 said that they had definitely or probably handled aspects of the patient care situation differently as a result of the information. Among the reported changes were advice given to the patient (48%), diagnosis (25%), and choice of drugs (33%), other treatment (31%), and tests (23%). Almost all of the respondents (95%) said the information resulted in a better informed clinical decision. Respondents reported that the information allowed them to avoid the following adverse events: patient misunderstanding of the disease (23%), additional tests (19%), misdiagnosis (13%), adverse drug reactions (13%), medication errors (12%), and patient mortality (6%). CONCLUSIONS: Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.

The health sciences librarian in medical education: a vital pathways project task force.

OBJECTIVES: The Medical Education Task Force of the Task Force on Vital Pathways for Hospital Librarians reviewed current and future roles of health sciences librarians in medical education at the graduate and undergraduate levels and worked with national organizations to integrate library services, education, and staff into the requirements for training medical students and residents. METHODS: Standards for medical education accreditation programs were studied, and a literature search was conducted on the topic of the role of the health sciences librarian in medical education. RESULTS: Expectations for library and information services in current standards were documented, and a draft standard prepared. A comprehensive bibliography on the role of the health sciences librarian in medical education was completed, and an analysis of the services provided by health sciences librarians was created. CONCLUSION: An essential role and responsibility of the health sciences librarian will be to provide the health care professional with the skills needed to access, manage, and use library and information resources effectively. Validation and recognition of the health sciences librarian's contributions to medical education by accrediting agencies will be critical. The opportunity lies in health sciences librarians embracing the diverse roles that can be served in this vital activity, regardless of accrediting agency mandates.

Measuring the value and impact of health library and information services: past reflections, future possibilities.

OBJECTIVES: To summarize the context, history and results of research studies conducted on the value and impact of health library and information services by the author since 1975 and to use this as a basis for examining ongoing developments related to evaluation research. To provide a comprehensive bibliography of library value and impact studies. METHODS: Literature review and background based on personal involvement in the studies under discussion. RESULTS: The author's studies demonstrate an ongoing evolution of value and impact studies since the mid-1970s. In health sciences libraries, the approach taken to measuring value and impact has been strongly influenced by the type of research being conducted in the health sciences field as a whole. As a result, health sciences library researchers have become early adopters of methods that incorporate outcome and impact measures and rigorous research designs, and the concept of evidence-based library and information practice. The paper recommends that a range of research approaches from various disciplines be used to guide future evaluation research. CONCLUSIONS: Value and impact studies will continue to be important resources for evidence-based practice as health information professionals deal with evolving user needs and new ways of delivering information to a variety of audiences.