How often are clinical questions answered when they arise during hospital shifts? Blair Anton and her team from Welch Medical Library at Johns Hopkins University were interested in this question and conducted an observational study over 2 48hr periods in the persistence of clinical questions in a small 20-bed ICU. I was very interested to learn that many questions (mostly asked during rounds) were carried over from shift to shift before being answered and that 38% were never resolved. The resources used by health professionals were PubMed, Wikipedia and UpToDate (plus some others) and people were satisfied with the answers they obtained 2/3s of the time. This interesting piece of research has far-reaching implications for department/unit information service delivery. Not all departments would need such rapid turnaround as an ICU though. What are the question lifecycles like for other hospital departments?
Next up was my talk about the HLA Journal Club. Despite the massive microphone feedback 1/2 through, it went well and was well received. There interest from attendees about joining the online journal club and I promised I would find out what the HLA Executive thought. I have sounded them out about it and all that have replied to my query have been positive. We can open it up to international membership with possible assistance from EAHIL. Perhaps even have joint evidence summary publication! Stay tuned.
Gussun Gunes was due to talk next but due to technical difficulties, she had to do her talk later and we moved on to Steve Glover and Jo Whitcombe who recounted their experiences being involved in a Stillbirth Priority Setting Partnership. The library team was approached when the project was well underway so they had tight deadlines to meet (and this on top of their day to day work so they had to employ outside assistance). Why is it that information professionals are never consulted from the get go on projects like this? The good news is that with this work, the their team have been invited to work with other priority setting partnerships working in similar subject areas and earlier too. Back to the tight deadlines. After a survey of interested parties establishing what research questions they had around stillbirth, the library team found that they had to answer 261 questions in one month after question deduplication. The lit search team divided the questions up into broad topics and used Excel and Google Drive to track questions (+ time for billing purposes) and created a base search strategy that was shared amongst themselves. Many questions were not addressed by the literature. The final questions that the interested parties have agreed to focus on (along with other priority research questions) are now online.
Gussun Gunes with slides now located, talked about her work with nurse researchers. She presented a finished paper on which she is an author – very good to see! She is contacted by nurse researchers and works with them throughout the systematic review process and while doing this, she also trains them in various reviewing processes (deduplication using EndNote eg). The main problems she mentioned that nurse researchers face are lack of time, lack of database searching skills and inability to understand the research literature. Another pressing issue is the lack of local language resources plus the difficulties in searching these.
Next up was a 4thyr medical student project to evaluate the effectiveness and impact of the clinical librarian service at Brighton NHS. The study period included 164 searches over a 12mth period for 5 hospital departments (the highest requester being the Neonatology dept). What I found interesting with this presentation was that no only does the CL service see repeat business from individuals and that 92% say they will use the service again, but that the searches themselves end up being used in multiple projects with differing impacts. This echos Blair Anton’s talk about the life cycle of a question but in this instance, when the question has been answered. I would be interested in how repeat questions are tackled. What if CLs undertook a priority setting exercise to determine repeat questions that their health services asked and run an evidence update service to address them? The other take away from this presentation (and echos Gussun’s talk) is that searching for answers can take longer than you think (this CL service averaged 219 mins per question with the range 10-960 mins).
The final presentation of the day was from Imrana Ghumra from Health Education England. HEE is working to transform knowledge services and wants to support librarians by developing competencies needed for workforce development (some of these developed from the HEALER research toolkit) and a national CPD training scheme. Extensive work and evidence have been collected to inform the development plan. You can have a look at these documents here: Knowledge for Healthcare: A Development Framework and the Library Services Briefing. The main point that Ghumara and the above documents repeat is that establishing and working in partnerships is essential.