The requirements of evidence-based practice increasingly pressure clinicians to obtain relevant biomedical information from a growing body of literature. Over the past six years, the Vanderbilt Eskind Biomedical Library (EBL) Clinical Informatics Consult Service (CICS) has developed and implemented a novel approach to address these needs. Librarians with specialized training in medical subject areas and in information retrieval (""""""""clinical informationists"""""""") participate on clinical teams in intensive care settings. Acting as expert consultants, they analyze the biomedical literature to identify, filter, and present the best examples of each clinical viewpoint expressed about key problems. Working in cooperation with the world-renowned Learning Sciences Institute at Peabody College of Vanderbilt, the investigators propose to evaluate formally the role of CICS in improving clinician knowledge and evidence-seeking behavior. While past studies have evaluated clinical medical librarians' roles, few if any studies have examined the effectiveness and utility of the new clinical informationist approach in sites where informationists are well-established. The project will create reusable evaluation tools transferable across environments. Through a combination of observation, interviews, and focus groups, investigators will examine librarian involvement in three existing Vanderbilt CICS intensive care units. The project will collect detailed information about the ways in which clinicians incorporate CICS-provided information into their workflows. Next, investigators will conduct a randomized trial to evaluate the effect of CICS on clinician knowledge. When a CICS-related clinical decision-making issue arises, the project team will administer a pre-test to clinicians and randomize them into two groups. Both groups will repeat the test after an appropriate interval for """"""""independent learning"""""""". The intervention group will have access to the result of the CICS consultation prior to the post-test; the control group will not. Finally, """"""""virtual cases"""""""" developed from actual patient CICS-related scenarios in each clinical unit will be used to evaluate the effect of CICS information in altering clinical decision-making and evidence-seeking behavior in a controlled laboratory setting. Demonstration of the utility of the clinical informationist approach can foster widespread adoption nationally, and increase the degree to which clinical practice becomes evidence-based.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM007849-03
Application #
6896109
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Florance, Valerie
Project Start
2003-06-15
Project End
2007-06-30
Budget Start
2005-06-15
Budget End
2007-06-30
Support Year
3
Fiscal Year
2005
Total Cost
$382,927
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Jerome, Rebecca N; Giuse, Nunzia Bettinsoli; Rosenbloom, S Trent et al. (2008) Exploring clinician adoption of a novel evidence request feature in an electronic medical record system. J Med Libr Assoc 96:34-41
Mulvaney, Shelagh A; Bickman, Leonard; Giuse, Nunzia B et al. (2008) A randomized effectiveness trial of a clinical informatics consult service: impact on evidence-based decision-making and knowledge implementation. J Am Med Inform Assoc 15:203-11
Rosenbloom, S Trent; Giuse, Nunzia Bettinsoli; Jerome, Rebecca N et al. (2005) Providing evidence-based answers to complex clinical questions: evaluating the consistency of article selection. Acad Med 80:109-14
Giuse, Nunzia B; Koonce, Taneya Y; Jerome, Rebecca N et al. (2005) Evolution of a mature clinical informationist model. J Am Med Inform Assoc 12:249-55