Evaluating clinical librarian services: a systematic review

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Presentation by Alison Brettle and Anne Webb on behalf of NW Clinical Libarian Systematic Review Group - International Congress of Medical Librarianship 2009

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Evaluating clinical librarian services: a systematic review

  1. 1. Approaches to evaluating Clinical Librarian Services: a systematic reviewPresented by: Alison Brettle, University of Salford, Salford, UK Anne Webb, The Christie NHS Foundation Trust, Manchester, UKOn behalf of NW England Clinical Librarians Systematic Review GroupPartly funded by North West Health Care Libraries UnitLibrary and Information Health Network North West
  2. 2. NHS and the North WestNationwide employs:• around 90,000 hospital doctors• 35,000 general practitioners (GPs)• 400,000 nurses• 16,000 ambulance staff(www.nhs.uk) Department of Health NW SHA 10 Strategic Health Authorities (SHA) Acute Trusts, Specialist Trusts, Mental Health Trusts, Primary Care Trusts (PCT) Ambulance Trusts The North West covers the 5 areas of Greater Manchester, Merseyside, Cheshire, Cumbria and Lancashire with a population of 6.8 million. Approximately 8% of people work in the healthcare sector – including a team of librarians interested in clinical librarianship!
  3. 3. UK North West Clinical Librarian Systematic Review Group:Lucy Anderson, NHS BuryAlison Brettle, University of SalfordMichelle Maden-Jenkins, Edge Hill University Maden-Rosalind McNally, National Primary Care Research andDevelopment Centre, University of Manchester Tracey Pratchett, University Hospitals of Pratchett, Morecambe Bay NHS Trust Jenny Tancock, University Hospitals of Tancock, Morecambe Bay NHS Trust Debra Thornton, Blackpool, Fylde and Wyre NHS Foundation Trust Anne Webb, The Christie NHS Foundation Trust
  4. 4. DriversThe Hill Report (2008) – includesrecommendations that librarians evaluate theirservicesMeasuring impact of services is a challengePrevious research demonstrated variability inmodels and limited effectiveness of ClinicalLibrarian Services
  5. 5. What’s Known to Date?3 other reviews Winning & Beverley (2003) (2003) Cimpl Wagner & Byrd (2004) Weightman & Williamson (2005)Identified Weaknesses Small sample size Low response rate Response bias Poor reporting/inadequate information on methods Researcher bias/desirability bias Non- Non-specific patient care outcomes Non- Non-use of reliable/valid methods Subjective reporting of results Results less likely to be quantified
  6. 6. Overall AimTo update previous reviewsProvide guidance for future evaluations.Clarification of the models of clinicallibrarianship and how best to measureimpact of services in relation to these?(Hill Report)
  7. 7. Objectives of Our Study1. To determine which models of Clinical Librarian services have been evaluated2. To determine whose perspective has been evaluated3. To determine what outcome measures have been used4. To determine the quality of the methods used
  8. 8. Methods 1- Searching 1-Searched 20 databases from 2001 onwardsScanned references and hand searched 2 journalsHILJ, JMLAGoogle searchGrey literature – mail lists, known contacts, CILIPUpdate etc.Bibliographies
  9. 9. Methods 2 – Filtering and ExtractionFiltering and article selectionInitial filter of irrelevant articles undertaken by 2people.Scanned titles and abstracts (in pairs)Obtained full papers (checked in pairs)Developed and evaluated critical appraisal/dataextraction toolExtracted relevant papers (in pairs)Data management tools: Refworks and Excel
  10. 10. Inclusion CriteriaStudies that meet the Hill definitionStudies which are described as outreach but the focus isto support patient careStudies which describe services providing patientinformation – evaluation outcome relating to patient carePublished post 2001Reports evaluation methodologyEnglish language
  11. 11. Results 1 Potentially relevant citations identified n=2040Excluded n = 857 Initial assessment of titles and abstracts n = 456 Full text assessment – potentially relevant items n = 91Excluded n = 62 Papers going forward to appraisal/ data extraction n= 29 Final Inclusion n = 21
  12. 12. Breakdown by CountryCountry No.UK 15US 5Holland 1
  13. 13. Breakdown by Study Design Study design No. of papers Survey 16 Qualitative 10 Experimental (e.g. RCT) 1 Quasi-experimental (e.g. Pre-post test) 1 Service evaluation 13 Action Research 2 Case Study 7 Other 5 Unclear 0 Not stated 0
  14. 14. Breakdown of Service ModelsInformation at the point of Information at the point ofneed need plus critical appraisal and synthesisQuestion and Answer Question and Answerservice service plus critical appraisal1 and synthesis 3Outreach Outreach plus critical14 appraisal and synthesis = informationist 4
  15. 15. Breakdown of OutcomesOutcome criteriaUsage statistics 62%Use of information 52%Relevance of results 48%Usefulness of results 48%Time saving 48%General impact on patient care 38%Time to respond 33%Other 24%Improvement in information literacy 23%Improvement in confidence 4%Cost 0%Not stated 0%
  16. 16. Breakdown of Perspective No. ofPerspective papersUser 16Librarian 7Library Service 11Organisation 3Unclear 1
  17. 17. Breakdown of QualityQuality measure (Weightman et al) no. %Appoint researchers who are independent of the library service 5 23Ensure that all respondents are anonymous and that they are 4 19 aware of this.Survey all members of chosen user group(s) or a random 12 57 sampleAgree a set of questions that are objective, well used in previous 9 42 research, and developed with input from library users.Use the critical incident technique. 6 29Combine a questionnaire survey with a smaller, but also random 8 38 sample of follow-up interviews.
  18. 18. Conclusion1. Models of Clinical Librarian Service – 4 models evaluated2. Evaluation has been mainly from a service and service user perspective3. A wide range of outcome measures have been used4. Quality has improved, but needs to improve further
  19. 19. Thank You! Thank you for listening Thank you to the NW Clinical Librarian Systematic Review Group Thank you to North West Health Care Libraries Unit for funding Any questions?Contacts:a.brettle@salford.ac.ukanne.webb@christie.nhs.uk
  20. 20. ReferencesCimpl Wagner, K. and Byrd, G.D. Evaluating the effectiveness of clinical medicallibrarian programs: a systematic review of the literature. Journal of the MedicalLibrary Association 92 (1):14-33, 2004. (1):14-Hill, P. Report of a national review of NHS library services in England: fromknowledge to health in the 21st Century, National Library for Health, 2008. Availablefrom: http://www.library.nhs.uk/aboutnlh/review (accessed 5th May 2008)Rankin, J. A. et al .The emerging Informationist Specialty: a systematic review of theliterature JMLA 96 (3): 194 - 206, 2008Weightman, AL and Williamson, J. The value and impact of information providedthrough library services for patient care: a systematic review, Health Information andLibraries Journal, 22: 4-25, 2005 Journal, 4-Weightman AL, Urqhuart C, Spink S, Thomas R. The value and impact of informationprovided through library services for patient care: developing guidance for bestpractice. Health Information and Libraries Journal 2008;26:63-71. 2008;26:63-Winning, M.A. and Beverley, C.A. Clinical librarianship: a systematic review of theliterature. Health Information & Libraries Journal 20: Suppl-21, 2003. Suppl-
  21. 21. GlossaryCILIP - Charted Institute of Library and InformationProfessionalsDH - Department of HealthHCLU - North West Health Care Libraries UnitHILJ - Health information and Libraries JournalJMLA - Journal of the Medical Library AssociationLIHNN - Library and Information Health NetworkNorth West (England)NHS - National Health ServicePCT - Primary Care TrustSHA - Strategic Health Authority
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