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Medical Libraries: An Essential Resource in Outcomes Improvement

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In healthcare outcomes improvement work, where best-practice insight and evidence-based knowledge are critical, medical libraries are an essential resource. Medical libraries are more valuable than ever in today’s digital world, in which information is readily available, but accessing accurate, focused evidence requires specialized skill and means.

Organizations aiming to improve quality and move successfully toward value-based care need both data from the enterprise data warehouse (EDW) and evidence from the medical library. While data identifies opportunities for improvement, evidence furnished by the medical library shows whether proposed solutions are viable. Together, both knowledge bases drive pragmatic, sustainable improvement.

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Medical Libraries: An Essential Resource in Outcomes Improvement

  1. 1. Medical Libraries: An Essential Resource in Outcomes Improvement James Bulger
  2. 2. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries: An Essential Resource By systematically researching and accessing best practice and evidence, medical libraries connect organizations with knowledge to drive outcomes improvement. Medical libraries are particularly valuable in today’s information-rich digital world. Google quickly answers any query, but accessing accurate, focused information requires diligence, skill, and the highest quality resources.
  3. 3. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries: An Essential Resource Medical librarians, who hold master’s degrees in their specialty, are uniquely qualified to connect outcomes improvement teams with reliable, current, and relevant evidence. Many medical librarians receive credentialing through the Medical Library Association Academy of Health Information Professionals in recognition of their exemplary qualifications, health information knowledge, and commitment to the profession.
  4. 4. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries: An Essential Resource In recent years, tightening health system finances have put medical libraries under pressure. Some organizations have closed their libraries, and others have reduced staff—often in conjunction with hospital mergers. Some hospital administrators aren’t aware of the value of medical libraries, or don’t understand that paid subscriptions deliver high-quality, evidence- based information they can’t access online for free. This presentation describes how getting the most out of published knowledge requires the resources of medical libraries and expertise of medical librarians.
  5. 5. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries Are Growing and Diversifying As technology advances, the medical librarian’s role is diversifying. Medical librarians support research through advanced search skills, instruction on effective use of information resources, and support of institution-level performance improvement or quality initiatives. Some participate in hospital rounds as clinical medical librarians, providing direct support as caregiver team members. Others fill the role of informationists, contributing both information science and clinical/biomedical science.
  6. 6. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries Are Growing and Diversifying To keep up with the increasing availability of online resources, today’s librarians are adept at gaining access to electronic resources through contract and licensing negotiations. They make information resources accessible from multiple locations; whether through enhanced retrieval from search engines or automated linking, medical librarians provide seamless access to full-text articles from PubMed citations. They can also establish proxy-server systems, which allow access to information from outside the institution.
  7. 7. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries Are Growing and Diversifying Librarians may also lead their institutions on maintaining compliance with copyright guidelines. Through their management of print and online journals, books, and information resources, medical libraries provide a deep knowledge base for the institution. This includes access to national guidelines, systematic reviews (e.g., the Cochrane Collaboration), or point-of-care tools (e.g., UpToDate), whether resources are focused by subject (e.g., drug information) or provider type (e.g., nursing-related collections).
  8. 8. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries Connect Organizations with Knowledge to Drive Outcomes Improvement Research demonstrates that medical libraries improve healthcare quality, and save time and money for clinicians and healthcare organizations. Hospital and health system libraries support outcomes improvement by providing evidence-based research. Medical librarians often sit on committees to help guide quality initiatives or develop evidence-based clinical guidelines.
  9. 9. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries on the Front Line of Outcomes Improvement Allina Health sought to improve spine surgery performance at some of its facilities, which prompted a major improvement initiative in the form of a multidisciplinary spine program. With support from the medical library, including a series of literature searches focused on spine surgery outcomes as well as the delivery of pertinent journal articles, the organization developed an evidence-based care model. The model aims to deliver care to every spine patient right care at the optimal time for the best possible outcome.
  10. 10. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries on the Front Line of Outcomes Improvement The Allina Library Services process produced 25 systemwide guidelines and contributed to several clinical outcomes improvement: A five percent reduction in Stage 1 lung cancer treatment variation, with a focus on optimal treatment. A 20 percent decrease in the number of heparin protocols, which has resulted in reduced incidence in bleeding, along with other safety benefits. Implementation of a system-wide guideline for acute pain management with opioids. > > >
  11. 11. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries on the Front Line of Outcomes Improvement Library Services also works closely with Allina’s Clinical Service Line councils and participates in the Clinical Practice Council, providing the knowledge base for Allina to make peer-reviewed, evidence-based recommendations for several issues: Appropriate conditions to prescribe medical cannabis. Appropriate age for mammography screening. Evidence in support of preoperative screening protocols. Appropriate use of postoperative pulse oximetry. Procedures in robotic surgery achieves the best cost and clinical outcomes. The effectiveness of decision-making in colorectal screening. > > > > > >
  12. 12. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries on the Front Line of Outcomes Improvement On a monthly basis, Library Services helps Allina identify possible improve- ment opportunities by searching the literature for current articles on clinical variation and cost reduction. Recent articles considered cover several important improvement areas: Variation in the cost of common surgical procedures. Cost analysis of a national surgical consensus guideline in breast cancer surgery. Analysis of safety and potential cost savings with early discharge after percutaneous coronary intervention. > > >
  13. 13. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. High-Quality, Value-Based Care Requires Data and Evidence High-quality, value-based care must be both data driven and evidence based to support the right kinds of improvement. Data from an enterprise data warehouse (EDW) can show areas of clinical variation and are strengthened when presented with the medical library to show the value and effectiveness of potential solutions to address that variation. Also, hot topics in the literature around variation can be funneled to an analytics team to dig in and understand how the topic may be affecting an organization.
  14. 14. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. High-Quality, Value-Based Care Requires Data and Evidence Recently, a large-scale, multisite study focused on the value and impact of medical libraries. The survey found that information provided by the library facilitated outcomes improvement: Contributed to a higher quality of care (93 percent of respondents). Saved time (85 percent). Provided new knowledge or substantiated prior knowledge or belief (91 percent). > > >
  15. 15. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. High-Quality, Value-Based Care Requires Data and Evidence The study confirmed that information provided by the library can drive better informed clinical decisions by substantiating prior knowledge or providing new knowledge. In one key improvement area—avoidance of adverse effects—the study highlighted a number of key outcomes related to patient safety, which the organization avoided as a result of information furnished by the medical library. These patient safety events included: misdiagnoses (13 percent), adverse drug reactions or interaction (13 percent), and medication error (12 percent).
  16. 16. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. High-Quality, Value-Based Care Requires Data and Evidence Given the rate of medical knowledge growth, it is almost impossible for clinicians to keep up with current findings, even in highly specialized fields. In 2016, nearly 870,000 citations were added to the MEDLINE database. Because clinicians make difficult decisions on a regular basis, the medical library provides expert direction on this huge volume of literature with focused, targeted information and answers.
  17. 17. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries-Key to Better Care, Reduced Cost Medical libraries help health systems improve outcomes by providing focused, reliable access to knowledge and information that defines best practice and evidence. They play key roles in achieving a higher quality of care that improves patient experience and population health, and reduces cost.
  18. 18. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Medical Libraries-Key to Better Care, Reduced Cost With the expertise to efficiently search the literature, medical librarians save valuable clinician time and provide evidence to support data-driven improvement and identify improvement opportunities. For many health systems with an outcomes improvement strategy, the medical library is a critical asset.
  19. 19. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. For more information: “This book is a fantastic piece of work” – Robert Lindeman MD, FAAP, Chief Physician Quality Officer
  20. 20. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. More about this topic Link to original article for a more in-depth discussion. Medical Libraries:An Essential Resource in Outcomes Improvement Improving Outcomes That Matter Most to Patients Caleb Stowell; Sara Sprinkhuizen – from ICHOM The Top Six Early Detection and Action Must-Haves for Improving Outcomes Kirstin Scott, Senior Medical Writer; Tracy Vayo, VP of Knowledge Services 7 Features of Highly Effective Outcomes Improvement Projects Brant Avondet, VP of Client Operations A Guide to Successful Outcomes Using Population Health Analytics Tom Burton, Senior VP and Co-Founder How Allina Health Deployed Evidence-Based Decision Making and Reduced Variation Health Catalyst Success Story
  21. 21. © 2016 Health Catalyst Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. James Bulger joined Health Catalyst January, 2015. Prior to coming to Health Catalyst, he worked for Allina Health, spending nearly 20 years in Library Services, and as manager for the past 8 years. James has a Master in Library Science (MLIS) degree from Dominican University. Other Clinical Quality Improvement Resources Click to read additional information at www.healthcatalyst.com James Bulger

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