MLA13 and ICML – Day 2 pt2

After lunch, it was time for the first International Clinical Librarian Conference session: Quality Assurance for Clinical Librarians, Informationists, and Embedded Librarians. My co-blogger wrote this post summarising the session. It was a good session but tight – speakers just had 15 minutes to speak. Aldrich talked about establishing yourself as a Clinical Librarian. If you haven’t had a predecessor, I would imagine it would be fairly daunting. The most important thing is to walk about the place like you belong. Don’t expect to be introduced but introduce yourself. Interact with your consituents, encourage questions and take advantage of down time by visiting them in medical/nursing lounges (I have reservations about this last tip).  Have some searches pre-prepared – this will be easier once you get to know the issues encountered. Be there, be visibile!  The next session was a report of the early phase of a research study by Bartlett and colleagues using the Value Study in order to further explore the value of medical libraries in Canada. Canada is unique in that the health system, although publicly funded, differs from province to province. One thing that is evident from the Value Study is that it is very difficult to establish a direct corelation between medical librarian input and patient care outcomes. It will be interesting to hear of the results. Bartlett’s presentation reminded me of a Krafty post about demonstrating value. I tend to agree with Kraft’s contention that organisations are only interested in how your services benefit them, not how some study in another part of the country etc etc. My co-blogger wrote that the most controversial session was the UpToDate talk given by Jane Surtees from the UK. Librarians have a love-hate relationship with UTD and I think this might stem from the type of marketing UTD does – bypassing libraries altogether. I didn’t realise that some of the aggressive audience response left Surtees in tears. Being aggressive is unjustified.  It was a very valid presentation because 1) UTD is pricey and 2) because of this, value has to be demonstrated in real terms to organsations who are working with reduced financial resources. Surtees mentioned that survey participants said that UTD helped them avoid unnecessary imaging tests. Imaging tests are expensive and generally overused with little information gained [Rao VM, Levin DC  Ann Intern Med. 2012; 157(8): 574-576.]. On the subject of overuse or interventions to avoid, NICE has a searchable database of Do Not Do information culled from their suite of guidelines. Next up was Victoria Goode from Welch Medical Library who presented on their team’s Value study. They used the Critical Incident Technique using a survey method that included some open-ended questions. Although only 10% of a population of 7000+ returned surveys, information proved to be valuable in improving services in key areas. Visibility was an issue (people didn’t know about the informationist service), off-site access was a problem, growing areas of information needs were not catered for (statistics, bioinformatics) and ways of working were revealed. The Welch Library have used these results to create specialist information portals, kickstart new collaborations, streamline access and think about marketing.  The final presentation in this session was given by the team at Vanderbilt University Medical Center Library, represented by Rachel Walden. This presentation was of great interest to me not only for the collaboration and guideline aspects but also because of the disinvestment aspect. There are lots of technologies in use that are ineffective, not cost effective or down right harmful. Guidelines can be used to address this somewhat. However, it has to be remembered that guidelines found on NICE for example are broad and do not address specific local needs and priorities – this is where organisations are encouraged to adapt them for their own area. I was very interested in the Choosing Wisely website which is basically a list of low value technologies. Adam Elshaug writes a lot on this topic; The Value of Low-Value Lists | Low Value Practices – An Australian Study. Walden stressed that it is important to document everything and that includes notes on low search results. Include disclaimers and limitations.  The quality of evidence has to be agreed on by the whole team – very important if you are working collaboratively in developing guidelines.  Lastly, stand up for quality! I had to laugh when Walden said it was very tempting to say ‘that’s rubbish!’ when a clincian points you to a guideline you know is low in quality – tell them it is low quality because … I like to think of it as an educational opportunity and a chance to demonstrate expertise.

Straight after this was the second part of The Role of Librarians in EBM, so I rushed over to the room it was in – it didn’t take long as it was almost next door! I blogged about this session for the MLA13 conference blog.  This was the last session of the day for me. After the session, I went down to the Exhibitors Hall to look around, and I caught up with a colleague who told me about some nifty badges she picked up (Data Queen!). Of course, I went to look at them, but I can’t remember who the vendor was now. Went back to the hotel room and blogged, then out for dinner.

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