Hospital Librarian Orientation Toolkit

The Hospital Library Subcommittee of the NN/LM NER Regional Advisory Council wanted to determine ways it could advocate for libraries in the region and then to provide products that could be used by other libraries throughout the region. They developed the Hospital Librarian Orientation Toolkit to provide orientation information to hospital and health science librarians in New England. It offers information on (1) library networking resources and (2) information to advance the professional growth and development of hospital librarians

Hospital Library Promotion Toolkit

The Hospital Library Subcommittee of the NN/LM NER Regional Advisory Council wanted to determine ways it could advocate for libraries in the region and then to provide products that could be used by other libraries throughout the region. The Hospital Library Promotional Toolkit is designed to aid hospital librarians in promoting their services to hospital administrators and the various communities within their organization. The tools considered for this kit meet three objectives: (1) to assist hospital librarians in their performance and reporting of services to management; (2) to help hospital libraries focus on promotion and marketing to meet specific educational needs of their institution; and, (3) to advance the growth and development of the professional hospital librarian. Table of contents: Sample Mission Statements: Draft your library’s Mission Statement from the sample drafts; samples are categorized by hospital type Sample Goals and Objectives: Draft your library’s goals and objectives from either the short-term (one-year) or long term. Always try to correlate the library’s goals and objectives with those of the institution Tips for Preparing an Annual Report: Use these tips for writing an annual report, demonstrating the value of the library program to hospital administration Sample Annual Report: Draft an annual report of the library function for hospital administration by making use of this sample Research/Literature Search Request Form: Capture the necessary information to perform literature searches and responses to reference questions. Completed form also provides librarian with record of resources used Foot Traffic, Door Count, Library Activities Form: Use these forms to count foot traffic, computer activity, and other types of library tasks Library Statistics and How to Report Library Activities: Use these forms (weekly and monthly) to capture a representative picture of the library\u27s activities; and to report them to senior hospital administrators List of Suggestions for Expanding Use of Library Services: Refer to this list for suggestions to expand the use of library services Library Scope of Service Checklist: Use this checklist as a framework to create a Scope of Service for a hospital library. A “Scope of Service” is a document that concisely describes “who you serve” and “how you serve them”. Hospital administrators may require a Scope of Service for their departments to assist with surveys conducted by The Commission (formerly JCAHO) Selected Bibliography on Promoting Hospital Librarianship: Refer to this selected bibliography for articles and books to help you promote the library, offering suggestions for new services, as well as fulfilling your mission statement, goals and objective

An Umbrella of Integrated Services for Hospital Librarians

Objective: The hospital library subcommittee wanted to determine ways it could advocate for libraries in our region and then to provide products that could be used by other libraries throughout the region. Methods: The committee held lengthy discussions on the needs of hospital libraries in such areas as staffing, budget, support/advocacy, and marketing. From these discussions, it was determined that the committee would develop two toolkits: (1) a Hospital Librarian Orientation Toolkit that offers information from both regional and state-specific resources and (2) a Hospital Library Promotional Toolkit that provides a practical approach to promoting libraries in a hospital setting. A third function of the committee was to develop and execute a methodology for providing state and regional support to libraries in institutions that are planning to hire, downsize, or eliminate the librarian or library services. The methodology for providing support to endangered libraries has been developed, and testing has been ongoing. Results: The Hospital Librarian Orientation Toolkit has been completed and delivered to several dozen institutions that have provided evaluations and suggestions for revisions. The Hospital Library Promotional Toolkit was completed in April 2007. A sample of both toolkits will be on display. Presented at the Medical Library Association Annual Meeting, Philadelphia, PA, May 2007

How much does pre-trial testing influence complex intervention trials and would more testing make any difference? An email survey

BACKGROUND: The UK Medical Research Council has proposed that complex interventions should be tested in exploratory trials prior to a full-scale trial so as to better define the intervention and test the feasibility of components such as recruitment. It is not clear to what extent this is being done. This study aimed to determine to what extent complex interventions are tested prior to a full-scale trial and whether more or different testing would have led to a different intervention being used in the trial. METHODS: Email survey of the authors of complex intervention trials published in seven major journals in 2004. RESULTS: 72% (50/69) of eligible authors replied. Eight authors did not consider their interventions to be complex. The majority of respondents' complex interventions were tested (34/42): some extensively. Conversely, only 17 of the 34 published reports describing these trials mention testing. Two-thirds (22/34) of those testing their interventions did not believe that more or different testing would have produced a more effective intervention. 31% (13/42) of all authors did believe further testing would have led to improvements. Five respondents mentioned a lack of funding as a reason for not doing more testing. CONCLUSION: Complex interventions are generally tested prior to their evaluation in a full-scale trial, although the amount of testing varies. Testing is often not described in trial reports, which makes it hard to judge whether a trial result could be improved with a better intervention, or whether further work with a different intervention is required

Template for a Healthcare Knowledge Services Center

IntroductionThe purpose of the HKSC model template is twofold:(1.) to transform the hospital library function into a health care knowledge services center; and(2.) to emphasize the importance of knowledge among health care professionals within the organization.The current information explosion provides the Healthcare Knowledge Services Center (HKSC) with opportunities to become a critical player in organizational information and knowledge management. An HKSC can assist an organization maintain its competitive advantage in the marketplace. The HKSC must become an integral player to the organization if they are to succeed in helping their health care organization realize: 1.) exceptional quality control; 2.) high risk management standards; and 3.) optimum patient safety levels. The emergence of evidence-based practice (EBP) has become paramount to all health care organizations. EBP will provide an HKSC with increased opportunities for wider visibility within the organization.PurposeTo define a sustainable model template for the Healthcare Knowledge Services Center that encompasses transitioning a traditional medical library into a vibrant knowledge services center, integral to the health care organization.Timeline5 years out (2010-2015); pilots (2011-12)Rationale for Making Transition 1.) Knowledge management (KM) provides a positive push forward;2.) KM provides the “bridge” between information and best practice (see Knowledge Pyramid , below);3.) KM supports institutional goals:a.) exceptional quality control;b.) high risk management standards; andc.) optimum patient safety levels; 4.) KM offers health care organizations a competitive edge in market; and5.) KM provides hospital librarians with an ideal window of opportunity to become dynamic players in the confluence of several critical current events:a.) the information explosion;b.) the national push for health care reform;c.) the universal adoption of evidence-based practice; andd.) the emerging trend of self-directed practice , where patients take responsibility for their own personal health (e.g., EHRs)

Knowledge Pyramid

Pyramid image depicting where Knowledge Management fits into the realm of Health Care, created as one part of the Template for a Healthcare Knowledge Services Center

Alcohol consumption and lifetime change in cognitive ability:a gene × environment interaction study

Studies of the effect of alcohol consumption on cognitive ability are often confounded. One approach to avoid confounding is the Mendelian randomization design. Here, we used such a design to test the hypothesis that a genetic score for alcohol processing capacity moderates the association between alcohol consumption and lifetime change in cognitive ability. Members of the Lothian Birth Cohort 1936 completed the same test of intelligence at age 11 and 70 years. They were assessed for recent alcohol consumption in later life and genotyped for a set of four single-nucleotide polymorphisms in three alcohol dehydrogenase genes. These variants were unrelated to late-life cognition or to socioeconomic status. We found a significant gene × alcohol consumption interaction on lifetime cognitive change (p = 0.007). Individuals with higher genetic ability to process alcohol showed relative improvements in cognitive ability with more consumption, whereas those with low processing capacity showed a negative relationship between cognitive change and alcohol consumption with more consumption. The effect of alcohol consumption on cognitive change may thus depend on genetic differences in the ability to metabolize alcohol

A Qualitative Study of an Integrated Maternity, Drugs and Social Care Service for Drug-using Women

Background: The care of drug-using pregnant women is a growing health and social care concern in many countries. A specialist clinic was established offering multidisciplinary care and advice to pregnant drug users in and around Aberdeen (UK) in 1997. The majority of women stabilise and reduce their drug use. By determining the needs and views of the women more appropriate services and prevention strategies may be developed. There has been little research conducted in this area and none in Scotland. Methods: This is a qualitative study that aimed to gain an understanding of the experiences of women drug users, seeking and receiving prenatal care and drug services from a specialist clinic. Twelve women participated in semi-structured one-to-one interviews. Results: The women preferred the multidisciplinary clinic (one-stop shop) to traditional prenatal care centred within General Practice. The relationships of the clients to the range of Clinic professionals and in hospital were explored as well as attitudes to Clinic care. The study participants attributed success in reducing their drug use to the combination of different aspects of care of the multi-agency clinic, especially the high level prenatal support. It is this arrangement of all aspects of care together that seem to produce better outcomes for mother and child than single care elements delivered separately. Some women reported that their pregnancy encouraged them to rapidly detoxify due to the guilt experienced. The most important aspects of the Clinic care were found to be non-judgemental attitude of staff, consistent staff, high level of support, reliable information and multi-agency integrated care. Conclusion: There is an impetus for women drug users to change lifestyle during pregnancy. The study highlighted a need for women to have access to reliable information on the effects of drugs on the baby. Further research is required to determine whether positive outcomes related to clinic attendance in the prenatal period are sustained in the postnatal period. Early referral to a specialist clinic is of benefit to the women, as they reported to receive more appropriate care, especially in relation to their drug use. A greater awareness of needs of the pregnant drug user could help the design of more effective prevention strategies

QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting.

To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults with confirmed TB in Tanzania. Sensitivity and specificity of QFT and TST for diagnosing active TB as well as indeterminate QFT rates and IFN-γ levels were assessed in 211 TB suspect children in a Tanzanian district hospital and contrasted in 90 adults with confirmed pulmonary TB. Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27) and 6% (2/31) respectively. In adults sensitivity of QFT and TST was 84% (73/87) and 85% (63/74). The QFT indeterminate rate in children and adults was 27% and 3%. Median levels of IFN-γ were lower in children than adults, particularly children <2 years and HIV infected. An indeterminate result was associated with age <2 years but not malnutrition or HIV status. Overall childhood mortality was 19% and associated with an indeterminate QFT result at baseline. QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performance in Tanzanian adults was good and comparable to performance in high-income countries. Indeterminate results in children were associated with young age and increased mortality. Neither test can be recommended for diagnosing active TB in children with immature or impaired immunity in a high-burden setting