the clinical librarian in an emergency department professor tim coats professor of emergency...
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The Clinical Librarian in an Emergency Department
Professor Tim Coats
Professor of Emergency Medicine
Leicester University, UK
Objectives
To identify information needs in emergency care
To look at current models
Speculate on the future
Knowledge needs
UK emergency model - based on junior doctors- FY2, ST level - often not aware of their own ignorance!
Types of condition different from previous experience- Common conditions and rare conditions
Often isolated working
Time pressure- acuity of patient’s needs- volume of patients
Knowledge needs
In summary, the challenge is:
Very rapidly getting the right bit of information to a clinician who may not be aware that they need it
Levels of information needed
Patient based - past medical notes “What was found last time this patient had a TIA?”
Local procedures - “How do I refer this patient to the TIA clinic?”
National guidelines - “How do I treat my patient who has a TIA?”
Specialised question - “How do I treat this patient with haemophilia who also has a TIA?”
Educational overview - “I don’t know much about TIA, where can I find out about it?”
Time available
Total of 20 to 30 minutes per patient- (history,examination, explanation, treatment, recording)
Finding information - ?10% of this?
Certainly no more than 5 mintues
Current systems
Books - ‘How to do it guides’
‘Google it’ - works well!
Phone a friend
Clinical Librarian
Clinical Librarian in Emergency Care
Cardiac arrest - get me a librarian stat
Role:- Understanding the language and clinical and practical issues of
emergency care- Saving clinicians time by assisting in literature searches- Enabling painless access to evidence / published material- Supporting evidence based patient care at the bedside- Providing tailored training in searching (aimed at junior staff)- Maintaining close links with clinical teams to understand their
information needs- Developing future information systems
Practical examples
Safer treatment for cyanide poisoning - preparation of evidence based case to Hospital Therapeutics Committee.
Learning how to search the literature for the FCEM exam ‘Clinical Topic Review’
Preparing a Cochrane review looking at the administration of heliox to children with croup
Looking at the evidence base for a local guideline on management of the acute red eye
Future Systems
Electronic patient recordSeries of ‘Knowledge’ buttons
- Local procedures- National guidelines- Systematic reviews- ‘Textbook’ material- Relevant literature search
Context based red flags- Information presented without active seeking- ? Connection to user level of knowledge
Summary
Emergency Physicians have particular information needs
Current systems do not fit the bill
A clinical librarian can enhance the system
The EPR presents an opportunity for the future