Abstract
The research sought to determine the effect of a clinical medical librarian (CML) on outcomes of in-patients on the internal medicine service. A prospective study was performed with two internal medicine in-patient teams. Team 1 included a CML who accompanied the team on daily rounds. The CML answered questions posed at the point of care immediately or in emails post-rounds. Patients on Team 2, which did not include a CML, as well as patients who did not require consultation by the CML on Team 1, served as the control population. Numerous clinical and library metrics were gathered on each question. Patients on Team 1 who required an answer to a clinical question were more ill and had a longer length of stay, higher costs, and higher readmission rates compared to those in the control group. Using a matched pair analysis, we showed no difference in clinical outcomes between the intervention group and the control group. This study is the largest attempt to prospectively measure changes in patient outcomes when physicians were accompanied by a CML on rounds. This approach may serve as a model for further studies to define when and how CMLs are most effective.
Highlights
Physicians have long been aware of the need to optimize care of their patients by searching the medical literature
This study is the largest attempt to prospectively measure changes in patient outcomes when physicians were accompanied by a clinical medical librarian (CML) on rounds
Of the 636 CML hours, more than 347 hours were at the bedside of patients and 128 hours were meeting with the patient care team and discussing patients
Summary
Physicians have long been aware of the need to optimize care of their patients by searching the medical literature. Research by Ely et al has shown that some clinicians fail to pursue the answers to their own questions that may make a difference in providing better patient care [2, 3]. In the mid-1970s, the clinical medical librarian (CML) emerged to help clinicians quickly find information for the care of their patients [4,5,6,7,8]. Physicians who worked with a CML recognized that the CML could help them find the information that they wanted, increase their knowledge of medical advances, and save them time [9]. CML services grew as the need for computer skills increased and the relevance of evidence-based medicine (EBM) and evidence-based practice (EBP) became increasingly
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