Liaison Work Research Articles

Supporting employers and their employees with mental hEalth conditions to remain eNgaged and producTive at wORk (MENTOR): A feasibility randomised controlled trial

Employees with mental health conditions often struggle to remain in employment. During the COVID-19 pandemic, these employees faced additional stressors, including worsening mental health and work productivity. In 2020, as part of a larger programme of work called the Mental Health and Productivity Pilot (MHPP), we developed a new early intervention (MENTOR) that jointly involved employees, managers, and a new professional (Mental Health Employment Liaison Worker, MHELW). The intervention involved trained MHELWs delivering ten sessions to employees with existing mental health conditions and managers (three individual sessions and four joint sessions) over twelve weeks. These sessions aimed to improve psychological flexibility, interpersonal relationships, and engagement of employees. This feasibility randomised controlled trial aimed to examine the feasibility and acceptability of the intervention from the perspective of employees and managers using a mixed methods approach. The intervention was largely considered feasible and acceptable. Initial findings suggest there may be benefits for employees productivity, mental health, and managers' mental health knowledge. Logistical challenges acted as a barrier to the participation of employees and managers in the trial and their retention throughout its duration. The major strengths of this study were the co-design and inter-disciplinary approach taken. Overall, findings suggest that this novel intervention has potential but needs some adjustments and testing in a larger sample.

Supporting carers to improve patient safety and maintain their well-being in transitions from mental health hospitals to the community: A prioritisation nominal group technique.

Carers of people with mental illness may face distinct challenges, including navigating fragmented health and social services during discharge from mental health hospitals. Currently, limited examples of interventions that support carers of people with mental illness in improving patient safety during transitions of care exist. We aimed to identify problems and solutions to inform future carer-led discharge interventions, which is imperative for ensuring patient safety and the well-being of carers. The nominal group technique was used which combines both qualitative and quantitative data collection methods in four distinct phases: (1) problem identification, (2) solution generation, (3) decision making and (4) prioritisation. The aim was to combine expertise from different stakeholder groups (patients, carers and academics with expertise in primary/secondary care, social care or public health) to identify problems and generate solutions. Twenty-eight participants generated potential solutions that were grouped into four themes. The most acceptable solution for each was as follows: (1) 'Carer Involvement and Improving Carer Experience' a dedicated family liaison worker, (2) 'Patient Wellness and Education' adapting and implementing existing approaches to help implement the patient care plan, (3) 'Carer Wellness and Education' peer/social support interventions for carers and (4) 'Policy and System Improvements' understanding the co-ordination of care. The stakeholder group concurred that the transition from mental health hospitals to the community is a distressing period, where patients and carers are particularly vulnerable to safety and well-being risks. We identified numerous feasible/acceptable solutions to enable carers to improve patient safety and maintain their own mental wellbeing. Patient and public contributors were represented in the workshop and the focus of the workshop was to identify the problems they faced and co-design potential solutions. Patient and public contributors were involved in the funding application and study design.

COPING WITH DEATH ANXIETY AND AWARENESS: EXPERIENCE WITH COVID-19 PATIENTS IN NEW YORK

Introduction: The global challenge that the Covid-19 pandemic represented for humanity, included local experiences and encounters from which helpful lessons may be drawn.
 Objectives: The primary objective was to assess and document death anxiety and death awareness among hospitalized intensive care unit (ICU) patients diagnosed with COVID-19 in a community-based teaching hospital. The secondary one was to reflect on mental health clinicians’ therapeutic styles and skills when caring for patients in critical care settings.
 Methods: A series of hospitalized ICU patients diagnosed with COVID-19 at the height of the pandemic in New York City were evaluated in this study. Patients’ psychological distress symptoms, death awareness, and death anxiety were measured using the Revised Death Anxiety Scale. Seventeen COVID-19 positive patients with various comorbidities who had been admitted to the ICU at Staten Island University Hospital were compared with seventeen COVID-19 negative patients with various comorbidities who had been seen and evaluated on the same ward over the same time period. The Revised Death Anxiety Scale (25 items) was used on all subjects by the deployed psychiatrists. The clinicians’ experiences as recorded through diaries during this time were examined and reflected on.
 Results: Out of seventeen COVID-19 positive patients who participated in this case series, eleven responded with heigh death anxiety scores as compared to the seventeen COVID-19 negative patients in which only three subjects were observed to have high scores. From the very beginning, the COVID-19 pandemic brought to the forefront massive challenges for both psychiatrists and patients. These challenges immediately affected rapport-building, often leading to an atmosphere of trust, but also exposing patients to additional distress. Prior to furthering and facilitating therapeutic dialogue, psychiatrists had to “anesthetize the therapeutic situation,” decrease the arousal level and be attentive throughout the encounter. This attentiveness had to be individually organized and modulated as patients displayed different personality styles, with variations in their internal world and severity of medical condition. In due course, individual patterns of reactions were observed such as fantasies concerning isolation and separation, contrasting attachment styles, need for punishment and guilt feelings and activation of panic and helplessness. The latter was particularly challenging as both patient and physician could become easily trapped in feeling helpless and confused, with strong interpersonal and relational overlays. Compassionate gestures and sensibility in connectedness conveyed vitality and much needed hope.
 Discussion and Conclusions: Although death anxiety and death awareness seemed overwhelmingly prevalent among the COVID-19 positive patients in comparison to COVID-19 negative patients, differences have been observed in terms of being age-specific, having multiple comorbidities compounding on COVID-19 positive status (e.g., obesity and COPD). In general, the acute psychological distress of patients improved with medical treatment and when stabilized they were moved out of the ICU. Patients with high scores who had a COVID-19 positive status tended to have increased stay in the ICU. Future studies should assess the long-term consequences of COVID-19 on patients’ general mental health and particularly death awareness and death anxiety. Additionally, health systems may use similar studies to understand the labor and costs borne by mental health clinicians as well as other clinicians working in such settings. In terms of medical education and liaison work, such research may inform training of clinicians in internal medicine, critical care, and mental health.

Canadian academic nursing librarians: Impacts of the COVID-19 pandemic on librarianship practice

ObjectiveThis study explored changes in the practice of academic nursing librarianship at large Canadian universities during the COVID-19 pandemic with a particular focus on academic nursing librarians’ work with nursing graduate students and nursing faculty.MethodsSemi-structured interviews were conducted with eleven academic nursing librarians about changes to their librarianship practice during the COVID-19 global pandemic. Interviews were conducted between 20 April and 14 May 2021, discussing experiences during the study period March 2020 to May 2021.ResultsCanadian academic nursing librarians experienced (i) the adoption of the completely virtual library ; (ii) changes to the type and prevalence of online instruction ; (iii) the discovery that online consultations work well ; (iv) the discovery of the extent to which relationships are valued and intentional ; (v) an increase in requests for instruction and co-authorship of knowledge syntheses; and (vi) the benefits and challenges of remote work.DiscussionExperiences were divergent, shaped in part by the institutions’ pre-pandemic practices. Additionally, some participants reported no impact of the pandemic on their research, instruction, and collaborations with nursing graduate students and nursing faculty. In particular, institutions already offering online masters programs in nursing reported less significant disruption. The temporary transition to the completely virtual library revealed benefits of online consultations, opportunities for reaching more students through asynchronous learning, the importance of relationships to nursing liaison work, and value of the flexibility to work remotely .ConclusionThe COVID-19 global pandemic continues to evolve. With a return to in-person classes at Canadian universities, there is much to learn from the experiences during the first 18 months of the pandemic.

Recruiting, Hiring, & On-Boarding Non-MLS Liaison Librarians: A Case Study

A case study of how the University of Oklahoma Libraries recruited, hired, and then on-boarded three Science Liaison Librarians who held advanced subject degrees but no Masters in Library Science. This study provides suggestions for modifying job postings, interview processes, and on-boarding to appeal to non-MLS subject experts and to fully inform them of the scope of liaison work.

Swatantra Clinic: A descriptive study on the specialized child mental health service for children in difficult circumstances at a tertiary care center in India.

In India, children in difficult circumstances, like institutionalized children have higher mental health morbidity and complex psychosocial concerns than the non-institutionalized children. To cater to the complex needs of these children referred by the Juvenile Justice System, a specialized service called 'Swatantra Clinic' was initiated by the Department of Child and Adolescent Psychiatry at the National Institute of Mental Health and Neurosciences, India. This article thereby aims to describe the psychosocial characteristics of these children, along with the array of specialized interventions provided during the first year of its inception in June 2018. It was found that majority of these children were girls and were from lower socio-economic, urban background, primarily referred for externalizing or internalizing concerns. The majority of them reported experiences of physical and verbal abuse along with family stressors and almost half of them had a diagnosable psychiatric condition. The nature of the psychosocial services rendered at the clinic mostly comprised of brief, individual and family counseling along with liaison work with various governmental agencies for rehabilitation services. These form the key components of a comprehensive, collaborative, time-bound and holistic care model to cater to the distinct psychosocial issues of this vulnerable population of children in low - middle resource settings. Policy implications are discussed.

Library Liaison Services in US Community Colleges

Library liaison services have been shown to be a valuable component of higher education in the US. Despite this established value, however, liaison services specific to community colleges are rarely discussed in the scholarly literature, while such services from universities and research institutions are well researched. Though it is understandable that liaison services at universities and community colleges would have similarities such as collaboration and outreach with students and faculty, it is only logical that they would also have differences due to the differences in user groups they serve. However, performing any reasonable comparison is difficult due to the absence of scholarly discourse regarding liaison services at community colleges. This article fills this gap by presenting survey data on the state of liaison services in community college libraries in the US. The data shows that a range of liaison work is being performed by community college librarians; A number of opportunities for further inquiry are also identified.

The capacity-building role of community liaison workers with refugee communities in Victoria, Australia

BackgroundA range of services within Australia and internationally have been developed that are focused on the engagement of individuals who are of refugee background to work as a liaison between their communities and mental health services. The Community Liaison Worker (CLW) role at the Victorian Foundation for Survivors of Torture (VFST) was developed in 2008 in order to engage in such capacity-building initiatives.AimsTo review and document the establishment, evolution and current status of the VFST CLW role, and examine the perspectives of CLWs on their role in trauma-informed community capacity-building.MethodsThe study comprised of two stages: a historical case study of the development of the CLW role, and a qualitative research study based on interviews with CLWs in order to identify key themes regarding various aspects of their role and understand the facilitators and barriers to their work of trauma-informed capacity-building with their respective communities.ResultsThe CLW role has evolved from the provision of direct services through joint work with Counsellor Advocates at VFST to a broader role that is focused on building the capacity of community members. Thematic analysis of interviews with the seven current CLWs identified the complexity of their dual role as members of their community and employees of VFST, their role in addressing short-term goals to meet community needs, and the long-term objective of empowering their community to become integrated and self-sufficient.ConclusionsCLWs at VFST demonstrate important work of liaison workers in facilitating trauma-informed capacity-building initiatives that are of benefit to members of their communities and also to service providers.

Implementation of a Quality Improvement Role for Unlicensed Assistive Personnel and Effects on Infection Prevention

Background: Care bundles comprise evidence-based practices and interventions that are easily and consistently implemented while improving patient outcomes. As patient acuity and task overload continue to increase, infection prevention bundle and process measure compliance and data collection may become a lower priority for registered nurses (RNs). In early 2019, a certified nursing assistant (CNA) began full-time quality liaison work on a 53-bed inpatient adult oncology unit at UNC Medical Center to provide targeted compliance data collection and to correct deficits in real time when possible and within the appropriate scope of practice. Methods: The quality liaison CNA is highly motivated, with a relevant clinical background and effective communication skills. After conducting a gap analysis, the unit developed specific responsibilities for several areas of quality improvement, including infection prevention. In addition to rounding on all patients daily, the quality liaison (1) performs direct patient care tasks like Foley catheter care, (2) conducts patient education on topics such as chlorhexidine gluconate treatments, (3) performs all relevant process measure audits, and (4) easily relays missed or needed care to RNs with a door sign created as part of this initiative. High-risk findings, such as a loose central-line dressing, prompt immediate communication to the RN, with follow-up and escalation when necessary. Results: Patients and staff received the quality liaison well, and the increased attention to care bundle components and auditing ensured consistent, evidence-based care along with accurate and reliable data collection. Compared to the previous calendar year, the number of central-line audits on the unit increased by >1,400 by the end of 2019. Patient outcomes improved, and during 1 fiscal year, the unit achieved rate reductions between 40% and 55% for central-line–associated bloodstream infections, catheter-associated urinary tract infections, and healthcare-associated C. difficile infections. Staffing and logistical challenges imposed by the COVID-19 global pandemic have hampered this work because the quality liaison was redeployed to direct patient care intermittently. Correspondingly, from July to October 2020, the same infection rates increased between 30% and 353%. Conclusions: Having a designated quality liaison is an effective means to achieving quality improvements while remaining an integral member of the patient care team. As staffing has improved on this unit, the quality liaison has refocused efforts, and infection rates are beginning to improve. Given the success of the quality liaison role in improving quality outcomes on this unit, the hospital is exploring expansion of this model to additional units.Funding: NoDisclosures: None

The Evolving Responsibilities, Roles, and Competencies of East Asian Studies Librarians: A Content Analysis of Job Postings from 2008 to 2019

A content analysis of 62 job postings for East Asian studies librarians in the United States and Canada during 2008–2019 demonstrates that major job responsibilities have expanded to include collection development and management, reference and research assistance, instruction, liaison work, and outreach; relationship building and collaboration are emerging roles; skills and abilities have been progressively occupying a larger proportion than knowledge and experience in the required qualifications; top frequently required abilities and skills are generic and behavioral; and professional experiences are often preferred rather than required. The results of this research are of practical relevance to subject specialists in other areas.

Embedded librarians as research partners in South Korea

Recently, many articles co-authored by librarians have been published in non-library and information science journals. This may indicate that embedded librarians are actively working as research partners in various fields. However, studies have rarely discussed the roles and experience of embedded librarians and, unlike the USA and European countries, the activities of embedded librarians in Korea are not well reported. This study collected and analysed co-authored articles from Korean faculty and librarians. In addition to identifying the role of the embedded librarian by analysing the author-contributions texts of the articles, the study examined the backgrounds of librarians and the difficulties of collaborating through interviews with librarian authors. The results of the analyses show that the number of collaborative articles by faculty and embedded librarians increased over the years and, of these, almost 70% were medical publications. The roles of the librarians outlined in the author-contributions texts were as reported in previous studies but, in many cases, their role was more significant than traditional liaison work, such as reporting the study’s methodology or approving the final draft. In the interviews, the embedded librarians expressed that they had experienced some difficulties, such as lack of time, insufficient guidelines and an inadequate curriculum in their library and information science department. For librarians to be recognized as research partners, they need to communicate well with team members and have knowledge, skills and abilities related to the research. Further, to achieve this collaboration, the curriculum of departments should be reformed. If such efforts are made, it is expected that embedded librarians will continue to excel in their role as liaison librarians, which has contributed to supporting research projects.

The discussion group "Maternity wards and cultures, exchanges around cradles"

At the Port-Royal maternity ward in Paris (14th arrondissement), a system has been set up as part of the liaison work. The discussion group "Maternities and cultures, exchanges around cradles" offers a sharing and carrying place in this so singular period of "becoming a mother" . Cultural and professional mixing is at the heart of this system. Presentation of observations of the group's movements over two years.

Understanding the Breadth and Depth of C-L Psychiatry: Assessing and Managing Delirium

Understanding the Breadth and Depth of C-L Psychiatry: Assessing and Managing Delirium

Non-clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review.

To describe research into non-clinical support eye health care for Aboriginal and Torres Strait Islander (Indigenous) Australians, the people who provide such care, and its impact on eye health outcomes. Systematic review and qualitative analysis of peer-reviewed research publications. Peer-reviewed research articles published between January 2000 and July 2018 and included in MEDLINE/EMBASE, Web of Science, Informit, EBSCO (CINAHL and Anthropology Plus), or ProQuest Central. We included English language, peer-reviewed articles reporting empirical data on non-clinical support for eye health for Indigenous Australians. Two authors independently assessed the titles and abstracts of 1678 unique articles for inclusion in a full text review; the full texts of 104 publications were reviewed, of which 77 were excluded and 27 included in our qualitative analysis. Qualitative analysis identified five key areas of non-clinical support for Indigenous eye health: coordination of eye care, integrating and linking services, cultural support, health promotion, and social and emotional support. People who provide non-clinical support include eye health coordinators, Aboriginal Health Workers, primary care clinicians, family members, carers, and community-based liaison workers. The availability of non-clinical support is associated with increased patient attendance at eye care services, higher visual acuity examination and cataract surgery rates, broader eye health knowledge, and greater cultural responsivity. Non-clinical support is critical for facilitating attendance at appointments by patients and ensuring that preventive, primary, and tertiary eye care services are accessible to Indigenous Australians. Greater financial investment is needed to support key providers of non-clinical support, especially eye health coordinators, community-based liaison officers, and family members and carers.

Trust, and distrust, of Ebola Treatment Centers: A case-study from Sierra Leone.

The paper considers local responses to the introduction of an Ebola Treatment Centre in eastern Sierra Leone during the West African epidemic of 2014-15. Our study used qualitative methods consisting of focus groups and interviews, to gather responses from patients, members of the families of survivors and deceased victims of the disease, social liaison workers from the centre, and members of the general public. The data indicate that scepticism and resistance were widespread at the outset, but that misconceptions were replaced, in the minds of those directly affected by the disease, by more positive later assessments. Social workers, and social contacts of families with workers in the centre, helped reshape these perceptions, but a major factor was direct experience of the disease. This is apparent in the positive endorsements by survivors and families who had members taken to the facility. Even relatives of deceased victims agreed that the case-handling centre was valuable. However, we also present evidence of continuing scepticism in the minds of members of the general public, who continue to suspect that Ebola was a crisis manufactured for external benefit. Our conclusions stress the importance of better connectivity between communities and Ebola facilities to facilitate experiential learning. There is also a need to address the wider cognitive shock caused by a well-funded Ebola health initiative arriving in communities with a long history of inadequate health care. Restoring trust in medicine requires Ebola Virus Disease to be re-contextualized within a broader framework of concern for the health of all citizens.

Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service

BackgroundLiaison psychiatry services provide mental health care for patients in physical healthcare (usually acute hospital) settings including emergency departments. Liaison work involves close collaboration with acute hospital staff so that high quality care can be provided. Services however are patchy, relatively underfunded, heterogeneous and poorly integrated into acute hospital care pathways.MethodsWe carried out in-depth semi-structured interviews with 73 liaison psychiatry and acute hospital staff from 11 different acute hospitals in England. The 11 hospitals were purposively sample to represent hospitals in which four different types of liaison services operated. Staff were identified to ensure diversity according to professional background, sub-specialism within the team, and whether they had a clinical or managerial focus. All interviews were audio-recorded and transcribed. The data were analysed using a best-fit framework analysis.ResultsSeveral key themes emerged in relation to facilitators and barriers to the effective delivery of integrated services. There were problems with continuity of care across the secondary-primary interface; a lack of mental health resources in primary care to support discharge; a lack of shared information systems; a disproportionate length of time spent recording information as opposed to face to face patient contact; and a lack of a shared vision of care. Relatively few facilitators were identified although interviewees reported a focus on patient care. Similar problems were identified across different liaison service types.ConclusionsThe problems that we have identified need to be addressed by both liaison and acute hospital teams, managers and funders, if high quality integrated physical and mental health care is to be provided in the acute hospital setting.

A programme theory for liaison mental health services in England

BackgroundMechanisms by which liaison mental health services (LMHS) may bring about improved patient and organisational outcomes are poorly understood. A small number of logic models have been developed, but they fail to capture the complexity of clinical practice.MethodWe synthesised data from a variety of sources including a large national survey, 73 in-depth interviews with acute and liaison staff working in hospitals with different types of liaison mental health services, and relevant local, national and international literature. We generated logic models for two common performance indicators used to assess organisational outcomes for LMHS: response times in the emergency department and hospital length of stay for people with mental health problems.ResultsWe identified 8 areas of complexity that influence performance, and 6 trade-offs which drove the models in different directions depending upon the balance of the trade-off. The logic models we developed could only be captured by consideration of more than one pass through the system, the complexity in which they operated, and the trade-offs that occurred.ConclusionsOur findings are important for commissioners of liaison services. Reliance on simple target setting may result in services that are unbalanced and not patient-centred. Targets need to be reviewed on a regular basis, together with other data that reflect the wider impact of the service, and any external changes in the system that affect the performance of LMHS, which are beyond their control.

Organisation and delivery of liaison psychiatry services in general hospitals in England: results of a national survey

ObjectivesTo describe the current provision of hospital-based liaison psychiatry services in England, and to determine different models of liaison service that are currently operating in England.DesignCross-sectional observational study comprising an...

Teaching librarians about data: The ACRL Research Data Management RoadShow

As research data management (RDM) has grown into an increasingly familiar service activity in academic libraries, there remains a knowledge gap for liaison and subject librarians attempting to take on these additional responsibilities. As one option to address this, the authors were contracted by ACRL to create a new full-day workshop targeting this specific audience. The result is the ACRL RoadShow, Building Your Research Data Management Toolkit: Integrating RDM into Your Liaison Work. Now in its second year, the RDM RoadShow has traveled extensively in the United States as well as one international trip and continues to assist in meeting the foundational RDM educational needs for liaison librarians and to identify where further education is desired.

Factors that impact access to ongoing health care for First Nation children with a chronic condition

BackgroundAccess to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child’s health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition.MethodsAn extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality.ResultsA total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues.ConclusionThere are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.