Critical Illness Clinical Trial
Official title:
The Clinical Informationist: Does the Model Work
This study is investigating the effects of an established clinical informationist program (evidence-based practice support service in which information professionals with significant clinical knowledge bases and advanced information seeking and appraisal skills) on clinical decision making at selected critical care units at Vanderbilt University Medical Center
Background To evaluate the role of the Clinical Informatics Consult Service(CICS), an
informationist service at the Eskind Biomedical Library (EBL) at Vanderbilt University
Medical Center (VUMC, in clinical decision-making, the EBL has been awarded a 3-year grant
from the National Library of Medicine (5 R01 LM07849-02). The CICS is a well-established
program that facilitates evidence-based practice by delivering targeted information in
answer to complex, patient-specific questions. The CICS places librarians with specialized
training in medical subject areas and in information retrieval ("clinical informationists")
on clinical teams in intensive care settings. Acting as expert consultants, they analyze the
biomedical literature to identify, filter, and present the best examples of each clinical
viewpoint expressed about key problems.
Evaluation Project Working in cooperation with the Center for Evaluation and Program
Improvement (CEPI) at Peabody College of Vanderbilt, the investigators will evaluate
formally the role of CICS in clinical decision-making and evidence-seeking behavior. While
past studies have evaluated clinical medical librarians' roles, few if any studies have
examined the effectiveness and utility of the new clinical informationist approach in sites
where informationists are well-established.
The project will also create reusable evaluation tools transferable across environments.
Through a combination of observation and interviews, investigators will examine librarian
involvement in three existing Vanderbilt CICS intensive care units. The project will collect
detailed information about the ways in which clinicians incorporate CICS-provided
information into their workflows. Next, investigators will conduct a randomized trial to
evaluate the effect of CICS on decision-making. Investigators will compare clinicians'
intended course of care vs. actual care when CICS results are provided and when clinicians
seek information themselves.
Finally, "virtual cases" developed from actual patient CICS-related scenarios in each
clinical unit will be incorporated into training tools that can be used to export elements
of the CICS model to other locations. Demonstration of the utility of the clinical
informationist approach can foster widespread adoption nationally, and increase the degree
to which clinical practice becomes evidence-based.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label
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