The Clinical Informationist: Does the Model Work

Critical Illness Clinical Trial

Official title:

The Clinical Informationist: Does the Model Work

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00226291
• Other study ID #: 040624
• Secondary ID: 5R01LM007849
• Status: Completed
• Phase: N/A
• First received: September 22, 2005
• Last updated: May 27, 2014
• Start date: August 2004
• Est. completion date: May 2007

Study information

• Verified date: May 2014
• Source: Vanderbilt University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

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

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 299
• Est. completion date: May 2007
• Est. primary completion date: February 2006
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

Evidence-based questions requested by clinician on current service as an attending, resident, fellow, or nurse practitioner on one of the units included in the study

Exclusion Criteria:

All others

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label

Related Conditions & MeSH terms

• Critical Illness

Intervention

Other:
• Synthesized evidence report
Each consultation response included a documented bibliographic search strategy with corresponding references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research materials.

Locations

Country	Name	City	State
United States	Vanderbilt University Medical Center	Nashville	Tennessee

Sponsors (1)

Lead Sponsor	Collaborator
Vanderbilt University

Country where clinical trial is conducted

United States, 

References & Publications (9)

Florance V, Giuse NB, Ketchell DS. Information in context: integrating information specialists into practice settings. J Med Libr Assoc. 2002 Jan;90(1):49-58. Review. — View Citation

Giuse NB, Kafantaris SR, Miller MD, Wilder KS, Martin SL, Sathe NA, Campbell JD. Clinical medical librarianship: the Vanderbilt experience. Bull Med Libr Assoc. 1998 Jul;86(3):412-6. — View Citation

Giuse NB, Koonce TY, Jerome RN, Cahall M, Sathe NA, Williams A. Evolution of a mature clinical informationist model. J Am Med Inform Assoc. 2005 May-Jun;12(3):249-55. Epub 2005 Jan 31. — View Citation

Giuse NB. Advancing the practice of clinical medical librarianship. Bull Med Libr Assoc. 1997 Oct;85(4):437-8. — View Citation

Jerome RN, Giuse NB, Gish KW, Sathe NA, Dietrich MS. Information needs of clinical teams: analysis of questions received by the Clinical Informatics Consult Service. Bull Med Libr Assoc. 2001 Apr;89(2):177-84. — View Citation

Mulvaney S, Bickman L, Lambert W, Sathe N, Jerome R, Guise NB. Barriers to and facilitators of evidence based practices in physicians. Society for Behavioral Medicine 28th Annual Meeting. Washington, DC. March 2007. (Poster)

Mulvaney SA, Bickman L, Giuse NB, Lambert EW, Sathe NA, Jerome RN. A randomized effectiveness trial of a clinical informatics consult service: impact on evidence-based decision-making and knowledge implementation. J Am Med Inform Assoc. 2008 Mar-Apr;15(2) — View Citation

Rosenbloom ST, Giuse NB, Jerome RN, Blackford JU. Providing evidence-based answers to complex clinical questions: evaluating the consistency of article selection. Acad Med. 2005 Jan;80(1):109-14. — View Citation

Sathe NA, Todd P, Gregg W, Clark J, Giuse NB. Virtual cases as a tool to promote the incorporation of EBM techniques into housestaff training . Medical Library Association Annual Meeting, Phoenix, AZ, May 2006. (Poster)

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Immediate and potential future clinical decisions		3 days post-consult	No
Secondary	Clinical action index		3 days post-consult	No
Secondary	Number of research articles read		3 days post-consult	No
Secondary	Satisfaction		3 days post-consult	No
Secondary	Colleague consults		3 days post-consult	No
Secondary	Time spent searching the literature		3 days post-consult	No

External Links

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