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The Clinical Informationist: Does the Model Work

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00226291
First Posted: September 26, 2005
Last Update Posted: May 28, 2014
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Nunzia Giuse, Vanderbilt University
  Purpose
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

Condition Intervention
Critical Illness Other: Synthesized evidence report

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Official Title: The Clinical Informationist: Does the Model Work

Further study details as provided by Nunzia Giuse, Vanderbilt University:

Primary Outcome Measures:
  • Immediate and potential future clinical decisions [ Time Frame: 3 days post-consult ]

Secondary Outcome Measures:
  • Clinical action index [ Time Frame: 3 days post-consult ]
  • Number of research articles read [ Time Frame: 3 days post-consult ]
  • Satisfaction [ Time Frame: 3 days post-consult ]
  • Colleague consults [ Time Frame: 3 days post-consult ]
  • Time spent searching the literature [ Time Frame: 3 days post-consult ]

Enrollment: 299
Study Start Date: August 2004
Study Completion Date: May 2007
Primary Completion Date: February 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 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.
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.
Other Names:
  • Literature summary
  • Evidence report
No Intervention: No evidence report

Detailed 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.

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

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

  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00226291


Locations
United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
Investigators
Principal Investigator: Nunzia B Giuse, MD, MLS Vanderbilt University Medical Center
  More Information

Additional Information:
Publications:
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)
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)

Responsible Party: Nunzia Giuse, Assistant Vice Chancellor for Knowledge Management; Director, Eskind Biomedical Library; Professor, Department of Biomedical Informatics, Vanderbilt University
ClinicalTrials.gov Identifier: NCT00226291     History of Changes
Other Study ID Numbers: 040624
5R01LM007849 ( U.S. NIH Grant/Contract )
First Submitted: September 22, 2005
First Posted: September 26, 2005
Last Update Posted: May 28, 2014
Last Verified: May 2014

Keywords provided by Nunzia Giuse, Vanderbilt University:
EBM
evidence based medicine
informationist
clinical medical librarian

Additional relevant MeSH terms:
Critical Illness
Disease Attributes
Pathologic Processes