Integrating a Librarian into a Multidisciplinary Rounding Team

Christine Caufield-Noll, MLIS, AHIP

Johns Hopkins Bayview Medical Center

Harrison Medical Library

October 21, 2008

Overview

• Rounding in the literature

• Rounding at Bayview– History– Interdisciplinary burn rounds

• Benefits of rounding

• Implementing a rounding program in your hospital

Rounding in the literature

• “Clinical medical librarian” first documented in a 1974 article by Virginia Algermissen

• Many different titles like clinical medical librarian, clinical librarian, librarian in context and informationist

Algermissen V. Biomedical librarians in a patient care setting at the University of Missouri-Kansas City School of Medicine. Bull Med Libr Assoc. 1974 October; 62(4): 354–358.

Rounding in the literature

• How are these information professionals different from traditional reference librarians?– They take library services to health

professionals by attending rounds, morning report and conferences

– Attending these functions allows these librarians to anticipate information needs of the clinical staff (Miller 1985)

– Working with the clinical staff in context is their primary duty

Rounding at Bayview

• How we began– Asked by a

medicine faculty member to participate in teaching rounds

– Conducted a two month trial of rounding on a medicine floor

Rounding at Bayview

– Librarian attended medical rounds twice a week for 2-3 hours

– Trial was successful and burn unit director asked the librarian to participate on his rounds after hearing about her work on the medical unit

– Staff appreciated the research provided by the librarian and thought her contributions added to the educational value of rounds

Rounding at Bayview

• Interdisciplinary burn rounds– Tuesday

mornings between 7:30 and 8:30

– Attendance ranges from 12 to 40 people

– Takes place in Burn ICU

Examples of search requests

• Burn injuries and liver disease (cirrhosis)

• Contraindications for skin grafting on a patient with lupus

• Virtual reality/distraction programs for pain during procedures (i.e. debridement)

• Studies on using essential oils vs. petroleum products on burn wounds

• Prevention of smoking on home oxygen

Benefits of rounding

• To the medical staff– Increases the educational value of rounds– Provides high-quality information to answer

patient care questions– Saves time and effort

Benefits of rounding

• To the library and the librarian– Helps the librarian know what the important

topics or common diagnoses are in that unit• May impact collection development

– Increases the librarian’s value to the hospital– Boosts the visibility of the library and

its services• May increase use of library resources• Provides a venue to promote library resources

Benefits of rounding

– Opportunities to assist with patient education– Ties the library into the hospital’s mission– May lead to other opportunities within

the hospital• Serving on other committees or the IRB

Implementing a rounding program• Begin with departments with whom you

have an existing relationship

• Support from department leaders is key

• If you do not have teaching rounds established in your institution, think about other groups to work with (nurses, therapists, social workers) – be creative!

• Have a trial period and establish own measures of success

References

• Algermissen, V. (1974). Biomedical librarians in a patient care setting at the university of missouri-kansas city school of medicine. Bulletin of the Medical Library Association, 62(4), 354-358.

• Brandes, S. (2007). Experience and outcomes of medical librarian rounding. Medical Reference Services Quarterly, 26(4), 85-92.

• Burdick, A. (2004). Informationist? internal medicine rounds with a clinical medical librarian. Journal of Hospital Librarianship, 4(1), 17-27.

References

• Marshall, J. G., & Neufeld, V. R. (1981). A randomized trial of librarian educational participation in clinical settings. Journal of Medical Education, 56(5), 409-416.

• Miller, N., & Kaye, D. (1985). The experience of a department of medicine with a clinical medical library service. Journal of Medical Education, 60(5), 367-373.

• Schwing, L. J., & Coldsmith, E. E. (2005). Librarians as hidden gems in a clinical team. Medical Reference Services Quarterly, 24(1), 29-39.