The Clinical Informationist: Does the Model Work

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Nunzia Giuse, Vanderbilt University
ClinicalTrials.gov Identifier:
NCT00226291
First received: September 22, 2005
Last updated: May 27, 2014
Last verified: May 2014
  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
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Official Title: The Clinical Informationist: Does the Model Work

Further study details as provided by Vanderbilt University:

Primary Outcome Measures:
  • Immediate and potential future clinical decisions [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Clinical action index [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]
  • Number of research articles read [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]
  • Satisfaction [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]
  • Colleague consults [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]
  • Time spent searching the literature [ Time Frame: 3 days post-consult ] [ Designated as safety issue: No ]

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

Genders Eligible for Study:   Both
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
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Please refer to this study by its ClinicalTrials.gov identifier: 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
  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)

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, 5R01 LM07849
Study First Received: September 22, 2005
Last Updated: May 27, 2014
Health Authority: United States: Food and Drug Administration

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

Additional relevant MeSH terms:
Critical Illness
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on July 20, 2014