Evidence Based Library and Information Practice

1. Evidence Based Library and Information Practice What is it? What’s in it for you? How can it work? ISKO UK Conference 2013, 9th July 2013 Dr Alison Brettle University of Salford, Editor-in-Chief Evidence Based Library and Information Practice Journal

2. Evidence Based Library and Information Practice • What is it? • What’s in it for you? • How does it work? • Examples from health library sector • Using evidence summaries

3. Evidence Based Practice • Method of applying research evidence to decision making • Expanded from health to a wide range of professions – including library and information (EBLIP) • All have similar themes around using best available evidence combined with professional judgement • All have advocates and critics

4. Originating from health care • “The process of systematically finding, appraising and using contemporaneous research findings as the basis for clinical decisions” (Rosenberg and Donald, 1995 p1122) • “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett et al, 1996 p71)

5. EBLIP • “EBLIP seeks to improve library and information services and practice by bringing together the best available evidence and insights derived from working experience, moderated by user needs and preferences……It thus attempts to integrate user-reported, practitioner observed and research derived evidence as an explicit basis for decision making” (Booth, 2006, p65)

6. The process

7. Why should you care? • “Wisdom means acting with knowledge whilst doubting what you know” • Jeffrey Pfeffer and Robert I Sutton

8. The advocates • Method of keeping up to date with an exponentially growing body of research thus ensuring that decisions are based on current evidence (particularly important in health care) • Informed decision making • Creates a bridge between research and practice

9. The critics • Cookbook medicine! • No different to professional practice

10. Barriers • Organisational dynamics • Lack of time/competing demands on time • Personal outlook/lack of confidence • Education and training gaps • Information needs not being met • Financial constraints

11. Ask • First step • Ask a question, often based on a problem or something arising from your practice • What are the “burning questions” in knowledge organisation?

12. Acquire • What evidence is needed to answer your question

13. Evidence?

14. Definition • “the available body of facts or information indicating whether a belief or proposition is true or valid” • (Oxford English Dictionary, 2011)

15. Evidence sources(Koufogiannakis, 2012)

16. Acquiring • Published research • Databases • Books, bibliographies • Mail lists, blogs, word of mouth • Conferences • Systematic reviews • Evidence summaries

17. Creating • Local evidence • Usage data • Transaction data • Evaluation results • Surveys, interviews, focus groups • Can you use any of these sources to answer your burning questions?

18. Implementing an evidence based approach • Clinical librarians • Using evidence summaries

19. Ask, acquire and appraise the evidence…. To undertake a systematic review on clinical librarianship – specifically on evaluating clinical librarian services To provide a group of librarians with the opportunity to develop skills in research and systematic reviews

20. Methods Systematic review methodology But on a group basis Evaluation of the process of undertaking the review Reflective diaries Post it exercises Group discussion (taped and transcribed) Analysis of the time spent undertaking the review

21. Ways of working Group responsibility for project – facilitator/mentor Meetings! Originally to discuss, plan and set tasks Later to undertake tasks on the review Public deadlines (conference presentations and papers) Working in pairs Elements of review undertaken in pairs – as a quality control, more importantly to build confidence Web based group communication tools (Grouploop and project wiki) Communicate and store documents Reflective diaries Time logs Part funded by strategic library unit

22. The evidence Impact – there is limited evidence that CLs Save health professionals time Positive effect on clinical decision making Impact on patient care - diagnosis and the choice of intervention Data collection Poor quality Some recent Improvement can be seen in the reporting of samples and response rates, more work required on data collection and analysis

23. To implement the evidence.. • Need to increase robustness in methods. Methods chosen should limit bias, be consistent and are reported explicitly • CLs need to measure impact of contribution to patient care rather than directly impacting on patient care. • Need to identify more specific impacts • Need to demonstrating organisational impact

24. Implementing the evidence To undertake a multi-method evaluation study on the impact of Clinical Librarian (CL) services in the North West health region. To use a framework that ensures consistent and robust data is collected across all Trusts, providing an increased body of evidence To test the use of the MAP (Making Alignment a Priority) Toolkit in ensuring that evaluations meet organisational objectives To build research capacity amongst a group of clinical librarians

25. Implementing: consistent, robust, data collection Recruitment Managed by experienced researcher Invited to participate at various levels Training and support provided 10 CLs, representing 16 Trusts Following recommendations Mixed methods qualitative and quantitative Survey Interviews – complex services Independent researcher Actual impact No contribution, has contributed, may contribute

26. Implementing (creating): Critical Incident Technique (CIT) Respected, established, strong evidence base Numerous disciplines, sectors, service and market research, Library and Information research ‘robust’ and ‘tried and trusted method of demonstrating impact’ (Bryant and Gray, 2006) ‘a sound methodological basis for library and information research’ (Hughes et al., 2007) 17 recent studies Impact of a particular incident Focused, accurate (Urquhart, 2001) less subject to recall bias, tangible

27. Can you identify the key drivers for change that are influencing your NHS organisation and its decision making? Do you want to demonstrate how your library service is aligned to the priorities of the NHS? Do you need help critically highlighting how your library adds value and impacts upon organisational change, policy and practice? http://alignmentprojectnwlibrarians.pbworks.com Implementing: impact outcomes specific and organisational

28. Decision Making and Evidence Based Practice • Patient centred care • Quality of care and Improving healthcare outcomes • Service development • Efficiency, Financial or Risk Management • Accountability and transparency

29. Improved quality of life for patient or carers DOH Business Plan 2011-15, Impact indicator, p.32. Improved Healthcare Outcomes Liberating the NHS, 2010, pp.21-22 & 6.7, p.49; DOH Business Plan, Coalition priority 2, p.2 & pp.11-13 Increased patient involvement / Shared decision making Liberating the NHS, 2010, 4.a, p.3 & 2.1-4, p.13; DOH Business Plan 2011-15, Action 1.5; NHS Constitution 2009, Principle 4, p.3, patient and public right, p.7; Operating Framework 2011-12, pp.7&24; An Information Revolution, 2010 ; Hill Report, 2008, Purpose 1; CQUIN National Goals 2011-2012, Goal 2;. Improved patient care experience Liberating the NHS, 2010, 4.a, p.3 & 2.1-4, p.13; DOH Business Plan 2011-15, Action 1.3.i, p7-8; NHS Constitution 2009, Value, Improving lives, p.16; Operating Framework 2011-12, 2 of 5 mechanisms, p.23.;CQUIN National Goals 2011-2012, Goal 2; Monitor’s Compliance Framework 2011-12, quality measure for statement of certification. Improved patient access to information Liberating the NHS, 2010, pp13 -16; DOH Business Plan 2011-15, Action 1.3., pp.7-8; NHS Constitution 2009, Patient and Public Right p.10; An Information Revolution, 2010; Monitor’s Compliance Framework 2011-12, p.49.

31. Acquiring evidence • 10 Clinical Librarians representing 16 NW NHS Trusts taking part • Survey sent for each incident – after 6 weeks • 357/788 (Response rate of 45.3%)

32. Use of CL Services

33. Evidence of effectiveness

34. Evidence of impact on decision making and EBP

35. Evidence of impact on patient centred care and health outcomes

36. Evidence of impact on service development

37. Evidence of impact on CPD

38. Evidence of impact on efficiency, financial or risk management

39. Logic model: contribution to patient care and organisational objectives Input Activity Output Outcomes Clinical Librarians Literature Searches Filtered/ Synthesised Evidence Short Medium Long Support research Revision of Guidelines Improved Patient care Training Health professionals who can find or use evidence Choice of Diagnosis or test Avoidance Referral or readmission Meet quality standards Journal Clubs Advice to patients Reduced LOS Evidence in guidelines and teaching Diagnosis Support financial strategies Interventions Based on best evidence External Factors

40. Assessing the impact of evidence summaries in library & information studies:A mixed methods approach Alison Brettle, PhD, University of Salford Lorie Kloda, PhD, McGill University, Canada Denise Koufogiannakis, MA, MLIS, University of Alberta, Canada

41. Background Gap between research and practice in library and information studies (LIS) (Booth, 2003; Crowley, 2005; Genoni, Haddow, & Ritchie, 2004; Turner, 2002) Only method likely to improve communication is “inclusion of research reports in (…) publications frequently read by practitioners.”(Haddow & Klobas, 2004) Importance of communicating with the target audience to improve impact of research (RiLIES project, 2012) Evidence Based Library and Information Practice journal, 2006- >200 evidence summaries

42. Evidence Summaries Structured abstract objective – design – setting – subjects – method – main results – conclusion Commentary • 300-400 words • appraisal of validity, reliability, applicability • significance, implications for practice

44. Research Objectives To investigate the impact of evidence summaries on library and information professionals and their practice Knowledge (cognition) Practice Users

45. Mixed Methods Phase 1Development and face-validation of tool Phase 2Survey questionnaire to readers (QUANT) Phase 3Interviews (QUAL)

46. Findings (Questionnaire) Survey Respondents

47. Findings (Questionnaire) Number of Evidence Summaries Read in Past Year No. of respondents

48. Popular Evidence Summaries • Decline in Reference Transactions with Few Questions Referred to Librarian when the Reference Desk is Staffed by a Paraprofessional (8) • The Presence of Web 2.0 Applications Is Associated with the Overall Service Quality of Library Websites (6) • Google Scholar Out-Performs Many Subscription Databases when Keyword Searching (4) • Statistical Measures Alone Cannot Determine Which Database (BNI, CINAHL, MEDLINE, or EMBASE) Is the Most Useful for Searching Undergraduate Nursing Topic (4) • A Graduate Degree in Library or Information Science Is Required, but not Sufficient, to Enter the Profession (3)

49. Knowledge organisation related evidence summaries • Use and access of grey literature in special libraries may be hindered by lack of visibility and cataloguing • Enhanced Catalogue Records Positively Impact Circulation but Are Not Used to Their Potential in Patron Searching • Self-archiving to Institutional Repositories Is Improved by Assisted and Mandated Deposit; Disciplinary Culture is not a Factor

50. Findings - questionnaire Reason for Reading Evidence Summary n=62