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

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Evidence based library and information practice

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


Evidence based library and information practice1

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


Evidence based practice

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


Originating from health care

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)


Eblip

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)


The process

The process


Why should you care

Why should you care?

  • “Wisdom means acting with knowledge whilst doubting what you know”

  • Jeffrey Pfeffer and Robert I Sutton


The advocates

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


The critics

The critics

  • Cookbook medicine!

  • No different to professional practice


Barriers

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


Evidence based library and information practice

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?


Acquire

Acquire

  • What evidence is needed to answer your question


Evidence

Evidence?


Definition

Definition

  • “the available body of facts or information indicating whether a belief or proposition is true or valid”

  • (Oxford English Dictionary, 2011)


Evidence sources koufogiannakis 2012

Evidence sources(Koufogiannakis, 2012)


Acquiring

Acquiring

  • Published research

    • Databases

    • Books, bibliographies

    • Mail lists, blogs, word of mouth

    • Conferences

    • Systematic reviews

    • Evidence summaries


Creating

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?


Implementing an evidence based approach

Implementing an evidence based approach

  • Clinical librarians

  • Using evidence summaries


Ask acquire and appraise the evidence

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


Methods

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


Ways of working

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


The evidence

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


To implement the evidence

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


Implementing the evidence

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


Implementing consistent robust data collection

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


Implementing creating critical incident technique cit

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


Implementing impact outcomes specific and organisational

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


Evidence based library and information practice

  • 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


Evidence based library and information practice

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.


Acquiring evidence

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%)


Use of cl services

Use of CL Services


Evidence of effectiveness

Evidence of effectiveness


Evidence of impact on decision making and ebp

Evidence of impact on decision making and EBP


Evidence of impact on patient centred care and health outcomes

Evidence of impact on patient centred care and health outcomes


Evidence of impact on service development

Evidence of impact on service development


Evidence of impact on cpd

Evidence of impact on CPD


Evidence of impact on efficiency financial or risk management

Evidence of impact on efficiency, financial or risk management


Logic model contribution to patient care and organisational objectives

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


Assessing the impact of evidence summaries in library information studies a mixed methods approach

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


Background

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


Evidence summaries

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


Research objectives

Research Objectives

To investigate the impact of evidence summaries on library and information professionals and their practice

Knowledge (cognition)

Practice

Users


Mixed methods

Mixed Methods

Phase 1Development and face-validation of tool

Phase 2Survey questionnaire to readers (QUANT)

Phase 3Interviews (QUAL)


Findings questionnaire

Findings (Questionnaire)

Survey Respondents


Findings questionnaire1

Findings (Questionnaire)

Number of Evidence Summaries Read in Past Year

No. of respondents


Popular evidence summaries

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)


Knowledge organisation related evidence summaries

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


Findings questionnaire2

Findings - questionnaire

Reason for Reading Evidence Summary

n=62


Findings questionnaire3

Findings - questionnaire

Cognitive Impact


Findings questionnaire4

Findings - questionnaire

Practice Impact

“You reported: My practice was (will be) improved. What did you (will you) do differently

after reading the Evidence Summary?”


Findings interviews

Discovery

  • New research

  • Interesting topics

  • Methods

  • Keeping current

    Sharing

  • With colleagues, managers

  • Report writing

  • Recommended reading

    Assistance

  • Research

  • Writing, presentations

  • Teaching (for professors)

Findings (Interviews)

Potential Impacts Uncovered


Evidence summaries conclusion

Evidence summaries - Conclusion

  • Tool validation

  • Impact on knowledge (cognition)

  • Impact on Practice

    • Individual practice

    • Workplace practice

  • Difficult to assess impact on community/users


Summary

Summary

  • Evidence based library and information practice is a way of improving your decision making in professional practice

  • Uses a structured approach

  • Asking questions, finding evidence, applying evidence and implementing it

  • Lots of different ways to involve yourself in evidence: are you tempted to have a go?


Acknowledgements

Acknowledgements

  • North West Clinical Librarians Group

  • Denise Koufogiannakis, University of Alberta

  • Lorie Kloda, McGill University


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