How much effort is needed to keep up with the literature relevant for primary care?

OBJECTIVES: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions). The authors estimated the volume of medical literature potentially relevant to primary care published in a month and the time required for physicians trained in medical epidemiology to evaluate it for updating a clinical knowledge base. METHODS: We included journals listed in five primary care journal review services (ACP Journal Club, DynaMed, Evidence-Based Practice, Journal Watch, and QuickScan Reviews). Finding little overlap, we added the 2001 "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." We counted articles (including letters, editorials, and other commentaries) published in March 2002, using bibliographic software where possible and hand counting when necessary. For journals not published in March 2002, we reviewed the nearest issue. Five primary care physicians independently evaluated fifty randomly selected articles and timed the process. RESULTS: The combined list contained 341 currently active journals with 8,265 articles. Adjusting for publication frequency, we estimate 7,287 articles are published monthly in this set of journals. Physicians trained in epidemiology would take an estimated 627.5 hours per month to evaluate these articles. CONCLUSIONS: To provide practicing clinicians with the best current evidence, more comprehensive and systematic literature surveillance efforts are needed.     

New measures for new roles: defining and measuring the current practices of health sciences librarians

The roles of academic health sciences librarians are continually evolving as librarians initiate new programs and services in response to developments in computer technology and user demands. However, statistics currently collected by libraries do not accurately reflect or measure these new roles. It is essential for librarians to document, measure, and evaluate these new activities to continue to meet the needs of users and to ensure the viability of their professional role. To determine what new measures should be compiled, the authors examined current statistics, user demands, professional literature, and current activities of librarians as reported in abstracts of poster sessions at Medical Library Association annual meetings. Three new categories of services to be measured are proposed. The first, consultation, groups activities such as quality filtering and individual point-of-need instruction. The second, outreach, includes activities such as working as liaisons, participating in grand rounds or morning report, and providing continuing education. The third area, Web authoring, encompasses activities such as designing Web pages, creating online tutorials, and developing new products. Adding these three measures to those already being collected will provide a more accurate and complete depiction of the services offered by academic health sciences librarians.     

Education for inpatients: working with nurses through the clinical information system

Librarians at the UMDNJ Cooper Library have been filling orders for patient education materials through Cooper University Hospital's Clinical Information System (CIS) since December 2000. This service was instituted in response to a JCAHO survey, which revealed that although patient education was being provided, it was not being routinely documented. Patient education orders fall into two categories: customized disease/procedure information and smoking cessation information. Nurses note the condition(s) and/or procedure(s) regarding which information is needed and indicate the education level of the material desired (basic, intermediate or advanced). Requests are received via a dedicated printer in the reference office. Librarians rely heavily upon a wide variety of Web-based consumer health resources, including proprietary resources such as MD Consult and Micromedex CareNotes. Patient Transport staff delivers two copies of all materials to nursing stations on patient care floors. One copy is for the patient to keep, while the other is attached to the patient's chart. To complete and document that patient education was provided, librarians record the order as filled in the CIS system.