This is a research paper submitted for LIBR220 (Medical and Health Sciences Librarianship), a graduate course in Library and Information Sciences at San Jose State University. / PURPOSE: To evaluate ways in which hospital librarians can help clinicians keep up with the rapid growth of genetic information and incorporate it into patient care as we enter the era of genomic medicine. SETTING: Hospital medical libraries DESCRIPTION: The fast-growing new field of genomic medicine applies human genetic information to the understanding and treatment of disease. Historically, evidence-based healthcare has been informed by studies on large populations. Breakthroughs in genetic analysis technologies are presenting healthcare providers with new opportunities to diagnose and customize clinical treatment based on the genetic structure of individual patients. In the hospital setting, access to genomic medicine information resources, clinical guidelines, and continuing education will be critical in the near future. This research paper will explore resources and programs that hospital librarians can offer to clinicians, to serve their genomic medicine information needs and help them navigate through unfamiliar territory.

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Objectives: The study examines how Loansome Doc services are implemented and used by libraries in the Southeast Region and describe end users' experiences with and attitudes toward Loansome Doc. Methods: 251 active DOCLINE libraries and 867 Loansome Doc users were surveyed. Results: Roughly one half of the libraries offered Loansome Doc services. Of those that did not, most indicated no plans to offer it in the future. The majority had a small number of end users and experienced minimal increases in interlibrary loan activity. Problems were relatively rare. Satisfaction with Loansome Doc was high among all types of libraries. End users were usually physicians or other health care professionals who requested articles for research and patient care. Most learned about Loansome Doc through PubMed or Internet Grateful Med. End users appeared to be largely self-taught or received informal instruction in Loansome Doc. Loansome Doc filled document requests in a timely manner, and end users reported being satisfied with the service. Conclusions: Greater promotion of what Loansome Doc is and how it can benefit libraries can increase the number of participating libraries. While satisfaction of Loansome Doc end users is high, satisfaction could be increased with more help on the PubMed screen, more library training, and faster delivery methods.

A quantitative survey was conducted in two Canberra hospitals that aimed at ascertaining the impact of information provided by medical libraries on clinical decision making. Specifically, this research study investigated clinical, cognitive and quality value of information provided by the medical librarians to the management of patients and doctors' ability to handle clinical cases differently as a result of such information. Furthermore, the relative value of information received from the library was assessed by comparing it to the value of information received from other sources in dealing with clinical problems. The research involved medical specialists and registrars affiliated with these hospitals. Doctors were asked to select any clinical situation which they frequently or currently encounter and for which further information would be useful to them. Once their information requests were identified, they were then asked to present such requests to the hospital library. In order to avoid any special treatment, participants were urged not to identify themselves to the library staff as partaking in the study. It was important that participants did not search for the information themselves. The doctors were asked to evaluate the material provided by the library in relation to clinical care and, thereafter, complete a short questionnaire. This research took place between October 1994 and March 1995. The questionnaires were sent to 288 doctors. This represented the total population of specialists and registrars affiliated with both hospitals at the time of the study. Analysis of the results is based on a 34% useable response rate. Medical specialists were by far the higher number of respondents (70%) as compared with registrars (30%). Eighty-one per cent of the doctors said that the information provided by the library refreshed their memory and 82% said that it would contribute to better quality of medical care. Eighty-six per cent indicated that some of this information was new to them and 99% said that the information provided was up to date. Ninety-four per cent said that the information provided by the library was of clinical value to them. As the result of the information provided by the library 75% of respondents would either definitely or probably handle some aspects of the clinical situation differently than they would have done it otherwise. The level of importance of the change for the optimal care of patients was assessed with 54% regarding it as important, 42% as moderately important. Specifically, as the result of the information provided, the doctors were able to change the following: diagnosis 10%, choice of lab tests 20%, choice of other diagnostic investigations 24%, choice of drugs 27%, choice of other management 58%, reduce length of hospitalisation 10%, post-operative care of patients 25%, advice given to patients 47%. On the basis of the received information the doctors were able to avoid the following: hospitalisation of patients 11%, risk of hospital acquired infection 8%, surgical intervention 19%, tests or other investigation 23%, additional out-patient visits 12%. Discussions with colleagues were reported to be most valued sources of information for the purpose of clinical decisions (59%), followed by diagnostic imaging (49%), librarian (45%), lab tests (42%) and patients' medical records (30%). The librarian's role as contributing to the process of clinical decisions was rated highly with 88% ranking it as either important or moderately important. The results of significance p test statistic performed at 0.05 significance level suggested that, for this study, there was a significant relationship between the frequency of library use and doctors' ability to change the choice of laboratory tests, diagnostic investigations, and the choice of prescribed drugs. The results of this research study demonstrate that medical librarians can positively contribute to clinical management of patients by providing timely and accurate information. Further research is recommended in order to determine the impact of the whole range of library services on health care outcomes.

Submitted by Priscilla Araujo (priscilla@ibict.br) on 2017-11-21T18:11:53Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Márcio da Silva Finamor_Mestrado_2017.pdf: 585594 bytes, checksum: 2d832fb48dc4a5b8e7d6b87575d9595e (MD5) / Made available in DSpace on 2017-11-21T18:11:54Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Márcio da Silva Finamor_Mestrado_2017.pdf: 585594 bytes, checksum: 2d832fb48dc4a5b8e7d6b87575d9595e (MD5) Previous issue date: 2017-09-11 / Essa pesquisa mostra o agir do bibliotecário na equipe multiprofissional em saúde - suas perspectivas de ação e inserção nesse novo ambiente. Tomando como referência o modelo bem-sucedido do sistema de saúde canadense, em que bibliotecários agem na equipe de forma rotineira: prática inexistente no Brasil. Busca conferir as atividades e competências desenvolvidas por bibliotecários médicos a fim de configurar uma nova proposta de trabalho. Constitui uma abordagem qualitativa pela amostragem por conveniência, selecionando especialistas como: profissionais da informação, médicos e profissionais de saúde convidados a discutir as perspectivas de agir e desafios. Concomitantemente, utilizamos a abordagem da teoria dos sistemas do sociólogo Niklas Luhmann, uma vez que as organizações de saúde são consideradas complexas, o que nos permitiu entender as contradições e dificuldade das relações e trazer para esse ambiente ambíguo pressupostos da teoria discursiva, do agir comunicativo e humanístico com base no filósofo Jürgen Habermas como uma forma especial de conceber ações comunicativas e discursivas dentro deste ambiente restrito. Conclui-se que as perspectivas de agir são promissoras e emergentes, mas que requerem uma reconfiguração na formação do bibliotecário e a aquisição de novas competências como a profissionalização normativa e competência comunicativa, assim como, a criação de eixos sobre informação em saúde e ciências da saúde em sua formação. / This research shows the role of the librarian in the multiprofessional health team - its perspectives of action and insertion in this new environment. Considereing as reference the successful model of Canadian health system, in which librarians act in the team as routine: a practice that does not exist in Brazil. It seeks to check the activities and skills developed by medical librarians in order to set up a new job proposal. This study has a qualitative approach by sampling for convenience, selecting specialists such as: information professionals, physicians and health professionals invited to discuss perspectives for action and challenges. Concomitantly, we use the Niklas Luhmann`s systems theory approach, since health organizations are considered complex, which allowed us to understand the contradictions and difficulties of relationships and to bring to this ambiguous environment presuppositions of discursive theory, communicative action and humanistic on the basis of the philosopher Jürgen Habermas as a special way of conceiving communicative and discursive actions within this restricted environment. It is concluded that the perspective of action are promising and emerging, but it requires a reconfiguration in the formation of the librarian and the acquisition of new competences such as normative professionalization and communicative competence, as well as the creation of axes of information in health and science of the health in their training.