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.
| Identifer | oai:union.ndltd.org:ADTP/218744 |
| Date | January 1996 |
| Creators | Ali, Irena Malgorzata, n/a |
| Publisher | University of Canberra. Information, Language & Culture Studies |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | ), Copyright Irena Malgorzata Ali |
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