Library outreach for health professionals.
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Community Health Services↗
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Using Web sites on quality health care for teaching consumers in public libraries.
More and more consumers are searching the Internet for health information. Health Web sites vary in quality, though, and not all consumers are aware of the need to evaluate the information they find on the Web. Nurses and other health providers involved in patient education can evaluate Web sites and suggest quality sites for patients to use. This article describes a project we implemented in 2 public libraries to educate consumers about quality health care and patient safety using Web sites that we had evaluated earlier. Participants (n = 103) completed resources on health care quality, questions patients should ask about their diagnoses and treatment options, changes in Medicare and Medicare options or ways to make their health benefits work for them, and tips to help prevent medical errors. Most consumers were highly satisfied with the Web sites and the information they learned on quality care from these resources. Many participants did not have Internet access at home or work and instead used the library to search the Web. Information about the Web sites used in this project and other sites on quality care can be made available in libraries and community settings and as part of patient education resources in hospitals. The Web provides easy access for consumers to information about patient safety initiatives and health care quality in general.
Adolescent↗
Medical libraries around the world.
A discussion is given of the buildings and equipment, staffs, and services of a number of medical libraries around the world, with special emphasis on American, European, and Asiatic medical libraries. Differences are explained on the basis of the traditions of the different countries, and the essential similarities pointed out.
Asia↗
Not virtual, but a real, live, online, interactive reference service.
In today's fast-paced environment, traditional medical reference services alone are not adequate to meet users' information needs. Efforts to find new ways to provide comprehensive service to users, where and when needed, have often included the use of new and developing technologies. This paper describes the experience of an academic health science library in developing and providing an online, real-time reference service. Issues discussed include selecting software, training librarians, staffing the service, and considering the future of the service. Use statistics, question type analysis, and feedback from users of the service and librarians who staff the service, are also presented.
California↗
Quality assurance for abdominal CT: a rapid, computer-assisted technique.
OBJECTIVE: Maintaining high standards in a large CT imaging department with multiple scanners, a large technical and clerical staff, and a rotating staff of radiologists is an ongoing challenge. We undertook a project to design and implement a simple, rapidly performed computer-assisted system of quality assurance (QA) for use in abdominal CT. In our project, we also analyzed the results of that QA system. MATERIALS AND METHODS: We graded 1810 abdominal CT studies done in a 50-week period, using a three-point scale to indicate the quality of the following five parameters of technical quality: IV contrast enhancement, oral contrast opacification, window settings and artifacts, conformity to radiologists' protocol, and completeness and accuracy of header and scout data. In addition, a parameter reflecting performance of the film library and clerical staff was similarly graded. To provide a measure of peer review for radiologists, any disagreements with prior CT study reports were recorded when comparison studies were reviewed in the process of CT interpretation. A commercially available spreadsheet and database software program was tailored to allow rapid, easily performed data entry and analysis. Tables and graphs showing performance of technologists and film library and clerical staff were generated. This customized program was made available on the radiology department computer network. Results generated by the program were further analyzed with linear regression models. RESULTS: Our QA system was successfully integrated into the routine operation of the abdominal CT division. During the first 11.5 months of operation, the system reflected improvement in each of the technical parameters with a statistically significant improvement in the combined average technical score (from 1.15 to 1.68 on a scale of 0-2; p < .0001). The "Throughout Speed/Old Exams" parameter for performance of the film library and clerical staff, which was analyzed separately from the technical parameters, also improved significantly (from 1.3 to 1.8; p < .02). Improvements were statistically significant, even when we controlled for potential variations in quality among different CT scanners and variations among the radiologists who rated the quality of the examination. Thirty-eight disagreements with previous scan interpretations (5% of all scan comparisons) were recorded for evaluation at peer review conferences. CONCLUSION: The ability to monitor performance continuously using a rapid, computer-assisted system has effected measurable improvement in our CT service. Technologist and film library and clerical staff performance improved for all parameters studied. Deficiencies were revealed and trends demonstrated. The QA system allowed us to identify disagreements in interpretation of CT examinations for subsequent peer review by radiologists. Our QA software program has been made available on the Internet as freeware to licensed Excel users via anonymous file transfer protocol at Internet Protocol 134.192.6.110.
Administration, Oral↗
Toxicological information series, IV. Information resources for chemical emergency response.
The need for rapidly available information by community agencies responding to chemical emergencies (leaks, spills, releases, fires, explosions, etc.) can be met by a number of resources. These resources include local poison control centers, the Toxicology Data Network (National Library of Medicine), the Agency for Toxic Substances and Disease Registry, ATSDR/NLM's ANSWER, the National Chemical Response and Information Center, the National Pesticide Telecommunications Network, The National Response Center (U.S. Coast Guard), the Federal Emergency Management Agency, the U.S. Environmental Protection Agency, the National Safety Council, private-sector database vendors, and textbooks addressing hazardous substances.
Emergencies↗
Tribal connections health information outreach: results, evaluation, and challenges.
In 1997, the National Library of Medicine (NLM), a component of the National Institutes of Health (NIH), initiated a program of intensified outreach to Native Americans, initially focusing on the Pacific Northwest in collaboration with the Pacific Northwest Regional Medical Library (PNRML). This initiative, known as the Tribal Connections Project, emphasized the establishment or strengthening of Internet connections at select Indian reservations and Alaska Native villages and related needs assessment and training. The hope was that these efforts would improve tribal access to health information available via the Internet and the Web. Phase I included sixteen tribal sites--eight in Washington, four in Alaska, two in Montana, and one each in Oregon and Idaho. Phase I results indicate that the project was successful in assessing local needs and building awareness of the Internet, forging new partnerships with and between the participating Indian reservations and Alaska Native villages and other organizations, making real improvements in the information technology (IT) infrastructure and Internet connectivity at fifteen of sixteen sites, and conducting training sessions with several hundred tribal participants across thirteen sites. Most importantly, the project demonstrated the key role of tribal community involvement and empowerment and contributed to development of an outreach evaluation field manual and the evolving concept of community-based outreach. The knowledge gained from Tribal Connections Project Phase I is helping refine and enhance subsequent NLM-sponsored tribal connections and similar community outreach efforts.
Community-Institutional Relations↗
Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.
This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.
Australia↗
Selected list of books and journals for the small medical library.
In the introduction to this revised list of 607 books and 141 journals, quality assurance programs of health care institutions and patient education are suggested as vehicles for more directly involving the hospital library and its collection in patient care. This list is intended as a selection guide for the small or medium-sized library in a hospital or comparable medical facility, or as a core collection for a consortium of small hospital libraries. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. To purchase the entire collection of books and to pay for 1989 subscriptions would require about $63,500. The cost of only the asterisked items totals $24,000.
Bibliographies as Topic↗
Random time sampling with self-observation for library cost studies: unit costs of reference questions.
The working time of reference librarians was sampled using random alarm devices and a structured checklist of mutually exclusive categories of reference questions. An average wage rate was applied to the unit time reciprocals derived from the resulting percentages. Wage costs for directional questions averaged $1.98; extended reference queries, $4.57. Random time sampling with self-observation gives acceptable reliability at low cost, minimal interference with service operations, and minimal distortion of collected data due to the collection process. It can be carried out by library managers themselves.
Costs and Cost Analysis↗
The new Health Sciences Library at the State University of New York at Buffalo.
The new Health Sciences Library at the State University of New York at Buffalo is a harmonious and functional blend of the old and the new. The old is a renovated Georgian style building with formal rooms containing fireplaces, carved woodwork and English oak paneling. The new is a contemporary four-story addition. Through the arrangement of space and the interior design, the new library offers users easy access to services and resources; accommodates the heavy daily flow of users and library materials; provides an environment of comfort, quiet, and safety; and promotes efficient communication among all segments of the library staff. This was accomplished through sound architectural design which included close consultation with the library director and staff during the planning process. The new library is equipped to face the challenge of meeting the needs of biomedical education, research, and clinical programs of the institution and its constituents in the years to come.
Facility Design and Construction↗
Equalizing rural health professionals' information access: lessons from a follow-up outreach project.
A follow-up outreach project was undertaken to extend and reinforce the work of a National Library of Medicine-funded outreach project conducted in west central Illinois in 1991. The participants included five of the eight original sites as well as additional populations. An evolving partnership with the state's Center for Rural Health expanded the project's geographic area statewide. Evaluation showed benefits of varied training formats, reexposure to end-user searching, and the importance of "readiness." Follow-up training and longer trials for practice searching resulted in greater volume of search and document delivery activity. Varied training formats proved successful in reaching specific groups. Loansome Doc activity throughout the eighteen-month project suggested sustained use of Grateful Med beyond the two-month trial periods. The introduction of Grateful Med/Loansome Doc to unaffiliated health professionals is an important component in equalizing information access. Future information service initiatives are suggested to meet the challenge of building a rural information infrastructure and support system for health professionals.
Evaluation Studies as Topic↗
Coverage by four information services of the core journals of rehabilitation and related topics.
In this study, three serials databases were used to identify core journals in rehabilitation and related areas. Simple strategies were used to search SERLINE (Serials Online, National Library of Medicine), Ulrich's International Periodicals Directory and SACHET (British Library serials database). Coverage of the journals identified by four secondary information services was then studied. These were Medline, Excerpta Medica, CINAHL (Cumulative Index to Nursing and Allied Health) and CATS (Current Awareness Topics Services, British Library). The results confirmed and extended the findings of earlier work: the number of core journals in rehabilitation is very large and their coverage by information services is very selective. Of the services studied here, CATS seemed to be most comprehensive for the journals identified.
Databases, Factual↗
The librarian's life, scholarship and librarianship.
Librarians must be more than custodians of the record or merely managers of information services if they are to understand their role and to participate in the life of scholarship. There are many approaches to this understanding including the historical, the social, the psychological and the epistemological. It can also be sought through a study of the sociology of knowledge and a study of the ways in which changes in communication technology in writing and printing have impacted on scholarship in the past. This may also provide us with the means of preparing for the impact of new computer technology on the scholarship of the future.
Career Choice↗
Performing continuous quality improvement for a digital health sciences library through an electronic mail analysis.
BACKGROUND: The goal of this prospective, cross-sectional study was to determine the user demographics of a digital health sciences library (DHSL), motives for use, the nature of users information requests, and success rate in finding answers. METHODS: The content of 500 consecutive electronic mail messages (e-mails) submitted to a DHSL were analyzed using a predetermined coding scheme. Data were entered into a database and frequency analysis was performed. RESULTS: The number of information requests from the 500 e-mail messages was 751. The largest sender category was patients and laypersons followed by students, then physicians. Motivations for use were primarily medical advice (42.8%) and patient care (13.8%). E-mail subject areas were mainly medical (61.8%) and technical (20.6%). Answers to information requests were found 54.3% of the time and senders felt the DHSL was valuable (97.8%). CONCLUSIONS: A DHSL is a valuable medical resource. DHSLs must serve the broad information needs of patients and laypersons in addition to health care providers. Developers and managers of DHSLs can use this information to guide future development of DHSL information content and services, as has been done at The University of Iowa.
Adult↗
'Genetics home reference': helping patients understand the role of genetics in health and disease.
The surge of information generated by the Human Genome Project has left many health professionals and their patients struggling to understand the role of genetics in health and disease. To aid the lay public and health professionals, the US National Library of Medicine developed an online resource called 'Genetics Home Reference' (GHR), located at http://ghr.nlm.nih.gov/. Launched in April 2003, GHR's goal is to help the public interpret the health implications of the Human Genome Project. It bridges the clinical questions of consumers and the rich technical data emerging from the sequenced human genome. The GHR web site is designed for easy navigation among summaries for genetic conditions and the related gene(s) and chromosome(s). This design strategy enhances the user's appreciation of how genes, chromosomes, and conditions are interrelated.
Genetic Diseases, Inborn↗
Today's medical knowledge. Evolution of data exchange between tradition and globalization.
The authors historically review bibliographic research concepts and define globalization in time. Moreover, recent free online data exchange is important in terms of medical progress, scientific updating and patient-care improving. In the author's opinion, data globalization is favoring medical knowledge flow even more. The concept of a traditional library has radically changed over time, gradually missing their pivotal role in research activity. To date, the birth of the Internet and its sudden development has given a great boost to the spread of worldwide information, quickly and cheaply. Nevertheless, besides the advantages, the Internet also hides misleading risks. In this paper, the professional Medline source is compared to common Internet sources. The authors state that Internet sources have a great importance in the spread of medical knowledge. They conclude, however, that the risk of too much available information could lead to a decrease in quality.
Bibliometrics↗
TOXLINE--an information resource.
TOXLINE is the National Library of Medicine's online bibliographic database covering the toxicologic, pharmacologic, biochemical, physiologic, and environmental effects of chemicals. It is a merged database composed of subsets from 13 different sources. Most of the citations in TOXLINE refer to journal articles; other publication types include meeting reports, monographs, patents, research project reports, technical reports and theses. TOXLINE is searched using a number of synonyms to fully express a concept, as compared to MEDLINE which can be searched by standard terms, thus obviating the need for synonym search terms. Toxicologists, other scientists, and clinicians are encouraged to become familiar with online searching techniques and to conduct their own searches.
Drug Information Services↗