The Clinical Informationist: Does the Model Work

May 27, 2014 updated by: Nunzia Giuse, Vanderbilt University
This study is investigating the effects of an established clinical informationist program (evidence-based practice support service in which information professionals with significant clinical knowledge bases and advanced information seeking and appraisal skills) on clinical decision making at selected critical care units at Vanderbilt University Medical Center

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background To evaluate the role of the Clinical Informatics Consult Service(CICS), an informationist service at the Eskind Biomedical Library (EBL) at Vanderbilt University Medical Center (VUMC, in clinical decision-making, the EBL has been awarded a 3-year grant from the National Library of Medicine (5 R01 LM07849-02). The CICS is a well-established program that facilitates evidence-based practice by delivering targeted information in answer to complex, patient-specific questions. The CICS places librarians with specialized training in medical subject areas and in information retrieval ("clinical informationists") on clinical teams in intensive care settings. Acting as expert consultants, they analyze the biomedical literature to identify, filter, and present the best examples of each clinical viewpoint expressed about key problems.

Evaluation Project Working in cooperation with the Center for Evaluation and Program Improvement (CEPI) at Peabody College of Vanderbilt, the investigators will evaluate formally the role of CICS in clinical decision-making and evidence-seeking behavior. While past studies have evaluated clinical medical librarians' roles, few if any studies have examined the effectiveness and utility of the new clinical informationist approach in sites where informationists are well-established.

The project will also create reusable evaluation tools transferable across environments. Through a combination of observation and interviews, investigators will examine librarian involvement in three existing Vanderbilt CICS intensive care units. The project will collect detailed information about the ways in which clinicians incorporate CICS-provided information into their workflows. Next, investigators will conduct a randomized trial to evaluate the effect of CICS on decision-making. Investigators will compare clinicians' intended course of care vs. actual care when CICS results are provided and when clinicians seek information themselves.

Finally, "virtual cases" developed from actual patient CICS-related scenarios in each clinical unit will be incorporated into training tools that can be used to export elements of the CICS model to other locations. Demonstration of the utility of the clinical informationist approach can foster widespread adoption nationally, and increase the degree to which clinical practice becomes evidence-based.

Study Type

Interventional

Enrollment (Actual)

299

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Tennessee
      • Nashville, Tennessee, United States, 37232
        • Vanderbilt University Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Evidence-based questions requested by clinician on current service as an attending, resident, fellow, or nurse practitioner on one of the units included in the study

Exclusion Criteria:

All others

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Synthesized evidence report
Each consultation response included a documented bibliographic search strategy with corresponding references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research materials.
Each consultation response included a documented bibliographic search strategy with corresponding references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research materials.
Other Names:
  • Literature summary
  • Evidence report
No Intervention: No evidence report

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Immediate and potential future clinical decisions
Time Frame: 3 days post-consult
3 days post-consult

Secondary Outcome Measures

Outcome Measure
Time Frame
Clinical action index
Time Frame: 3 days post-consult
3 days post-consult
Number of research articles read
Time Frame: 3 days post-consult
3 days post-consult
Satisfaction
Time Frame: 3 days post-consult
3 days post-consult
Colleague consults
Time Frame: 3 days post-consult
3 days post-consult
Time spent searching the literature
Time Frame: 3 days post-consult
3 days post-consult

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Nunzia B Giuse, MD, MLS, Vanderbilt University Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2004

Primary Completion (Actual)

February 1, 2006

Study Completion (Actual)

May 1, 2007

Study Registration Dates

First Submitted

September 22, 2005

First Submitted That Met QC Criteria

September 22, 2005

First Posted (Estimate)

September 26, 2005

Study Record Updates

Last Update Posted (Estimate)

May 28, 2014

Last Update Submitted That Met QC Criteria

May 27, 2014

Last Verified

May 1, 2014

More Information

Terms related to this study

Other Study ID Numbers

  • 040624
  • 5R01LM007849 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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