SIIReN - System Integration & Innovation Research Network

Primary Health Care System

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“Just-In-Time (JIT) Librarian Consultation Service"
Presenters: William Hogg, Jessee McGowan
April 14, 2011


Objective:  The purpose of this presentation is the review a librarian consultation service called the Just-in-time (JIT) librarian consultation service.

Project design/Implementation:  The JIT project provided a librarian service to answer clinical questions in a rapid time frame (under 15 minutes).  Family physicians, nurses and other members of the primary care team were taught how to use this service, including how to create a clinical question and which types of questions they may request from the librarian.   The questions were asked using a hand-held device or a web-based form.  A detailed librarian flow chart was developed to assist librarians in selecting electronic evidence-based sources for answering questions. Physicians and a research librarian in the Department of Family Medicine provided training in evidence-based medicine for the project librarians and support staff.  As well, the project librarians received detailed training about the information needs and resources in the family medicine discipline.   This project was evaluated RCT design and a mixed methods approach.

Implications and Conclusions:  The study demonstrated the development and implementation of a cost-effective and user-friendly librarian consultation service that provided primary care professionals with information to assist them in answering their questions arising from patient visits.  Using a librarian to respond to clinical questions may allow primary care professionals to have more time in their day, thus potentially increasing patient access to care. Participation in this RCT decreased the use of consultations with other practice physicians, return patient visits, referrals, and other actions in the control group; reductions in these areas decrease costs. 

The results of a cost consequence analysis showed that the direct cost per question for JIT was quite low and could be further reduced.  Saving physician’s time during their day could potentially lead to more access to family physicians by patients.  Nationally implementing such a service could happen quickly as the time required to train professional librarians to do this service is short, especially when compared to alternative ways of improving access such as setting up a new medical school. 

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