An innovative model of evidence-based practice for other professions.
Several other professions have defined their research agendas [2-4]. Researchers representing the health professions and a wide range of other professions as diverse as the behavioral, social, policy, environmental, and management sciences have also conducted systematic reviews [5-14]. To the authors' knowledge, however, only our profession has linked these two discrete activities coherently into a potentially potent strategy. This linkage could draw attention to our profession as an innovative leader in evidence based practice. We predict that other professions likely will want to adapt our approach to address the needs of their own respective memberships.
Each systematic review team has refined its focused research question at this time and is at a different stage of completion of the respective systematic reviews. Recently, one team published its findings in the Journal of the American Medical Informatics Association (JAMIA) . Some teams reported on their progress at the MLA 2014 annual meeting [16-18]. Other teams are still closer to the formative stages of their reviews. Constituting the MLA Research Section's Research Agenda Committee, we have developed general guidelines for forming and managing the teams . When necessary, or as requested, we have provided guidance on conducting the systematic reviews. Table 1 (online only) lists the subject areas of the reviews, team leaders' names, and team leaders' contact information.
This systematic review initiative traces its origins to the renewal of the MLA research policy by leaders in our profession . The 2007 MLA research policy, The Research Imperative, set bold directions for our profession's generation and use of applied research for making decisions. Two recommendations, appearing in the first section of the action plan for the policy, catalyzed a process that has now led to the systematic review initiative. These recommendations are that MLA will:
* Ask the MLA Research Section to create a forum for identifying research priorities in the field.
* Ask the Research Section to recommend annually to the MLA Board of Directors an MLA research agenda that suggests research topics of highest priority to the association .
The first MLA research agenda, which appeared during 2009, offered twelve key research questions . The MLA Research Section asked the authors to conduct a second delphi study during 2011 to identify new top-ranked research questions . The authors thought that these fifteen new questions needed to be addressed with systematic reviews. They developed a process that would allow them to coordinate the formation and monitor the progress of the fifteen teams aligned to each of the fifteen questions . The authors decided to grant near-complete autonomy to the teams. This autonomy, coupled to the authors' encouragement that teams manage themselves with relatively flat organizational structures, seemed to enable the teams to conduct the systematic reviews in ways that the teams thought to be most appropriate. The authors expect that, over the coming year, most of the teams will submit their systematic reviews for publication. This initiative will help populate a growing list of nearly fifty systematic reviews affecting our profession . As most Journal of the Medical Library Association readers know, systematic reviews represent potentially the highest form of evidence in evidence-based library and information practice (EBLIP) [24, 25].
What you can do
There are three arenas in your practice where you can act upon this information: individual, institutional, and professional association.
Individual. On the individual level, you can model EBLIP by using systematic reviews to make important decisions. When systematic reviews are not available, you can still use the highest forms of evidence such as a randomized controlled trial or cohort study. You also can encourage colleagues who are conducting systematic reviews by thanking them for their efforts. Most importantly, you can identify vital questions that remain unanswered, formulate effective EBLIP questions , and alert colleagues about these gaps. Whenever possible, you should urge MLA leaders to contribute questions for future MLA research agenda formulation processes.
Institutional. Groups of colleagues making joint decisions on important matters can use systematic reviews or other forms of high-level evidence. We can identify and discuss gaps in the existing evidence base and alert our colleagues to these gaps. Whenever possible, we can encourage MLA leaders to contribute questions for future MLA research agenda formulation processes. Institutionally, we can create incentives for interested colleagues to join teams conducting systematic reviews through granting research leave. We also can encourage agencies to fund systematic review teams through grants or contracts.
Professional association. As a profession, we can encourage the pursuit of systematic reviews by creating incentives through grants, contracts, awards, or other recognitions for team members. We can encourage MLA leaders to submit what they view to be the most important research questions and to vote on others' worthy questions. We can encourage published researchers to lend their expertise in gauging the answerability of leaders' research questions.
The authors will host a session on this systematic review project during the first section program at MLA '15 in Austin, Texas. We invite you to attend this session to learn more about this innovative project, introduce your own ideas, and raise any questions.
Received September 2014; accepted November 2014
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Jonathan D. Eldredge, MLS, PhD, AHIP; Marie T. Ascher, MS, AHIP; Heather N. Holmes, MLIS, AHIP
Jonathan D. Eldredge, MLS, PhD, AHIP (corresponding author), jeldr firstname.lastname@example.org, Associate Professor, Biomedical Informatics Research, Training and Scholarship, Health Sciences Library and Informatics Center/Family and Community Medicine, 1 University of New Mexico, MSC09 5100, Albuquerque, NM 87131-0001; Marie T. Ascher, MS, AHIP, email@example.com, Associate Director, User Services, Health Sciences Library, New York Medical College, 15 Dana Road, Valhalla, NY 10595; Heather N. Holmes, MLIS, AHIP, holmesh@summahealth .org, Clinical Informationist, Medical Library, Summa Health System, Akron City & St. Thomas Hospitals, and Instructor, Department of Internal Medicine, Northeastern Ohio Medical University, 55 Arch Street, Suite G-3, Akron, OH 44304
Table 1 Medical Library Association research agenda systematic review teams Team Question 1 There are still a number of relevant questions from the 2008 research agenda, but to me this is most critical: "What is the quantifiable evidence that the presence of a librarian, not just information resources, improves patient outcomes, increases research dollars, improves student outcomes (e.g., better board scores), or increases hospital intelligence (e.g., if the top hospitals have access to hospital librarians/libraries)?" 2 Is there a significant difference in patient outcomes (or research output or educational outcomes) between institutions with and without libraries? 3 What is the added value that libraries bring to education, research, and patient care in the health sciences and health care fields? Even if it is not possible to quantify benefits, documenting qualitative research results rigorous enough to stand the scrutiny of administrators and researchers would be of great value. 4 Low health literacy can result in medication errors, noncompliance with treatment regimes, poor health outcomes, and even death. What is the role of the medical librarian with health care providers, community organizations, local public libraries, and members of the public to improve health literacy among entire communities? 5 What are the information needs of practicing physicians and other health care workers? The Covell article is still heavily cited but was published way back in 1985. The information environment has changed dramatically. We need to update that study in light of new educational strategies, resources, technology, and social networks. 6 The explosion of information, expansion of technology (especially mobile technology), and complexity of the health care environment present medical librarians and medical libraries with opportunities and challenges. To live up to the opportunities and challenges, what kinds of skill sets or information structure do medical librarians or medical libraries require or need to acquire so as to be strong partners or contributors of continuing effectiveness to the changing environment? 7 Does what we do matter? Longer form: Do the resources we provideumaterials, reference services, and educational offeringsumake a difference to our customers: save lives, shorten length of stay, improve educational outcomes, increase research dollars, improve research results? 8 How do we provide information support in a clinical world that functions based on electronic medical records systems and other similar informatics platforms and tools. What is the library's role, if any, in providing preclinical education with respect to informatics applications like electronic medical records systems? 9 Do health sciences libraries and librarians have any measureable (statistically significant) positive impacts on consumer health, the outcomes of medical care, the productivity of biomedical researchers, and the knowledge obtained by graduates of biomedical and health sciences training programs, and at what total cost? 10 How best to objectively document library/librarian impact on the "bottom line" (time, money saved, shorter length of stay, return on investment for expensive electronic resources, support training programs/Magnet status, funded research support, etc.)? Team Name Email 1 Laure Perrier firstname.lastname@example.org 2 David Lightfoot email@example.com 3 Margaret Jane Foster, firstname.lastname@example.org AHIP 4 Mary Lou Klem email@example.com 5 Aileen McCrillis, AHIP firstname.lastname@example.org 6 Patricia F. Anderson email@example.com 7 Lindsay Alcock Glynn firstname.lastname@example.org 8 Brenda M. Linares, AHIP email@example.com 9 Margaret Henderson, AHIP firstname.lastname@example.org 10 Anne Madden email@example.com
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|Author:||Eldredge, Jonathan D.; Ascher, Marie T.; Holmes, Heather N.|
|Publication:||Journal of the Medical Library Association|
|Date:||Apr 1, 2015|
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