Setting up a search clinic in a palliative care department

HLG Nursing Bulletin Vol 32 (2)

Elinor Bastin
Knowledge Centre Manager and Outreach Librarian
The Knowledge Centre
Bodleian Health Care Libraries
Oxford University
Old Road Campus Research Building
Headington,
Oxford
OX3 7DQ
Eli.bastin@bodleian.ox.ac.uk

Abstract

As an outreach librarian working for the Bodleian Health Care Libraries, I piloted a search clinic at a palliative care department over a 6-month period. The project has moved through three phases, from a weekly search clinic, to a fortnightly model, and now to a more ad-hoc arrangement, as awareness of the outreach and library services has improved in the department.

This article describes the search clinic model and the three phases of the outreach project.

Background

I took on the role of Knowledge Centre Manager and Outreach Librarian for the Bodleian Health Care Libraries, at the University of Oxford, in April 2011. As part of my remit, I work with NHS and university staff at the Churchill Hospital and on the Old Road Campus. This includes the palliative care department, Sir Michael Sobell House, located on the hospital site (Oxford University Hospitals NHS Trust, 2012). The Sobell House Study Centre Manager contacted us at the start of 2011 for support searching databases and journals following the retirement of their librarian. Full of enthusiasm and keen to promote our library and outreach services to the departments under my remit, I got in touch with her to find out if and when I could give a presentation to staff to raise awareness of our services. I wanted to find out from the palliative care consultants whether the search clinic model would help to fill the gap left by their librarian.

The search clinic model

The team of Outreach Librarians at the Bodleian Health Care Libraries have run a fortnightly ‘search clinic’ for local NHS Trust staff since 2006. The search clinic is promoted via a global email sent out to all staff once a month, most recently with the subject heading “Library Search Services and Online Resources for June”, detailing the availability of a named librarian from 11.30-1.30pm on a Thursday. The librarian offers to come to the department or ward where staff work, or invites staff to come to the library for help with literature searches and e-resources (Bodleian Health Care Libraries, 2012). There is a comparable service offered at St George’s Library, described as “a 30 minute slot of dedicated time with a librarian to discuss general information problems”, and “an opportunity to obtain a quality search on a topic in consultation with a librarian” (St George’s University of London, no date). Apart from these two services and associated webpages, there is little in the available literature about ‘search clinics’. This is a theme which needs to be fully addressed in the future.

Phase 1

Phase 1 was to meet the consultants and introduce the concept of the search clinic to them. The literature suggests that palliative care healthcare professionals mainly require support with finding journal articles (Callinan et al., 2010). When I was invited to give a presentation to consultants at Sobell House in August 2011 I came prepared to demonstrate how to access resources via NHS Athens, the UpToDate database and other resources that the library service provides. I gave a 15 minute presentation to the eight consultants about the facilities available at the Knowledge Centre, including a demonstration of the electronic resources available to NHS staff via Athens, and I talked about the outreach service that we provide both to the university and NHS Trust. For the rest of the hour, we talked about their information needs, including a demonstration of how best to search the databases to answer a question about adding calcium or alendronic acid and vitamin D to patients with short-term prognoses who have been on long-term courses of steroids . I finished the hour-long session by offering to start a 6-week trial search clinic, to enable all staff at Sobell House to come and talk to me about searching for answers to their clinical questions, and about our other library services. My offer was accepted.

The Study Centre Manager put up posters in the department to advertise the search clinic sessions, and sent an email out to all staff the day before the clinic was held, which she forwarded to me. The search clinic was held from 2-3pm every Wednesday from 14/09/11 – 19/10/11. For an hour I sat with a laptop in the Study Centre’s e-learning suite, and was available for staff who wanted to pop in for an informal chat. I went armed with an old conference bag full of library registration forms and leaflets about library services, NHS Athens and NHS Evidence Healthcare Databases Advanced Search, prepared to answer any enquiries.

During the six sessions, I saw an average of three people per session, and had three 1-1 training sessions (each lasting from 20 minutes to one hour), one group session with four nurses (45 minutes), and I was given 13 literature searches to complete for six staff members. Topics for the literature searches ranged from caregivers’ skills for end of life care to nutrition for palliative patients.

The group training session was particularly successful. Four Community Macmillan nurses came to my search clinic session at Sobell House on 12/10/11 to find out what resources and services the library can offer them. They were interested in the literature searching service, and keen to learn what resources their NHS Athens usernames would allow them to access. We discussed the value of searching in different ways on Cinahl (thesaurus vs keyword searching), and I was surprised at how quickly they picked up the Boolean logic language of AND/OR. I also demonstrated how they could access the latest edition of the Royal Marsden Manual online, and how the UpToDate database can help them to find quick information about end- stage renal failure and dialysis, or palliative care and dialysis, for example.

After the six weeks, the Study Centre Manager, Practice Development Nurse and I reviewed the pilot search clinic and agreed to make a few adjustments, to see if changing the day and regularity would be more suitable for staff.

Phase 2

Phase 2 of the outreach project began at 2pm on a Tuesday in November, and lasted until the end of March 2012. Again, the Study Centre staff put up posters to promote the new dates and times, and sent an email out to all staff on a fortnightly basis to remind them that I was coming for the hour-long search clinic. I completed one literature search and one group session in both November and December 2011, and enjoyed a flurry of activity in January and February this year, with one literature search and two 1-1s in January, and three literature searches and two 1-1s in February. Interestingly, the nursing staff were the main group requesting 1-1s, and the consultants requested literature searches. I wound down the service at the end of March as interest in the search clinics declined while the nursing staff were putting together their staff portfolios and the NHS cuts started to hit the department hard.

Looking to the future: Phase 3

We are now in the third phase of the project. After two quiet months with little contact from staff at Sobell House, I have had a few sessions with the Study Centre staff to help them with reference management and locating full text articles, two literature searches and one session with a third year medical student collaborating with one of the consultants, to get him started on a palliative care systematic review. This year, I intend to continue to raise awareness of both the library service and what I can offer in my role as an outreach librarian, and I would like to continue to build working relationships with the 70-odd staff working in the department. Frequent friendly emails to the Study Centre staff and the Practice Development Nurse, in particular, and occasional visits to see them, are an important way of keeping in touch and maintaining links.

Conclusion

This project has been well worth the effort involved in making the trip to the department once a week or once a fortnight, as it has opened my eyes to the information needs of all members of staff who work in palliative care. Staff have been friendly and generally receptive to the search clinic model. I now would like to extend the model to other departments at the Churchill Hospital, including the urology and renal units over the next 12 months. I have learnt that it is important to keep promoting the service in as many different ways as possible, via email, posters, and by encouraging staff to tell their colleagues (word of mouth), and I look forward to building on this work.

References

Bodleian Health Care Libraries (2012). Search Clinic. Available at: http://www.bodleian.ox.ac.uk/medicine/services/search-clinic (Accessed: 8 June 2012).

Callinan, J., McLoughlin, K., & McCarthy, P. (2010) ‘Analysis of library associated information needs of staff in a specialist palliative and gerontological care centre in Mid-West Ireland’, Health Information & Libraries Journal, 27, pp.286-295.

Oxford University Hospitals NHS Trust (2012). Palliative care. http://www.oxfordradcliffe.nhs.uk/cancer/palliative.aspx (Accessed: 8 June 2012).

St George’s, University of London (No date). Search clinic. http://www.sgul.ac.uk/about-st- georges/services/library/training/information-skills-1/search- clinic (Accessed: 8 June 2012).

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