Submitted by Javier Crespo

Related Reports…

From time to time we look out for articles for reports that intersect the medical librarians’ interests in health care, technology, and of course libraries and information services. The following are summaries of recent reports that have come across my desktop. Perhaps you may find them useful:

The Science of Spread: How Innovations in Care Become the Norm

This report was released in September 2007 by the California HealthCare Foundation (http://www.chcf.org/). The report is interested in how change within health care institutions are diffused throughout an organization and how they are adapted by other institutions. The report surveys the literature—both popular and health care-specific—of diffusion or spread of ideas, process, or practice changes.

The report mentions Institute for Healthcare Improvement own white paper. Disseminating Issues in Healthcare described a framework for diffusion that, while recognizing the need for collaborative team processes, places a primary responsibility for change on the organization’s key leadership.

Other theorists mentioned in the report are Paul Plsek and Sarah Fraser. One of Plsek’s concerns is the varying levels of changeability or where health care professionals for example, fall in the “readiness to change spectrum” (page 9). Sarah Fraser is concerned with innovators behave as (often impatient) messengers of spread while others within an organization may be weary of change.

The Science of Spread Report examines five case studies of spreading improvement in healthcare. I’ll mention two:

The report exemplifies the Veterans Health Administration as an example of change leadership in improving patient satisfaction while reducing costs. The VHA developed an advanced access system that allowed patients to make same-day appointments and reducing wait times. Another tool for spreading improvement within the VHA system was its electronic health record that has been widely deployed.

The report returns to the Institute for Healthcare Improvement (http://www.ihi.org/ihi) and their 100,000 Lives Campaign (see the 5 Million Lives Campaign at http://www.ihi.org/IHI/Programs/Campaign/). The campaign was a national initiative that utilized partnerships with major healthcare associations and locally based networks or nodes of hospitals. Nodes would be composed of regional collaborative teams and mentor hospitals that spread the message of specific and previously identified improvement goals in six areas of care.

The report concludes by summarizing the roles of leaders, champions, front-line caregivers in ensuring change spread and offering six lessons to facilitate change. See the report at: http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=133461.

The Horizon Report 2008 Edition

The Horizon report series is a collaboration of The New Media Consortium and the EDUCAUSE Learning Initiative. The Horizon report is a research project spanning five years that identifies “likely to have a large impact on teaching,…within learning-focused organizations.” The technologies are organized into timeframes or horizons that represent when their wide adoption would take place.

Two technologies are identified as already widely adopted or being adopted within a year: grassroots video and collaboration webs. Recording events to the web is already widespread. Educational applications are abundant with specially branded YouTube channels from institutions like UC Berkeley and the University of Maryland Baltimore County. With collaboration webs building, storing, and sharing documents of all types are employed by groups of instructors and students. Content is developed by groups and distributed widely. Wikis, Google Docs, Zoho Office, and Slideshare are a few examples.

Two more technologies are likely to be widely adopted in the next two to three years: mobile broadband and data mashups. Mobile broadband allows for ultra-remote networking on small devices and is already prevalent . Education, research, and health care uses are already growing. In the healthcare setting think of the librarian providing on-the-spot searches to providers at home visits or incident triage centers with PubMed OnTap. Penny has written about mashups previously (http://nnlm.gov/ner/newsletter/27/techtimes27.html). Mashups are easily illustrated when you think about a diagnostic resource being able to dynamically create a PubMed search with relevant citations based on the resulting diagnosis.

In the next four to five years collective intelligence and social operating systems are likely to be widely adopted. The ability to cull knowledge from a large group of people through a resource like Wikipedia, Freebase, or the Human Brain Cloud can be considered examples of collective intelligence technology. Social operating systems place the emphasis on the relationships a user has with other individuals when using a utility like an email application. A deeper example might be an information resource’s ability to graphically call up profiles (pictures, mini-bios, bibliographies) from an individual on a web page, article, or other document without the user having to initiate another search.

In addition to providing overviews of these current and emerging technologies, the Horizon Project summarized the technologies’ relevance to teaching and learning, more specific examples with accompanying websites, and suggestions for further reading.

The Horizon Projects “2008 Horizon Report” is available at: http://wp.nmc.org/horizon2008/

Submitted by Javier Crespo

NER is pleased to announce the following funded outreach projects:

Tufts University, Hirsh Medical Library: SPIRAL Enhancement Project

Tufts University will expand the work of its acclaimed SPIRAL resource. SPIRAL stands for Selected
Patient Information Resource in Asian Languages (http://spiral.tufts.edu/). The subcontract funding will allow the project to increase the language and content offerings on the SPIRAL Asian Languages in Health Information Website.

The goal of the SPIRAL project is to promote health literacy by collecting health information in multiple Asian languages for non-English speakers to search, and for health care providers to make available to their non-English speaking patients.
Project objectives are:

1. Addition of new topics: Consumer health resources created by Asian medical schools will be investigated, and when appropriate, integrated within SPIRAL’s collection of links.
2. Addition of new language – Japanese: Recruit Japanese translator(s) to join the pool of translators who were identified previously to work with the SPIRAL project.
3. Promote and publicize the SPIRAL site to the physicians, health care providers, libraries, and communities serving the targeted patient populations.
4. Redesign web site layout to improve aesthetics and appeal, user navigation, including provisions for Section 508 compliancy, and organization of featured materials.

River Valley Healthy Communities Coalition: River Valley Health Information Literacy Outreach Project

The goal of the River Valley Health Information Literacy Outreach Project is to increase awareness of reliable online health information and improve the health literacy of youth and young adults in rural Northern Oxford County, Maine. The River Valley Healthy Communities Coalition (RVHCC) will:

1. Assess community health information needs and services.
2. Increase the capacity of teachers and librarians to use reliable online health information resources to improve health literacy.
3. Pilot health information literacy lessons in local schools, community–based adult education programs, and public libraries.
4. Encourage consumer health information outreach by Healthy Communities Coalitions throughout the state of Maine.

RVHCC is a non-profit organization serving nine towns (Andover, Byron, Canton, Dixfield, Hanover, Mexico, Peru, Roxbury, and Rumford). We first wrote about Healthy Communities projects in a previous newsletter article (http://nnlm.gov/ner/newsletter/13/ad-perspective13.html) The project team will train 15 teachers and librarians to pilot three health information literacy lessons using the National Library of Medicine (NLM) online resources in schools, adult education programs, and libraries. During the pilot it is expected that the project will reach 200 youth and young adults and that 80% will report increased awareness of NLM resources and 60% will use online resources to find health information. RVHCC is collaborating with Rumford Hospital and Central Maine Medical Center.

The above two subcontracts join the following four current subcontracts that are well under way.

• Littleton Regional Hospital, Gale Medical Library: Northern New Hampshire Health Information Outreach.
• Massachusetts General Hospital, Treadwell Library: Health Information Project with CAPIC (Community Action Programs, Inter City, Inc.).
• University of Vermont, Dana Medical Library: Connecting Patients, Providers, and the Community with Quality Health Information.
• Yale University, Cushing/Whitney Medical Library: Information Needs of Connecticut School Nurses.

Submitted by Michelle Eberle

Stay up to date professionally without leaving your desk! The National Network of Libraries of Medicine/ New England Region brings you a new distance education series. This ongoing series will feature hot topics in health sciences librarianship and major updates to National Library of Medicine resources. Stay tuned for more to come! Announcements about future programs will be highlighted on the NN/LM-NER distance learning page and announced on the NAHSL-L listserv. (http://nnlm.gov/ner/training/distancelearning.html)

Recent Programs Included

“Health Literacy”
Guest speaker: Rima Rudd
Date: February 12, 2008
Time: 1-2 PM

Our first program held on February 12, 2008 featured guest speaker, Rima Rudd, Senior Lecturer on Society, Human Development, and Health at the Harvard School of Public Health with a lecture on health literacy. Dr. Rudd shared the importance of health literacy in the context of research findings, promising initiatives and roles for professional action. This was a unique opportunity for members to hear from one of the most prominent researchers in the field and to inquire with burning questions. Dr. Rudd wrote several reports that are helping to shape the agenda in health literacy research and practice. They include the health literacy chapter of the Health and Human Services book Communicating Health: Priorities and Strategies for Progress (2003) and the Educational Testing Services report, Literacy and Health in America (2004). She served on the Institute of Medicine Committee on Health Literacy, on the National Research Council Committee on Measuring Adult Literacy, on the Joint Commission Advisory Committee on Health Literacy and Patient Safety.

“Library as Commons: Improving the Library Experience”
Guest speaker: Cheryl Bryan
Date: March 19, 2008
Time: 1- 2 PM

Libraries today are expected to create havens for those seeking a quiet place to work, study or read and places for shared exploration and work groups. They also provide access to new technologies, while providing traditional print and media sources all in the same floor plan. Cheryl Bryan, Consultant with the Southeast MA Regional Library System, explored the trend towards defined activity zones, allowing the space to be reconfigured to current demands and uses, reminiscent of the simplicity of the traditional Japanese house. How are libraries successfully doing this now? How can we modify traditional services and introduce new media and formats to our communities? The successes of public libraries with library as commons was shared to provoke thoughtful discussion of this important issue for medical libraries too.

“Marketing Showcase”
Guest speaker: You!
Date: April 9, 2008
Time: 1-3:30 PM

This unique opportunity provided members with a chance to share what worked best in promoting their library and to hear effective marketing strategies from other medical librarians throughout the region. Each participant had 10 minutes to share their project, program, resource, or approach and describe how it increased the visibility and status of the library within the organization and community. Five “best in show” projects will be chosen and highlighted by the NN/LM-NER in the next NER’eastah Newsletter. The Marketing Showcase was co-facilitated by Michelle Eberle and Mark Goldstein.

We look forward to continuing to bring you meaningful educational programming in this new format.

We want your feedback! To suggest a topic and/or speaker for an upcoming Connecting with the NER program, please contact Michelle Eberle at michelle.eberle@umassmed.edu.

I just wanted to thank everyone for sending in their suggestions for the next major redesign of DOCLINE, which will focus on the redesign of the Requests and Serial Holdings modules. The redesign project will take a year or more to complete. Even though the deadline has passed, please feel free to pass along any additional suggestions that may come your way. And thanks!

Help? Advice? Questions?

Contact Mark:
508-856-5964

mark.goldstein@umassmed.edu

Submitted by Mark Goldstein

• Expecting a reduction in staff, hours, services, or space?
• Organizing a move of the library within your institution?
• Leaving the library (for a new job, retirement, etc.), yet hoping the institution will hire a suitable replacement?
• Just got word that your institution (and library) will be going through a consolidation or merger?
• Are rumors circulating about the possible elimination of the library’s functions?
• Has your institution announced that it’s closing its doors?
• Arriving to your institution as the new librarian?

If you responded in the affirmative to any of these questions, contact Mark at 508-856-5964 or mark.goldstein@umassmed.edu for an advocacy consultation over what the NER can provide you in the way of a measured response.

Submitted by Mark Goldstein

… which may be reason enough to review the “update reasons” for not filling requests as a lender.

There are three types of reasons for a request to either route on to another library, or discontinue routing and retire: (1.) Routing Reasons are system generated during the routing process; (2.) Removal Reasons are system generated in Time-triggered actions; and (3.) Update Reasons are chosen by a potential lender as a reason for not filling a request.
Please review the list of update reasons, below.

List of Update Reasons

Note: Reasons followed by an asterisk (*) stop a request from further routing. The request is retired unfilled.

Of special note: we should focus on the update reason known as the LIC (license restriction) code. Lenders should use this code when the library’s journal subscription prohibits Interlibrary loan (ILL) under the conditions specific to this request. For example, subscription prohibits ILL from the online journal outside the lender’s country and the borrowing library is outside the lender’s country. Journal subscriptions which entirely prohibit ILL under the publishers’ license agreement should not be listed in DOCLINE Serial Holdings.

Submitted by Mark Goldstein

DOCLINE® Version 3.3 was released into production on February 10, 2008. The release notes are, as follows:

Institution Record

Address: Moved electronic delivery addresses (e.g., email, Ariel, and fax) from the DOCLINE Options page to the Address page of the Institution record so that all “ship to:” addresses were in one location.

Address: Added “Edit Routing Table” link on initial Institutions Update page to speed access to routing table maintenance.

DOCLINE Options: Added ability for lenders to receive email notification of new Normal, Rush, and/or Urgent Patient Care requests routed to them. Allows libraries to more easily monitor all or select incoming DOCLINE requests.

Out of Office: Allow libraries to request their library be set “Inactive” during extended staff absence due to vacation or special circumstances. Provides a more efficient mechanism for your Regional Medical Library to review and process Out of Office requests.

Data: The Canadian province two letter code for Newfoundland and Labrador has been updated to reflect the Canadian change from NF to NL. LIBIDs in this province were updated throughout DOCLINE from NFCxxx to NLCxxx.

Requests

Borrow: Added warning message on Borrow / Manual method to alert users to more efficient borrow methods. Libraries should only place requests via Borrow / Manual after verifying that citation is not in PubMed and bibliographic record is not in LocatorPlus, or when LocatorPlus is unavailable.

Routing: If a library has selected email notification of new requests, upon routing to a potential lender, DOCLINE will send an email to library designated email address.

Serial Holdings

Reports: Revised user interface for requesting and viewing of serial holdings reports.

Help

Help screens were added or modified for new features and changes to DOCLINE 3.3.

Submitted by Mark Goldstein

Caritas Labouré College (MAUCLJ)
Boston, MA
New Affiliate Member (formerly Full member)

Central Connecticut State University (CTULRZ)
New Britain, CT
New Affiliate Member

Children’s Safety Network (MAULWE)
Newton, MA
New Affiliate Member

Greenfield Community College (MAULRR)
Greenfield, MA
New Affiliate Member

InRhodes Resource Center (RIULNZ)
Providence, RI
New Affiliate Member (formerly Full member)

NELINET, Inc. (MAULUL)
Southborough, MA
New Affiliate Member

North Shore Community College (MAUCGM)
Lynn, MA
New Affiliate Member

University of New England at Portland (MEUWSR)
Portland, ME
New Affiliate Member (formerly Full member)

Waldo County General Hospital (MEWAD)
Belfast, ME
Reinstated Full Member

Submitted by Hathy Simpson

I have been busy developing a new skill building section for the Evidence-Based Practice for Public Health (EBPPH) website, http://library.umassmed.edu/ebpph. The section is intended to provide public health practitioners and health science librarians with an overview of the process of practicing evidence-based public health. Below is a sampling of this new section.

What is Evidence-Based Public Health?
Evidence-based public health (EBPH) is the use of the best available evidence to develop interventions, policies, and health promotion programs for population-based public health practice. EBPH requires integrating public health practitioner expertise, experience, and community values with the best evidence from systematic research.

The Evidence-Based Public Health Process
Evidence-based public health process involves selecting, implementing, and evaluating demonstrated interventions to address an identified public health problem. For example, do school-based intervention programs prevent obesity in children?

The process can be broken down into six steps:

1. Define the problem
2. Find the evidence
3. Assess the evidence
4. Develop and prioritize potential solutions
5. Implement the selected solution(s)
6. Evaluate the results

Step 1: Define the Problem
Write a statement of the problem. This statement should include:

• The health/safety issue of concern
• The population affected by the concern
• The size and scope of the problem: Public health data and statistics to help quantify the problem can be found at PHPartners.org: Health Data Tools and Statistics (http://phpartners.org/health_stats.html)
• Potential interventions (brainstormed solutions to the problem)
• Potential outcomes of these solutions (the measurable results you hope to happen)

Step 2: Find the best evidence
Search and select the best evidence for effective solutions to the problem. The EBPPH website is designed to allow users to find the best evidence to inform public health practice decisions. The resources are arranged along a Pathway of Evidence-Based Resources. (http://library.umassmed.edu/ebpph/pathway.cfm) We recommend that you search for evidence in the following order:

1. Evidence-Based Guidelines (http://library.umassmed.edu/ebpph/guidelines.cfm)
2. Systematic Reviews (http://library.umassmed.edu/ebpph/syst_reviews.cfm)
3. Pre-Formulated and Filtered Searches of Published Studies (http://library.umassmed.edu/ebpph/filt_search.cfm)
4. Best Practices (http://library.umassmed.edu/ebpph/best_pract.cfm)
5. Public Health Databases (http://library.umassmed.edu/ebpph/dblist.cfm)
6. Public Health Journals (http://library.umassmed.edu/ebpph/journallist.cfm)
7. Sometimes evidence, especially for a new public health problem, is not available from the published literature.

The Partners in Information Access for the Public Health Workforce ( http://phpartners.org), provides access to additional public health information resources:

• Health data sets and statistics (http://phpartners.org/health_stats.html)
• Government reports and grey literature (http://phpartners.org/guide.html#Reports%20and%20Other%20Publications)
• Newsletters, listservs, and news feeds (http://phpartners.org/news.html)
• Policy statements, laws, and regulations (http://phpartners.org/legis.html)
• Conference abstracts, presentations, and webcasts ( http://phpartners.org/conf_mtgs.html)

Step 3: Assess the Evidence
Assess the quality, relevance, and usefulness of the evidence to solve the identified problem. Compare your community’s health problem to the research findings.

Determine the following:

• Characteristics of population groups studied or targeted
• Possible interventions to resolve the problem
• Relevance of the findings to your community’s problem and target population(s)
• Potential benefits, harms, and costs of the intervention(s)
• Barriers to implementation

The EBPPH website will link to resources for critical appraisal of public health practice evidence.

Step 4: Develop and Prioritize Potential Solutions
Based upon the results of assessment of the evidence, develop and prioritize feasible solutions to the problem.

Step 5: Implement the Selected Solution(s)
Translate the evidence into practice. Develop an action plan and implement the selected solution(s) to solve the public health problem.

Step 6: Evaluate the Results
Evaluate the implemented solutions. The evaluation should include both performance and outcome measures to determine if the program was effective in meetings its goals and objectives.

I will keep you posted on the progress of this new learning section of the website. Feedback is always accepted and greatly appreciated! I am also available to provide free training on how to search for evidence for public health practice. I can be reached at hathy.simpson@umassmed.edu or 508-856-2085.

Today, March 19, the National Library of Medicine (NLM) released a new search engine for MedlinePlus GoLocal, http://www.nlm.nih.gov/medlineplus/golocal/, using the Vivisimo search software. By popular demand, search results now include health information from MedlinePlus, as well as the health services in MedlinePlus Go Local.

A look through the MedlinePlus Go Local search logs shows that many users are looking for health information as well as services. Examples include drug names such as Provigil and Cialis, disorders such as GERD and TMJ, and services such as dentists that take Medicaid and where to get a flu shot. In addition to adding health information from MedlinePlus, the new search results also feature improved relevance rankings, links to maps and directions, bold-face search words in context, and an integrated spell checker that suggests alternative search terms and spelling corrections.