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1.
Albert KM 《Medical reference services quarterly》2007,26(3):1-19
Satisfying clinical information needs remains a major challenge in medicine, underscored by recent studies showing high medical error rates and suboptimal physician adherence to evidence-based practice guidelines. Advanced clinical decision support systems can improve practitioner performance and patient outcomes. Similarly, integrating online information resources into electronic health records (EHRs) shows great potential for positively impacting health care quality. This paper explores the evolution and current status of knowledge-based resource linkages within EHRs, including the benefits and drawbacks, as well as the important role librarians can play in this process. 相似文献
2.
This paper defines what is meant by Knowledge Management, investigates how it interlinks with new ways of delivering health care and gives a synopsis of a study that investigated issues around implementation of Knowledge Management across a sample of healthcare librarians. Areas of investigation that are related to Knowledge Management include: HSG(97)47, evidence‐based medicine, clinical governance, information and communication technologies, and the changing role of the healthcare librarian. A diagram is included in this paper which illustrates how the healthcare librarian interacts with resources, staff and practices, so contributing to the knowledge base of health care. The paper concludes that Government policy, new technologies and the push towards the practice of information age medicine are forcing changes throughout the NHS. Recognition of Knowledge Management is still in its infancy in the NHS—it calls for major change in organizational thinking and acceptance by the librarian that their service must also be subject to continuous improvement. 相似文献
3.
Undertaking an information-needs analysis of the emergency-care physician to inform the role of the clinical librarian: a Greek perspective 总被引：1，自引：0，他引：1
Lappa E 《Health information and libraries journal》2005,22(2):124-132
AIM OF STUDY: The primary focus of this pilot study was to gain a better understanding of the information needs of emergency-care clinicians. The secondary focus was to compare the traditional current practice of information provision within other emergency departments in Greek hospitals, with the new model of clinical librarianship (CL). RATIONALE: Clinical staff in the emergency department deal with a variety of cases, they have no time to visit the library, but need information instantly in their place of work. Clinical decision making in the emergency department setting frequently requires the clinician to obtain additional sources of information and clinical librarians may facilitate this. STUDY DESIGN: The present study focused on two professional groups: medical librarians (group A) and clinicians (consultants, senior registrars, registrars, nurses (group B), working in the emergency departments of two Greek hospitals. The study was organized through a questionnaire survey and some in-depth interviews. RESULTS: This study showed that, for 100% of the clinicians in daily practice, the main information needs arise while treating patients, and that information would help in making patient-care decisions. Clinicians made little use of hospital libraries because they are usually under tremendous time pressure. The main outcome of the study was the use of a clinical librarian as an information provider. Clinical librarians supply information to assist decisions, based on this model. This extends the librarian's role in evidence-based medicine, giving much stronger attention to the relevant evidence in clinical practice. CONCLUSIONS: Nowadays, health services are facing organizational change. The introduction of new technology, and rapid growth of medical knowledge creates a demand for new ways of providing information. Clinical librarian programmes may deliver patients specific information in a timely manner. The mission of the clinical librarian is to facilitate access to quality information which is necessary for improving health, and to act as an informationist in the emergency department. 相似文献
4.
V Florance 《Bulletin of the Medical Library Association》1992,80(2):140-149
Despite technological advances that support wide-ranging access to and transfer of knowledge, practicing physicians continue to underutilize current biomedical literature. This paper explores the nature of clinically applicable medical knowledge through a structural analysis of clinical questions. The author analyzed a set of sixty questions, based on actual online search requests of practicing physicians, for stated and unstated needs, certainty levels, implicit and explicit assumptions, decision-making processes, and type of answer required. As a result, four states of information valuable in patient care were identified: prediagnostic assessment, diagnosis, treatment choice, and learning. These states are presented in frame-like structures that integrate declarative and procedural components of medical decision making. It is concluded that clinical problem solving requires a blend of declarative and procedural knowledge. The ratio depends, in part, upon the reasoning process underway at the time of the request. Procedural knowledge required for clinical problem solving may be absent from current biomedical journal literature or difficult to identify. 相似文献
5.
Integration of multiple information systems of a medical center will change the way physicians work and practice medicine in the future. Several major steps must be taken by an institution to make this a reality. Since 1983, Georgetown has been engaged in an Integrated Academic Information Management System (IAIMS) project to bring together multiple sources of information that reside on different computers and database systems. Georgetown is developing a Biotechnology and Biomedical Knowledge Network that includes informational and clinical databases, scholar workstations, instruction on computer use, a campuswide network with local area network nodes, and a modular approach to systems integration. The IAIMS project, spearheaded by the medical library, has enabled a broad spectrum of health professionals to benefit directly from new, dynamic information services. The network is heavily used; in 1991, more than 2,100 individual users conducted more than 148,500 computer functions and more than 104,000 searches. There is economy of scale in high-volume use. Overall, the average search cost is $1.57; for high use databases the cost is $0.38, and for low use, it is $9.41. As described in this paper, IAIMS offers a cost-effective means of enhancing patient care by improving information services to physicians. At Georgetown, IAIMS has advanced the concept of integration, accelerated use of computers in education, increased user acceptance of advanced technologies, and established cost factors for providing information resources. While progress made in improving the transfer of medical information is impressive, it is clear that IAIMS requires several more years of support to achieve full implementation. 相似文献
6.
Sue Lacey Bryant Helen Bingham Ruth Carlyle Alison Day Linda Ferguson David Stewart 《Health information and libraries journal》2018,35(1):70-77
This article is the fourth in a series on New Directions. The National Health Service is under pressure, challenged to meet the needs of an ageing population, whilst striving to improve standards and ensure decision making is underpinned by evidence. Health Education England is steering a new course for NHS library and knowledge services in England to ensure access to knowledge and evidence for all decision makers. Knowledge for Healthcare calls for service transformation, role redesign, greater coordination and collaboration. To meet user expectations, health libraries must achieve sustainable, affordable access to digital content. Traditional tasks will progressively become mechanised. Alongside supporting learners, NHS librarians and knowledge specialists will take a greater role as knowledge brokers, delivering business critical services. They will support the NHS workforce to signpost patients and the public to high‐quality information. There is a need for greater efficiency and effectiveness through greater co‐operation and service mergers. Evaluation of service quality will focus more on outcomes, less on counting. These changes require an agile workforce, fit for the future. There is a bright future in which librarians’ expertise is used to mobilise evidence, manage and share knowledge, support patients, carers and families, optimise technology and social media and provide a keystone for improved patient care and safety. 相似文献
7.
Jennifer A Byrnes Tracy A Kulick Diane G Schwartz 《Journal of the Medical Library Association》2004,92(3):334-340
A National Library of Medicine information access grant allowed for a collaborative project to provide computer resources in fourteen clinical practice sites that enabled health care professionals to access medical information via PubMed and the Internet. Health care professionals were taught how to access quality, cost-effective information that was user friendly and would result in improved patient care. Selected sites were located in medically underserved areas and received a computer, a printer, and, during year one, a fax machine. Participants were provided dial-up Internet service or were connected to the affiliated hospital's network. Clinicians were trained in how to search PubMed as a tool for practicing evidence-based medicine and to support clinical decision making. Health care providers were also taught how to find patient-education materials and continuing education programs and how to network with other professionals. Prior to the training, participants completed a questionnaire to assess their computer skills and familiarity with searching the Internet, MEDLINE, and other health-related databases. Responses indicated favorable changes in information-seeking behavior, including an increased frequency in conducting MEDLINE searches and Internet searches for work-related information. 相似文献
8.
本文以ISIWebofScience数据库中收录的以知识共享为主题的文献信息作为数据源,然后运用CiteSpaceⅡ软件绘制了知识共享研究领域的国家或地区分布、机构分布、经典作品和研究热点与前沿的知识图谱,并进行了分析。研究发现,美国、英国、日本、德国和瑞典等在知识共享领域开展了广泛的合作研究,并且产出总量丰富。本文将研究热点与前沿分为知识共享相关的理论研究、技术方法研究和实践应用三个层面的内容。主要包括设计、交流、本体、网络、绩效、隐性知识、实践社区、知识建模、决策支持、人力资源开发、信息可视化、分布式案例推理和Web2．0等。 相似文献
9.
Information needs of United Kingdom primary care clinicians 总被引：1，自引：0，他引：1
Swinglehurst DA 《Health information and libraries journal》2005,22(3):196-204
BACKGROUND: The scope of primary care makes knowledge management in this context very challenging, especially as access to information increases and the role of primary care within the NHS expands. OBJECTIVES: This paper reviews the literature on the information needs of primary care clinicians to enable evidence-based decision making. Drawing on the literature, and using a specific example of a clinical informaticist service, some lessons are drawn on the role of information professionals in facilitating evidence-based health care. METHODS: Literature review. Case study of clinical informaticist service. CONCLUSIONS: There are numerous barriers to clinicians engaging with evidence-based practice. However, providing evidence-based information to clinicians' questions in a user-friendly format has the potential to facilitate changes in practice. The successful implementation of information services requires attention to both academic and service dimensions, fostering closer working relationships between clinicians and information professionals. 相似文献
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11.
Julie G. Kosteniuk Debra G. Morgan Carl K. D'Arcy 《Journal of the Medical Library Association》2013,101(1):32-37
Objectives:
The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs.Methods:
A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008.Results:
Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access).Conclusions:
When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.Highlights
- Medical textbooks were the most popular information source for family physicians'' (FPs'') clinical decision-making purposes, and medical journals were the most popular information source for the purpose of updating FPs'' general medical knowledge.
- FPs considered medical textbooks to be the most reliable (trustworthy) source, colleagues the most physically accessible, and continuing medical education the most relevant and intellectually accessible.
- The lowest ranked information sources across all four attributes were personal digital assistants, mental health professionals, pharmaceutical sales representatives, and other decision aids.
Implications
- The most popular information sources for clinical decision-making purposes among FPs were sources characterized as reliable and generally physically accessible.
- This study suggests the need for further research into interventions that target information access barriers in FPs'' practice settings and the promotion of reliable evidence for FPs'' clinical decision-making purposes.
12.
In information retrieval research, models and systems traditionally assume that a single person is querying and reviewing the results. However, several empirical studies of professional practice identified collaboration during IR as everyday work patterns in order to solve a shared information need and to benefit from the diverse expertise and experience of the team members. Moreover, most IR systems that are employed in professional work routines are designed for individual use and prototype collaborative systems are too limited to support use in todays work practice. To bridge this gap, this papers develops and formalizes a decision theoretic approach towards supporting a team of people that explicitly set out together to resolve a shared information need. We develop a formal cost model for collaborative IR that considers the trade-off between estimated relevance of a document as well as estimated document redundancy. From this cost model, we use a decision theoretic approach to derive the notion of activity suggestions, that is, a formal optimum criterion that describes optimum collaboration strategies in IR as the solution of an integer linear program. Those collaboration strategies are suggested to team members with the aim to facilitate the collaborative performance of information retrieval tasks. We demonstrate the application of our model by means of search result division in two collaborative search tasks. In the conducted experiments, we study the effects of different domain knowledge and resulting relevance assessments of team members in four different conditions. The gathered results indicate that our approach can improve the retrieval effectiveness of teams in recall-oriented tasks. 相似文献
13.
Gerhard Bissels Sabine D. Klein Isabelle de Kaenel 《Health information and libraries journal》2019,36(4):372-377
The feature is a part of the series about medical library services in various countries. It gives an overview of medical library services to support research, education and clinical practice in Switzerland. Data were collected by means of an online survey and set in the wider context of the Swiss healthcare system. Key findings are that library services, including support by academic librarians, are provided to health care staff in hospitals – both university and others, while there is no information service infrastructure to serve the large number of GPs and specialists who mostly run their own practice. The authors recommend that – if the health authorities take EBM seriously – information services should be introduced for these small practices. J.M. 相似文献
14.
构建基于Ontology的知识门户 总被引：9，自引：1，他引：9
知识门户为用户提供了万维网上基于特定学科领域信息的视窗，方便用户查找相关的、特定学科的信息。智能存取系统（Intelligent Access）的构建与知识门户的信息供应需要进行大量的人工编辑和维护工作。为了减轻这些人工劳动，在构建与维护知识门户的综合方法中，可以利用Ontology作为概念的中枢提供和访问信息，并将信息结构化。 相似文献
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16.
Helge Knüttel Evamaria Krause Martina Semmler‐Schmetz Iris Reimann Maria‐Inti Metzendorf 《Health information and libraries journal》2020,37(1):83-88
This feature is part of a series about medical library services in various countries. It gives an overview of the state of and selected current developments of medical library services to support research, education and clinical practice in Germany. Findings from an online survey and issues of access to health information are discussed in relation to the German health care system.J.M. 相似文献
17.
S S Fuller D S Ketchell P Tarczy-Hornoch D Masuda 《Bulletin of the Medical Library Association》1999,87(4):393-403
Health sciences librarians at the University of Washington (UW) are partners in the evolution of Internet-based clinical information systems for two medical centers, University of Washington Medical Center and Harborview Medical Center, as well as the UW Primary Care Network clinics. Librarians lead information resource and systems development projects and play a variety of roles including facilitator, publisher, integrator, and educator. These efforts have been coordinated with parallel development efforts by the Integrated Advanced Information Management Systems (IAIMS) clinical informatics group in developing electronic medical record systems and clinical decision support tools. The outcome is MINDscape, a very heavily used Web view of the patient medical record with tightly integrated knowledge resources as well as numerous Web-accessible information resources and tools. The goal of this article is to provide a case study of librarian involvement in institutional information systems development at UW and to illustrate the variety of roles that librarians can assume in hospital settings. 相似文献
18.
适应情景演化的应急响应知识库协同框架体系构建 总被引：1，自引：0，他引：1
[目的/意义]知识库集结描述清晰、反映全面、关联紧密的知识,是应急决策的智力支持,也是应急响应情报体系形成的前提,在应急响应决策中发挥着重要作用。提升到用于应急决策的高度,必须适应信息量大、精确性高、跨领域多的情景演化要求,形成知识库协同架构有序、高效、及时地提供应急解决方案。[方法/过程]围绕应急响应,从公众、救援人员、决策者3个角度对知识库的使用需求进行梳理,并结合应急响应各阶段过程,从常识知识、事实与经验知识以及运算推理规则3个维度探索应急响应的知识库体系框架的构建。[结果/结论]所构建的知识库体系框架注重应急响应知识普及功能,应急过程中的快速响应功能。体系框架中以常识性知识库c-KB、事实经验知识库e-KB、推理知识库r-KB 3个知识库组建,为应急决策提供了精确、及时的知识支撑。 相似文献
19.
Caldwell L Davies S Stewart F Thain A Wales A 《Health information and libraries journal》2008,25(2):125-134
BACKGROUND: Using specific examples, this paper describes the tools, methods and resources used to develop Managed Knowledge Networks (MKNs) within the NHS Scotland e-Library (http://www.elib.scot.nhs.uk). MKNs help to complete the knowledge management cycle by providing a place to share the learning and discuss the evidence for practice through combining the use of the published material (explicit knowledge) with the experience and knowledge held by individuals, communities and organizations (tacit knowledge). OBJECTIVES: First of all, this paper outlines the e-Library infrastructure, which provides an inter-operable framework to manage the published knowledge using a metadata management system; and a knowledge-sharing tool to support the development of MKNs. It then covers the various stages involved in developing an MKN: gathering and analysing information needs in a variety of ways; presenting and organizing the resources and services for the users as identified in the needs analysis; managing the tacit, personal and local knowledge. CONCLUSION: The toolkit described enables the Knowledge Services Group to take the needs of users, transcribe these into Specialist e-Libraries to provide access to the published information and to support this with accessing and sharing the knowledge of colleagues via MKNs. 相似文献
20.
Deborah Ward Susan E Meadows Joan E Nashelsky 《Journal of the Medical Library Association》2005,93(1):88-96
OBJECTIVE: This article describes the contributions of medical librarians, as members of the Family Physicians' Inquiries Network (FPIN), to the creation of a database of clinical questions and answers that allows family physicians to practice evidence-based medicine using high-quality information at the point of care. The medical librarians have contributed their evidence-based search expertise and knowledge of information systems that support the processes and output of the consortium. METHODS: Since its inception, librarians have been included as valued members of the FPIN community. FPIN recognizes the search expertise of librarians, and each FPIN librarian must meet qualifications demonstrating appropriate experience and training in evidence-based medicine. The consortium works collaboratively to produce the Clinical Inquiries series published in family medicine publications. RESULTS: Over 170 Clinical Inquiries have appeared in Journal of Family Practice (JFP) and American Family Physician (AFP). Surveys have shown that this series has become the most widely read part of the JFP Website. As a result, FPIN has formalized specific librarian roles that have helped build the organizational infrastructure. CONCLUSIONS: All of the activities of the consortium are highly collaborative, and the librarian community reflects that. The FPIN librarians are valuable and equal contributors to the process of creating, updating, and maintaining high-quality clinical information for practicing primary care physicians. Of particular value is the skill of expert searching that the librarians bring to FPIN's products. 相似文献