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How clinical librarians can link health professionals with the evidence

June 21, 2011

I attended the CHLA conference a couple of weeks ago and was thoroughly refreshed and inspired by the program. I will share some of the highlights over a few blog postings.

One of  the most fascinating speakers was Dr. Eddy Lang, who gave a most insightful key note entitled: Information Science in the Evidence Based Era: Meeting the Perceived and Unperceived needs of Evidence Consumers. He is an eminent academic emergency physician and researcher who is passionately interested in Evidence-Based Medicine (EBM) and Knowledge Translation (KT).

Some of the gems from his talk included four scenarios of when evidence would be needed in clinical practice and what the gaps might be.

  • Treating a 25 year old female in the emergency ward with anxiety attack and symptos of a pulmonary embolism. Should you recommend a CAT scan or not? A CAT scan delivers a high amount of unnecessary radiation. To make a decision, the physician needs access to a validated decision tool – the pulmonary embolism rule out criteria – which may establish that in fact, the embolism is not the primary problem and preempt unnecessary radiation exposure. Physicians lack the the skills to find this information at the point of need during critical decision points.
  • A resident presenting on atrial fibrillation excluded key onging trials within Calgary – found in the Clinical site
  • In developing clinical tools such as orders sets, health professionals lack embedded decision support for levels of evidence.

Drawing on Alison Brettle’s study, Dr. Lang identified 4 models of clinical librarian integration that can help physicians access information at the point of need:

  • Questions and Answers
  • Questions and Answers + Critical appraisal
  • Outreach: proactively engaging and embedding librarians
  • Outreach + Critical appraisal + Synthesis


“Evidence stamp” from


BC launches new prescription for health program

June 1, 2011

Last week, the BC government announced a $68.7-million Healthy Families BC strategy to “help families make healthy choices and introduce innovative approaches to challenges facing the health care system.”

The first program of this strategy is the $24-million Prescription for Health program intended to equip B.C. doctors with tools to assess and work with patients to develop a health promotion and illness prevention plan appropriate for them. The key elements of the program include the following:

  • Prescription for Health is available to patients with at least one of these risk factors: smoking; unhealthy eating; physical inactivity and medical obesity.
  • Patients can identify a lifestyle change goal, which will be documented by the physician on a Prescription for Health.
  • The patient’s Prescription for Health may refer them to free-of-charge lifestyle programs to help patients achieve their individual lifestyle change goals. Examples of lifestyle support resources: the Physical Activity Line, Dietitian Services at HealthLink BC, QuitNow Services, a tobacco-cessation service and information resource, the Patient Voices Network peer coaching program.
  • As an incentive, 50,000 participating patients can receive up to $50 toward programs that support their goals: gym membership, physical activity programs or nutritional programs.

For more information on Healthy Families BC or Prescription for Health, please visit

I consider this a significant leap away the from the traditional focus on treatment to the more cost-effective prevention strategies – potentially avoiding up to $2 billion in yearly health-care costs. Obesity alone costs up to $830 million a year to the economy. What’s really fascinating is that patients get a financial incentive – it’s a really good idea to reward good behaviour. It will be interesting to see what the uptake of the program will be like, and what outcomes will result.

It’s good to ask…about your medications

January 13, 2011

This year, we are doing a fantastic series of workshops in the community to promote medication safety. The workshop is titled It’s Good to Ask about your Medications based on the It’s Good to Ask Program which encourages patients and consumers to participate more actively in their health care. Given that the average person only spends 12 hours per year with health professionals, it is essential that they are equipped to manage their own health for the rest of the 364.5 days.*

Our key messages include

  • Why its good to ask questions about your medications: What medication am I  taking? Why am I taking this medication? How do I take this medication?
  • Ways to ask questions to get the answers you need.

Our presentation to the Health Watch Program was very well received and we learned a great deal from the participants too.

  • There were about 16 participants, many of whom listened while attending to important business such as taking weight and blood pressure readings and receiving massage sessions.
  • They were an eager and engaged audience asking questions and making insightful comments through out the session. For example:
    • Do doctors keep as uptodate as pharmacists?
    • What does it mean to take medication with food? Does it have to be a full meal or can it be a snack such as a muffin?
    • Are vitamins better absorbed in powder rather than tablet form?
  • We learned that the group actively supports members in taking charge of medication safety through:
  • supply of medication booklets which members fill and carry
  • keeping uptodate medication history records at the centre
  • supply of vials used to store a dose of all of a patient’s drugs and corresponding list to be kept in the fridge. Emergency responders would be able to find this vial if the patient was unconscious.
vial for emergency medication

Vials for storing medication accessible to emergency responders if patient is unconscious

  • Despite being a group that interacts with pharmacists regularly, they picked valuable points. For example, they were not aware that all prescriptions dispensed in B.C. are tracked in the PharmaNet system and patients can walk into any pharmacy and the staff there will have access to their information.
  • They recognized that
    • pharmacists are the most handy and accessible health care profession : “it is easier to talk to a pharmacist than a doctor”
    • pharmacists are a good source of information about the recommended daily requirements for vitamins and other supplements
    • 811 is the number to call for non emergency health information
    • the patient is the most important member of the healthcare team.
*Barlow, J. Interdisciplinary Research Centre in Health, School of
Health & Social Sciences, Coventry University, May 2003.

Glad to be back

November 9, 2010

I am back after a long blogging hiatus courtesy of an unsustainable schedule that is hopefully, now under control. The myriad issues competing for my attention have included family visiting from overseas,  house renovation and sale, American Sign Language classes, a grant proposal…among others. The grant proposal is for a mobile health intervention to address malaria education needs along the coast of Kenya. Over the next little while, will be posting on this and other activities that I have been involved in over the last few months.