The Essential Value of Medical Research Libraries

By Jaclyn Castek

In 1981, a group of clinical epidemiologists at McMaster University in Hamilton, Ontario, led by David Sackett, an American-Canadian physician, introduced the concept of evidence-based medicine. Since then, the emphasis on utilizing the literature to follow the tenets of evidence-based medicine continues to grow.

The rapid growth of information technology and clinical information resources has made locating the literature needed to make the best evidence-based decisions for patient care complicated and time-consuming. The increased need for documentation and administrative duties has created a significant decrease in the time available to physicians and other health care professionals tasked with performing literature searches. Many hospitals and health care systems have a medical librarian, or team of librarians, who can help connect medical staff to vital information on evidence-based medicine.

Medical librarians are expert fact finders with skills and training in information retrieval. This skill set allows them to provide services that enable hospital staff to make timely and evidence-based decisions. Medical librarians help physicians, nurses, pharmacists, hospital administrators and allied health providers navigate information sources. Not only do medical librarians provide access to literature, they also often perform literature searches, provide instructional sessions on literature searches and evaluation and conduct one-on-one consultations. Additionally, they serve on interdisciplinary committees to provide high-quality evidence to support committee initiatives.

Because medical librarians assist many hospital departments and serve on hospital-wide councils, they play a significant role in multidisciplinary collaboration across a hospital or health system. They possess a unique ability to connect researchers or those involved with policy changes or quality improvement with individuals who can provide value to these projects. Some hospital librarians play more embedded roles within the clinical team by participating in morning rounds, attending safety briefings and being involved in accreditation preparation and surveys.

The services provided by medical librarians improve literature searching skills, save health professionals’ time, provide the latest evidence for decision-making, and have even been proved to reduce patient length of stay, reduce costs and enhance patient safety.

Several studies have shown the impact medical librarians have on patient care. In a 2011 study of medical students, 88% of respondents reported they changed a treatment based on new information skills taught by a medical librarian, while 79% changed a treatment plan based on a search done by a medical librarian (Aitken, 2011). A survey of about 16,000 physicians conducted a few years later found that 13% of respondents said they avoided a misdiagnosis or adverse drug reaction when using information provided by their library; additionally, 12% said they reduced medication errors and 6% said they avoided patient mortality (Marshall, 2013).

A 2016 study showed that 39% of those who use medical librarian services reported a positive impact on quality of care; 45% reported that services ensured that interventions were based on best practice or most current evidence; 25% reported improvement in patient and staff safety and 16% reported reduced referral, tests and readmissions (Brettle, 2016), which positively contributes to the American Board of Internal Medicine’s Choosing Wisely Initiative.

Medical librarians also play a significant role in nursing departments in hospitals and health care systems. A major aspect of Nurse Residency programs is learning and utilizing evidence-based practice skills, including performing literature searches and conducting research. Many Nurse Residency programs include training and presentations provided by medical librarians and assistance with literature searching processes from start to finish.

Additionally, medical librarians contribute to the Magnet Accreditation Program, the highest credential for nursing in the United States. This highly sought recognition program places heavy emphasis on evidence-based practice and research. There is a higher expectation for evidence-based practice and improved quality outcomes. By teaching nurses and nursing students literature searching and evaluation skills, they help facilitate and promote a climate for professional development and evidence-based practice for hospital nurses.

With their unique skill set and mastery of the art of literature searching, medical librarians can make it possible for clinical teams to focus their expertise, available time and energy on providing high quality, evidence-based care to patients.

Jaclyn Castek is Manager, Library Services, Tampa General Hospital. 

Aitken, EM, Powelson, SE, Reaume, RD, & Ghali, WA (2011). Involving clinical librarians at the point of care: results of a controlled intervention (full text). Academic Medicine, 86(12), 1508-1512. 

Brettle, A, Maden, M, and Payne, C (2016), The impact of clinical librarian services on patients and health care organisations (full text). Health Information and Libraries Journal, 33: 100–120. 

Marshall JG, Sollenberger J, Easterby-Gannett S, et al. The value of library and information services in patient care: results of a multisite study (full text). Journal of the Medical Library Association,101(1):38-46. 

Sackett DL, Rosenberg WM, Gray, JA, et al. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71–72.

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