摘要：Objective: The research sought to determine the effect of a clinical medical librarian (CML) on outcomes of in-patients on the internal medicine service. Methods: A prospective study was performed with two internal medicine in-patient teams. Team 1 included a CML who accompanied the team on daily rounds. The CML answered questions posed at the point of care immediately or in emails post-rounds. Patients on Team 2, which did not include a CML, as well as patients who did not require consultation by the CML on Team 1, served as the control population. Numerous clinical and library metrics were gathered on each question. Results: Patients on Team 1 who required an answer to a clinical question were more ill and had a longer length of stay, higher costs, and higher readmission rates compared to those in the control group. Using a matched pair analysis, we showed no difference in clinical outcomes between the intervention group and the control group. Conclusions: This study is the largest attempt to prospectively measure changes in patient outcomes when physicians were accompanied by a CML on rounds. This approach may serve as a model for further studies to define when and how CMLs are most effective. Highlights Physicians have more queries for a clinical medical librarian (CML) when the patient has more complex medical problems. The research provides a detailed description of how a CML can function in a medical team and identifies team members most likely to ask questions that require a CML's searching abilities. The most frequently used resources to answer clinical questions were PubMed, followed by Access Medicine and MD Consult. No difference was found in clinical outcomes between the intervention group and the control group. Implications A CML can be most effective by rounding with those physicians who see the more complex medical problems (severe diseases and high number of secondary diagnoses). It is difficult to compare the effects of CML intervention, because so many variables outside the CML's control are involved. These include the physician's utilization of the literature, the physician's level of competence, the uniqueness of each patient, and the practice setting. Although difficult to implement, further research addressing the impact of a CML on patient outcomes would likely benefit from a more sophisticated study design compared to the case-control study undertaken here.
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