I'm glad that Jim has taken the chance of sticking his head above the
parapet. I have no intention of pouring hot oil on him (or whatever it
is one does with heads and parapets!). I don't find Jim's comments
pessimistic, rather realistic. At *present*, he is right, we don't have
the necessary funds, staff etc. etc. to get on and do this. However, I
don't think that anyone is suggesting that we all get up on Monday
morning and declare ourselves to be Informationists/Clinical Information
Scientists/whatever.

What we need to do in the first place is to talk, as individuals or
preferably as a body, to those for whom we run the services. We need to
find out what they really need and how we can best fulfil those needs.
So that's the first point: CONSULTATION. 

Secondly, we need to find out how we go about becoming informationists.
Maybe it will start as I expect we started with computers (which were
already installed everywhere by the time I cam into libraries). We will
have temporary add-on staff whose role will be exploratory as much as
anything, to see if things could work and how they might work. So point
two we could call RESEARCH.

Then we get to a stage where we find people hired as informationists
have worked out how that job will work. We start thinking about ways in
integrating them into healthcare librarianship. Perhaps they are part of
each multidisciplinary team, rather than being directly part of the
library. Perhaps every library will have a manager and an informationist
working together. Perhaps things like stock ordering, cat and class
could be done by central teams, leaving staff in individual libraries to
do the informationists stuff. Who knows? We need to see what works best
for us and for clinicians. (I can't think of a way to describe this
phase! Possibly EVOLUTION.)

Concurrent with this we need to look at funding. Who funds it? How? How
much? And yeah, I know it would be nice to be paid as much as doctors,
but hey! In you dreams, Jim!:-)

And finally, if we really need clinical training then there needs to be
discussion about that between clinicians and the Library Association and
library schools. 

So, as with anything this process will take time, not be an overnight
change. Just as now we look back to that wacky world without hole-in-
the-wall machines, the Internet, Medline on CD and blue smarties, one
day we look back and wonder how those funny turn of the century
healthcare librarians ever managed without clinical training and without
being based in multidisciplinary teams. I hope that it is progress. And
I hope that Jim will be with us as we dip our toes into the water. Vive
la revolution!

Sara Stock
In message <[log in to unmask]>, Jim Moore
<[log in to unmask]> writes
>Dear all,
>Time to put my head above the parapet! I've now read the article and the
>comments so far. There is much I agree with, but also I have some
>concerns - I'm afraid I'm a pessimist, as the list will have noted by
>now! I welcome some more optimistic amendments to my comments!
>
>>
>>(Gil) It seems to me that this Informationist (why not Clinical
>Information
>>Scientist?) is exactly the same, in job scope, to the Information
>>Scientist described. It is just that the academic discipline is
>>different. I can see no problem with medical graduates following this
>>job stream if that is their ambition. 
>
>>(Sara)The article also suggests that medical librarians need clinical
>>training. This doesn't seem totally unreasonable as some background
>>knowledge obviously helps a librarian to make the right decisions, look
>>for the right information, and identify related information. I have
>>certainly seen adverts for law librarians requiring a background in
>law.
>>However, the authors haven't said how much clinical training is needed,
>>and to what level. They could mean anything from someone with science A
>>levels and a grounding in medical terminology, to fully qualified
>>doctors running libraries. 
>
>This all makes sense, Gil and Sara, and there are a few Librarians who
>DO have a Health background/degree (as a former Speech and Language
>Therapist, I am one of them!) HOWEVER, the salary would need to be on a
>medical/clinical level, rather than a Library one, or no health
>professional would consider the job! And there lies one funding problem.
>Then, if the Clinical Librarian (which sounds a good title to me!) gets
>that kind of salary, what about the Librarian who manages the Library?
>Would the NHS cough up?!
>
>>(Sara) It seems to me that the job described is mostly that of a good
>>librarian. The authors seem to be saying that they want someone to find
>>information, read it, assimilate it, and then advise the clinician.
>It's
>>a step further than we usually go, and I don't see why, time, staff and
>>other resources allowing, a librarian couldn't fulfil that role.
>
>Perhaps, Sara, but the time, resources etc,. are NOT available, are
>they? We would need an ADDITIONAL post. Maybe that is the way forward -
>additional posts (like the Clinical Librarians at Whipps Cross and
>Barnet?)? I think that Librarians in NHS Libraries are currently trying
>to be all things to all men, or Jack/Jill of all trades - depending on
>how you look at it. Year on year, we get busier with ILLs, lending
>books, etc. etc, and so we do not have the time to do this assimiliation
>and appraisal. I have always been a bit concerned about Librarians doing
>very much filtering of information for clinicians, simply because we are
>NOT clinicians, and so we may be making wrong assumptions. However, my
>concerns would lessen if some Librarians WERE clinicians.  
>
>>
>>(Sara) The informationist (what an ugly Americanism!) is just another
>kind of
>>librarian. We're an ever evolving breed, keeping up with changes with
>>changes in technology and changes in the various other professions
>which
>>we serve. Something we have always been good at is listening to our
>>users. If this is what the medical profession want and feels it needs,
>>we should at the very least be out there discussing it with them.
>
>>(Mike) I agree with Sara: it's a development of the profession, not a
>>substitute.  Colleagues in South Thames will have heard me banging on
>>about the importance of us becoming 'information colleagues' of the
>>clinicians in the same way that the consultant in the next office is a
>>'clinical colleague.'  I felt quite encouraged by the article, not
>>threatened.  In Chichester the library is linked into the Clinical
>>Effectiveness Support Unit of the acute trust, library staff are on the
>>clinical guidelines committee, communications and R&D groups.  I
>>appointed a qualified nurse onto the staff several years ago to give us
>>the clinical cred that the article recommends and, if it weren't for
>>the students, we could probably close the library doors, abandon the
>>traditional library activities and function happily as a clinical
>>information service as the article describes.
>
>I think the phrase 'if it weren't for the students' is a key one, Mike!
>I would suggest this is not only undergraduate students, but also people
>undergoing continuing education. These make up a major part of our
>workload in this Integrated (Acute, Mental Health, Community) NHS Trust
>Library in a DGH. This workload still grows each year. Mike seems to
>have achieved a good situation, and all credit to him, but I wonder how
>common it is in the NHS? I struggle to maintain our current level of
>library service to 1,500+ members, with no funding from our Trust. Would
>a Clinical Librarian would get them digging deep in their pockets for
>additional funding?!
>
>> (Mike)I think the key to it is to sell our information skills, rather
>>than our library stock & services.  This is similar to the way that
>>other professions attract business on the basis of their personal skill
>>and experience, e.g. solicitors, architects.  Most of the research I've
>>seen on where clinicians seek information says they go to people first
>>(colleagues, specialists) before trying services.  We need to be in the
>>'people' list.
>
>I fully agree that we need to sell ourselves, Mike, but maybe we need to
>be able to sell both information skills AND library services.
>
>> (Andrew) I heartily endorse Mike Roddham's comments (below). We see
>this 
>>in all health sectors with consumer health, clinical librarians and 
>>peripatetic librarians. 
>>Commercial begins!
>------------------------------------------------------------------------
>------------
>List members may be interested that this is entirely the approach 
>that Graham Walton and I have adopted in the brand new Library 
>Association title:
>
>Managing knowledge in health services. Walton & Booth eds. 
>Library Association, 2000.
>
>If you are going to ICML look out for details of a book launch. 
>------------------------------------------------------------------------
>--------------
>>Commercial ends
>
>>We and our contributors felt that traditional skills like cat and
>class, 
>>though undoubtedly still of value particualrly in management of 
>>information resources should be placed in a subordinate position to 
>>more generic information skills such as filtering, appraising and 
>>orgaanising knowledge bases as well as wider skills such as 
>>marketing, political awareness, training and outreach. Readers can 
>>of course decide for themselves how much is aspiration and how 
>>much is the new environment of health care information 
>>management!
>
>Visionary thinking, I agree, but what is the reality of the demand on
>the ground? I think it has to be BOTH the expected library service AND
>this more pro-active, clinical information work. And then, of course,
>there will need to be new funding for the latter, at a time when the
>former is not exactly overfunded.
>
>Sorry if this seems all negative and money-oriented! I think the ideas
>expressed in the paper are generally sensible, and agree there is a need
>for funding the kind of post described. Librarians would be best placed
>to fulfill this post, and I'm sure do in some cases, where staffing
>allows them to, or their interests have led them in this direction.
>
>Jim

Sara Stock
Library Services Manager 
North Essex Hospitals' Library & Information Service
Colchester General Hospital
Turner Road
Colchester
Essex
CO4 5JL
T: (01206) 742146 or 742396
F: (01206) 742107


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