ICLC Birmingham June 2011
description
Transcript of ICLC Birmingham June 2011
ICLC Birmingham June 2011
Lisa Lawrence
Clinical Librarian, Derby Hospitals NHS Foundation Trust
The Role of a Clinical Librarian:
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Aims
Clinical librarianship as an innovation in UK health librarianship
Postgraduate dissertation, submitted September 2010
Reasons for the study
Rogers’ Diffusion of Innovations theory
Literature review
Methods
Findings
Conclusion
Any Questions?
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Reasons for the study
Postgraduate dissertation.
Clinical librarian at Derby Hospitals – interested to know more
about UK CL services.
Purpose - To investigate the role of the CL in the UK, within the
context of Rogers’ Diffusion of Innovations theory.
Objectives - investigate roles, establish commonalities/disparities,
gain a better understanding of current implementations through
use of DOI.
Provide a picture of awareness levels of CL services and any
consequent effects on diffusion and adoption of the role.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Rogers’ Diffusion of Innovations (DOI) Theory
Rogers, E. M. (2003). Diffusion of Innovations. (5th edition) New
York: Simon & Schuster.
“Getting a new idea adopted, even when it has obvious
advantages, is difficult. Many innovations require a lengthy
period of many years from the time when they become available
to the time when they are widely adopted”
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Rogers’ DOI Theory
Rogers describes an innovation as
“an idea, practice or object that is perceived as new by an
individual or other unit of adoption”
Rogers interprets diffusion as
“the process in which an innovation is communicated through
certain channels over time among the members of a social
system. It is a special type of communication, in that the
messages are concerned with new ideas. … The newness of the
idea in the message content gives diffusion its special
character”
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Aspects of DOI Theory
Communication:
Interpretation; Perception; Situation
Time
Adoption or Rejection
Innovation-decision process:
Knowledge; Persuasion; Decision; Implementation;
Confirmation.
Adopter-categories:
Innovators; Early adopters; Early majority; Late majority;
Laggards.
Rate of adoption
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Aspects of DOI Theory
Measure of control over process?
Social system structure – e.g. hierarchical
Innovation decisions:
- Optional innovation-decisions
- Collective innovation-decisions
- Authority innovation-decisions
- Contingent innovation-decisions
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Aspects of DOI Theory
Consequences of adoption or rejection:
1. Desirable vs undesirable
2. Direct vs indirect
3. Anticipated vs unanticipated
Characteristics of innovations:
1. Relative advantage
2. Compatibility
3. Complexity
4. Trialability
5. Observability
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Aspects of DOI Theory
Rogers states:
“Innovations that are perceived by individuals as having greater
relative advantage, compatibility, trialability, and observability
and less complexity will be adopted more rapidly than other
innovations. Past research indicates that these five qualities
are the most important characteristics of innovations
in explaining rates of adoption”
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
DOI – a suitable framework
Evaluations of pilot projects saw CL
services as an innovation
Are CL services diffusing in the UK?
DOI theory – suitable model to use
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Literature Review
What is clinical librarianship?
Background of clinical librarianship:
- USA experience
- UK experience
“Typical” role of CL
All examined within the DOI
framework
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Literature Review – Conclusions
“In terms of Rogers’ characteristics of innovations, the innovation of clinical
librarianship in the UK offers a small body of evidence, currently suggesting
• Relative advantage - Some indications of cost savings and more
effective EBP.
• Compatibility - Consistent with trends in healthcare and health
librarianship.
• Complexity - No consistent model of practice, perhaps
making widespread roll-out more difficult?
• Trialability - Multiple pilot projects allow opportunity for
experimentation - perception of
adaptability?
• Observability - Accumulating evidence base helpful”
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Literature Review – Conclusions
Some central recognition of importance of CL role.
UK CL projects mainly contingent innovation-decisions.
Widespread knowledge, but consequences of implementations
require further understanding.
- CL project evaluations consistently confirm Desirable aspects
- Direct/Indirect changes (individual/social system) not yet entirely evident
- Unclear exactly what Anticipated and Unanticipated consequences occur.
Further research is called for in order to clarify these issues.
Methods
Methods:
Online questionnaire, Follow-up Focus Group
Analyses undertaken using online survey software for
quantitative data and thematic analysis for qualitative
information.
Ethics:
Approval from Research Governance
Consent from organisations/participants
Data protection/anonymisation
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Methods
Online questionnaire
Piloted, amended, then sent to potential 45 respondents
Focus group
Smaller group, more detailed
discussion, themes arising from
questionnaire responses
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Response Rate
- 20 partial responses (44%) response rate
- 17 complete responses (38%) response rate
Clinical Librarians
- 70% respondents CL service established 3 years+
- 65% respondents involved in their service for up to 3 years
- Some variation in job titles/job roles
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
CL Services
- Core services and optional services
- 7 respondents (36.8%) using “clinical champions”
- Variety of teams as first team/dept. supported
- Core services as initial provision
- Not all current CLs aware of initial CL services
- Initial services shaped according to clinician preference
- 52% respondents indicated services changed over time
- Clinician or library led changes
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
CL Opinions & Awareness of Perceptions of CL Services
- Mixed opinions
- General belief clinical teams/departments pleased
- Less direct evaluation available
- Feedback indicates services valued
Best aspects of CL services – greatest impact?
- Literature searching core
- Current awareness/training actually reaches more users?
- Value of interaction in department
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Effects on library
- Library staff expectations of CL service changed over
time
- Changing situations, necessitate realistic service
delivery
- Modify and adapt service according to:
- clinical teams needs/expectations
- library staff needs/expectations
- Generally not encountering unforeseen consequences
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Service Users
- Variety of staff and students
- Heaviest users generally medical staff
- Least usage among administrative/non-clinical staff
- Some CLs (59.2%) indicate change in usage over time
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Service developments
- Small adaptations as required
- No wholesale changes to service model
- Progression to supporting more teams both library-led
and clinician-led
- Some services have plans for future development
- Influence of external factors
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Service awareness
- CLs believe some service awareness in their
organisation
- No total unawareness
- Only 1 respondent indicated complete awareness
- Board level awareness in some organisations
- CL perceptions or truth?
- Actual knowledge or guesswork?
- Further marketing of services required?
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Questionnaire Findings
Advantages of CL services to teams and organisations
Time saving for clinical staff
Best use of each professional’s skills
Supports EBP
Supports a questioning culture
Better informed staff should lead to better patient care
Awareness of need to prove the value of library services as a whole –
need to demonstrate impact
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
DOI Theme: Desirability, Adaptability, Trialability, Observability
- Anticipated themes: Roles & Responsibilities, Tailoring
- Emergent theme: Empowerment
All participants CLs by job title and role
All slightly different experience of clinical librarianship
All participants chose to tailor services
Although CLs sometimes feel undervalued, unproductive, also a
sense of empowerment
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
DOI Theme: Compatibility and Relative Advantage for Individual
Teams and Wider Organisation
- Anticipated themes: Advantages, External Influence
CLs save clinicians time!
Improving practice
Improving skills
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
All participants felt role helps to
market library – “public face”.
External circumstances/decisions
have significant impact on decisions
made within CL service.
Emphasise need to demonstrate the
value of the service in a time of
economic uncertainty.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
DOI Theme: Consequences – Anticipated & Unanticipated
- Anticipated themes: Consequences
Accepted any consequences as natural outcomes of their work.
Embraced outcomes positively, regardless of expectations and
workload demands.
Participants identified the need for peer support, advice and to
share practice as a consequence. Highlighted importance for sole
CLs.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
DOI Theme: Perception / Awareness
- Anticipated themes: Awareness Variation, Perception (CL)
- Emergent themes: Awareness (Library), Perception
(Library)
Library staff awareness can be problematic, some colleagues are
aware, but no real understanding of aims/purpose.
Awareness variations – served departments better than wider
organisation.
Acknowledged need to improve awareness, particularly with
managerial staff and/or budget holders.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Focus Group Findings
Participants emphasised the need for wider representation
Participants suggested sometimes symptomatic of perceptions of
library services as a whole.
CL services part of the whole library service, need that foundation
to function effectively.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Summary Findings
CLs have varied job titles, roles and responsibilities.
The role is tailored according to the needs, requirements and
desires of clinical teams and organisations.
CLs provide a quality role to their organisation.
CLs feel empowered in their roles
CLs understand the effects of external influences on their services.
Awareness levels vary, both at individual and organisational levels,
and within and without the library.
Need to address perceptions of library services.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Conclusions
DOI theory provided a good framework for examination of CL
services. Specific themes could be investigated.
Adaptable/trialable nature of the role – a strength (a relative
advantage), rather than a weakness? Aiding diffusion of the
innovation?
Relative advantage also in the quality role the CL fulfils.
UK CL projects remain contingent on other decisions. Emphasis
on need to evidence and prove the value, impact and worth of the
role.
Need to improve awareness and perceptions.
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Any Questions?
The Role of a Clinical Librarian:A Diffusion of Innovations Interpretation
Thank You
Huge thanks to all those who participated in my
research project!
Thanks to all of you for listening today.
Further information:
Lisa Lawrence
Royal Derby Hospital