Since the 2012/2013 academic year, the Health Sciences Library at Louisiana State University has been involved in 14 funded projects from government and non-profit agencies, providing more than $188,000 to improve healthcare within the community. These grants have been partnerships with public libraries, school systems, fitness centers, state agencies, state and federal emergency services, and other not-for-profit organizations. Within these various organizations, projects have involved education, arts and humanities, science, information literacy, and health and behavior issues. Many of these community-based projects received funding for one year, but developed into long-term initiatives. In a majority of these projects the partnerships have involved the funded organization with the community partners providing significant specialized skills in order to create educational products with long-term success. Using the project segments of development, project management and outcomes, this chapter will utilize vignettes to illustrate the trials and triumphs of each project within the scope of those segments. The chapter will discuss the experience of facing those trials, celebrating the success of a project and pushing that success and network connections to the next opportunity.

The Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) outlined the implementation of health information technology in healthcare settings in the United States. The...

Professionals in health care are on information overload. On a daily basis, administrators, laboratory technicians, physicians, nurses, and those in risk management and quality improvement are overwhelmed with job-related information. Nevertheless, literature continues to show that knowledge transfer of new practices in health care does not result in practice at the bedside (1–4). As a result, a different approach is needed to educate professionals in health care about important new medical practices. Librarians have the opportunity to serve as gatekeepers and quality filters. Although there are a few alert services such as Medscape (http://www. medscape.com), WebMD (http://www.webmd.com), MDLinx (http://www. mdlinx.com), and medpage Today (http://www.medpagetoday.com), as well as newsfeeds from professional associations, many of these resources provide a deluge of information but not the specificity many professionals in health care want or need. For years, librarians provided current awareness or table of content services to their patrons. As technology developed, many of these services ceased because it was assumed that professionals in health care could set up their own alerts. Using targeted alerts, librarians and other information professionals can provide health care professionals with the information they need when it becomes available, thus stimulating a faster knowledge transfer. An alert is a very brief (one or two sentences) message with a link to a resource that has been recently published. At times, this may be breaking news of a drug recall or could just be a very important article in a major journal that affects

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.

OBJECTIVES:To contrast barriers to colon cancer (CRC) screening and Fecal Occult Blood Test (FOBT) completion between rural and urban safety-net patients.METHODS:Interviews were administered to 972 patients who were not up-to-date with screening.RESULTS:Rural patients were more likely to believe it was helpful to find CRC early (89.7% vs 66.1%, p < .0001), yet were less likely to have received a screening recommendation (36.4% vs. 45.8%, p = .03) or FOBT information (14.5% vs 32.3%, p < .0001) or to have completed an FOBT (22.0% vs 45.8%, p < .0001).CONCLUSIONS:Interventions are needed to increase screening recommendation, education and completion, particularly in rural areas.

PURPOSE:To determine the effect of common components of primary care-based colorectal cancer (CRC) screening interventions on fecal occult blood test (FOBT) completion within rural and urban community clinics, including: (1) physician's spoken recommendation, (2) providing information or education about FOBTs, and (3) physician providing the FOBT kit; to determine the relative effect of these interventions; and to compare the effect of each intervention between rural and urban clinics.METHODS:We conducted structured interviews with patients aged 50 years and over receiving care at community clinics that were noncompliant with CRC screening. Self-report of ever receiving a physician's recommendation for screening, FOBT information or education, physician providing an FOBT kit, and FOBT completion were collected.FINDINGS:Participants included 849 screening-eligible adults; 77% were female and 68% were African American. The median age was 57; 33% lacked a high school diploma and 51% had low literacy. In multivariable analysis, all services were predictive of rural participants completing screening (physician recommendation: P = .002; FOBT education: P = .001; physician giving FOBT kit: P < .0001). In urban clinics, only physician giving the kit predicted FOBT completion (P < .0001). Compared to urban patients, rural patients showed a stronger relationship between FOBT completion and receiving a physician recommendation (risk ratio [RR]: 5.3 vs. 2.1; P = .0001), receiving information or education on FOBTs (RR: 3.8 vs 1.9; P = .0002), or receiving an FOBT kit from their physician (RR: 22.3 vs. 10.1; P = .035).CONCLUSIONS:Participants who receive an FOBT kit from their physician are more likely to complete screening.

This article examines the relationship between literacy and colorectal cancer (CRC) screening knowledge, beliefs, and experiences, with a focus on fecal occult blood tests (FOBTs). Participants were 975 patients in 8 Louisiana federally qualified health centers. Participants were 50 years of age or older and not up to date with CRC screening; approximately half (52%) had low literacy (less than a 9th-grade level). Participants with low literacy were less likely than were those with adequate literacy to be aware of advertisements promoting CRC screening (58.7% vs. 76.3%, p < .0001) or to believe it was very helpful to find CRC early (74.5% vs. 91.9%, p < .0001). The majority of participants had positive beliefs about the benefits of CRC screening using FOBTs. Participants with low literacy had more perceived barriers to FOBT completion and were more likely to strongly agree or agree that FOBTs would be confusing, embarrassing, or a lot of trouble; however, none of these remained significant in multivariate analyses controlling for relevant covariates. Confidence in being able to obtain an FOBT kit was high among those with low and adequate literacy (89.8% vs. 93.1%, respectively, p = .20); yet multivariate analyses revealed a significant difference in regard to literacy (p = .04) with low-literacy participants indicating less confidence. There was no significant difference by literacy in ever receiving a physician recommendation for CRC screening (38.4% low vs. 39.0% adequate, p = .79); however, multivariate analyses revealed significant differences in FOBT completion by literacy (p = .036). Overall, findings suggest that literacy is a factor in patients' CRC knowledge, beliefs, and confidence in obtaining a FOBT.

BACKGROUND:Few studies have examined differences between rural and urban women in mammography barriers, knowledge, and experiences. Exploring differences can help inform tailored interventions.METHODS:Women, aged ≥40, who had not been screened in the past 2 years were recruited from eight federally qualified health centers across Louisiana. They were given a structured interview assessing mammography knowledge, beliefs, barriers, experiences, and literacy.RESULTS:Of the 1189 patients who participated, 65.0% were African American, 61.6% were rural, and 44.0% had low literacy. Contrary to guidelines, most believed mammography should be done annually (74.3%) before age 40 (70.5%). Compared to urban women, rural participants were more likely to believe mammography will find small breast lumps early (34.4% vs. 6.5%, p<0.0001) and strongly disagree that mammography is embarrassing (14.6% vs. 8.4%, p=0.0002) or that they are afraid of finding something wrong (21.2% vs.12.3%, p=0.007). Rural women were more likely to report a physician recommendation for mammography (84.3% vs. 76.5%, p=0.006), but they were less likely to have received education (57.2% vs. 63.6%, p=0.06) or to have ever had a mammogram (74.8% vs. 78.1%, p=0.007). In multivariate analyses controlling for race, literacy, and age, all rural/urban differences remained significant, except for receipt of a mammogram.CONCLUSIONS:Most participants were unclear about when they should begin mammography. Rural participants reported stronger positive beliefs, higher self-efficacy, fewer barriers, and having a physician recommendation for mammography but were less likely to receive education or screening.

Click to increase image sizeClick to decrease image size Notes Comments and suggestions should be sent to the Column Editor: Julia Esparza (E-mail: jespar@lsuhsc.edu).

Click to increase image sizeClick to decrease image size Notes Comments and suggestions should be sent to the Column Editors: Helen-Ann Brown Epstein (E-mail: habrown@med.cornell.edu); Julia Esparza (E-mail: jespar@lsuhsc.edu); Kristen Young (E-mail: Kristeny@umich.edu); and Michael Dean Brunelle (E-mail: mbrunelle@nahospital.org).

A teaching hospital was using a hybrid electronic health record (EHR) system with no links to point-of-care tools other than Micromedex. The librarians saw a need to integrate knowledge-based information into the institution's EHR to aid clinical decision making. The decision was made to start simply with links to a few point-of-care resources. A ticket was opened with Computer Services and the request to add links to library resources was approved. After implementation, focus groups were held with internal medicine residents regarding their perceived value of the library resources linked in the record system. Feedback was useful and served to spur further requests for additions to the EHR, which were also subsequently approved.