Outline Background Procedure logs Critical Care Literature updates

Outline Background Procedure logs Critical Care Literature updates delivered by handheld computer Current project goals Literature reviews Examples Next steps 1 Mount Sinai Hospital & Interdepartmental Division of Critical Care Medicine University of Toronto

Outline Background Procedure logs Background Ø Increasing use of handhelds by physicians Current project goals Literature reviews Examples Next steps 2 CMAJ 2003, 169: 952

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 3 Background Ø Increasing use of handhelds by physicians Ø Critical Care literature overload Large amount of excellent literature Incorporation in clinical practice takes time Difficulty keeping up to date

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 4 Background Ø Increasing use of handhelds by physicians Ø Critical Care literature overload Ø Critical Care trainees receive a Palm. OS handheld device for procedure logging

Outline Background Procedure logs Current project goals Literature reviews Background Ø Increasing use of handhelds by physicians Ø Critical Care literature overload Ø Critical Care trainees receive a Palm. OS handheld device for procedure logging Examples Next steps 5 Ø A handheld based procedure log has been implemented for the CCM training program

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 6 Critical Care Procedure Logs Ø Customized handheld procedure log developed to track trainees’ educational experience.

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 7 Critical Care Procedure Logs Ø Customized handheld procedure log developed to track trainees’ educational experience. Ø Internet-linked: allows data upload to a central server, accessible to the Program Director and to individual trainees

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 8 Critical Care Procedure Logs

Outline Background Critical Care Procedure Logs INTERNET Procedure logs telephone line Current project goals Literature reviews Examples Next steps 9 infrared

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 10 Critical Care Procedure Logs Data accessible via a secure website:

Outline Background Procedure logs Current project goals Literature reviews Literature Reviews: WHY? Ø Increased volume of medical literature Ø Increase complexity of medical literature Ø Frequent development of new therapies Examples Next steps 11 Ø Outdated medical texts

Outline Background Procedure logs Literature Reviews: GOALS Ø Implement a Critical Care literature review process Current project goals Literature reviews Examples Next steps 12 Ø Post literature abstracts on a website and handheld devices Ø Facilitate “just in time” learning

Outline Background Procedure logs Current project goals Literature Reviews Sidney Liswood Library Mount Sinai Hospital Critical Care Division Faculty Automated literature search based on key words and selected journals Manual Literature search Literature reviews Clinically relevant articles selected Examples Abstracts posted on Divisional website Journal club appraisals posted on website Next steps 13 Handheld access through Avantgo Critical care trainees Critical care faculty Free access on web

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 14 Literature Reviews: METHODS

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 15 Web based Literature Reviews

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 16 Handheld Literature Reviews

Outline Background Procedure logs Handheld Download of Reviews The Problems It will never work Great idea! Go for it! Current project goals Literature reviews Technology Next steps 17 Naysayers 5%-10% Silent Majority 80%-90% Zealots 5%-10%

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 18 Next steps. . Ø Optimize literature update process § automated search several months behind § manual search inconsistent Ø Increase users of handheld system § increase awareness § regular Journal Club appraisals Ø Obtain user feedback

Outline Background Procedure logs Current project goals Literature reviews Presented by the Technology Application Unit, Intensive Care Unit, Mount Sinai Hospital Project Staff Stephen Lapinsky, Associate Professor, Dept. of Medicine Randy Showalter, Research Manager, TAU, Mount Sinai Hospital Sandra Kendall, Director, Sidney Liswood Library, Mount Sinai Examples Next steps 19 David Hallett, Biostatistician, ICU, Mount Sinai Hospital

Outline Background Procedure logs Current project goals Literature reviews Examples Next steps 20