Info.Rx Cases: Patient journals/diaries/calendars: case(s)

Thursday, December 17, 2009

Patient journals/diaries/calendars: case(s)

I've just realized I haven't posted since October! I guess there has been a lot going on and not much time to write about it. Mostly I have been busy in the teaching rooms which continues to be productive and fascinating. The rest of the time is increasingly taken up with ordering pamphlets and tracking pamphlet orders. For some reason more and more of them are being requested by various nurses and doctors, even though fewer of them are available for order in print format as information goes digital. Finding a balance between print and e-resources is proving to be a challenge which is a topic for another day.

Keeping track

What I' m going to post today is a list of journals/diaries/calendars that can be given to patients and families when they are asked to keep track of behaviours, symptoms and/or side effects of medications. Doing so can help in the diagnostic and treatment process. Because it is often hard remember how often you can't sleep or feel anxious for example, keeping track while it happens helps the doctor/nurse get a better sense of what's really going on. There are a variety of instances in which such a thing can be useful.

Here are some of the most commonly requested:

Sleep:

Health Link BC: Sleep diary

Keeping track of symptoms:

Depression and Bipolar Support Alliance: Mood and anxiety calendar
Mood Disorders Association of Ontario: Mood diary (pdf)
International Foundation for Functional Gastrointestinal Disorders: Bowel disorder symptom diary (pdf)
Ovarian Cancer Action: Ovarian cancer symptom diary
About.com: Daily symptom diary for kids
About.com: Tracking fibromyalgia or chronic fatigue syndrome symptoms
The Lung Association: Asthma diary card (scroll down)
American Urogynecologic Society Foundation: Bladder diary
National Headache Foundation: Headache diary
World Headache Alliance: Headache diary

Medication side effects and pain:

American Cancer Society: Track cancer side effects and pain

Eating/exercise:

WebMD: Food diary and food allergy triggers
American Cancer Society's Great American health challenge: Food diary
US Gov. Weight-Control Information Network: Sample food diary (scroll down)

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About Info.Rx

Update:

In the fall of 2008 a Clinical Medical Librarianship component was added to the service. The librarian now acts as a resident supervisor in the teaching rooms at the clinic one half-day per week, providing support for clinical decision-making in addition to continued support for patient education.

The service is based on an innovative InformationRx model first implemented in the UK (see: Early experience of the
contribution of an information specialist within a primary
healthcare team: a partnership venture between
library and healthcare services, doi: 10.1177/0961000604048915].

This model sees the information professional acting as a member of the health care team by providing informational/instructional support for patients/families and health professionals at point of care. Support for the service is provided by the main hospital library and is vital for ensuring long term sustainability.

The information professional is available 7 hrs per week to consult with patients/families that are in need of health information.

Health staff are encouraged to write InformationRx for patients which can then be filled by the information professional. Consultations with patients are treated as clinical encounters and are documented in the charts. The service has a clinic in the Centre's appointment scheduling software.

Patients and family members are welcome to drop in, or to submit questions by phone or email at their convenience. They can schedule appointments by contacting the information professional directly or by calling their team coordinator.

The library provides support by welcoming questions from patients and their families when the coordinator is not available. Herzl patients and families are able to borrow books from the Patient and Family Resource Centre's (PFRC) print collection, and a family medicine section has been created on the PFRC website which provides links to reliable and up-to-date consumer health resources.

About this blog

The Patient health Information Service at Herzl (H-PHIS) opened its doors in early July of this year (2007) and is in the early developmental stages. The challenges faced by myself (the service's coordinator), the staff, and the health care team at the HFPC are many and varied, as is to be expected when implementing a new and innovative service.

Perhaps the most unique aspect of the InfoRx model is the presence and participation of the information professional/librarian at point of care. This new and multidisciplinary approach presents a distinctive challenge. Health and support staff are not always clear on what knowledge and skills a librarian brings to the team. Conversely, I must be able to recognize and adapt to the needs and character of the community and of the setting itself.

This blog was created in response to some very astute and constructive criticism. After presenting to the residents at their weekly rounds, I was approached by one of the partners at the clinic who suggested that rather than introducing myself and the service and then explaining how to use it, it would have been more effective to present some cases illustrating what the service has to offer to the residents and to their patients. I see this as a perfect example of the kind of disconnect that can happen when two very different professions come together. In essence I had presented the way I would have to my own professional colleagues, but this was not the most appropriate approach given my audience.

After giving it some thought it occurred to me that it could be useful, both for myself and the rest of the team, for me to present a weekly case here, and talk about some of the challenges we are faced with and how these might best be resolved. Hopefully this will introduce some transparency to the InfoRx process.

This is meant to serve as a record of, and forum for discussion about, our challenges and successes. It is hopefully also an opportunity for other information professionals to be inspired by one example of what can be accomplished outside of the library setting.

Thursday, December 17, 2009

Patient journals/diaries/calendars: case(s)

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