Paper Presentations – Kathy Schilling’s “Knocking it out of the park for cancer symptom support”

The abstract:

Knocking it Out of the Park for Cancer Symptom Support:  Lessons Learned in the Development and Evaluation of a Cancer Patient Self-Management System
Texas, 3:00pm-3:50pm
Presenter: Katherine Schilling, Ed.D.  Associate Professor of Library and Information Science,
Indiana University, Indianapolis, Indiana

  • Katherine Schilling, Ed.D.  Associate Professor of Library and Information Science,
  • Indiana University
  • Christine M. Newlon, Indiana University School of Informatics
  • Kimberly Wagler-Ziner, Assistant Scientist, Center for Research and Scholarship, IU School of Nursing and Behavioral Research Recruitment Core Coordinator, Indiana University Simon Cancer Center
  • Robert Skipworth Comer, Indiana University School of Informatics
  • Anna M. McDaniel, PhD., Indiana University School of Informatics and Indiana University School of Nursing

Background: The patient symptom monitoring and management system (SMMS) is a secure web portal through which cancer patients’ symptoms are recorded and tracked.  It incorporates ongoing assessment of patients’ symptoms, tailored information delivery, and automated symptom messaging to oncology nurses.  This presentation describes issues and challenges in developing and evaluating the SMMS.  Portal design, usability, security, and pilot testing with patients and healthcare providers will be discussed, and results of evaluation activities will be described.
Methods: The patient-driven SMMS was developed at a major oncology center, then piloted with newly-diagnosed colon cancer patients (n = 12).  Each week, over a period of eight weeks, patients recorded their cancer-related symptoms such as fatigue, nausea, numbness, pain, diarrhea, loss of appetite, and others (N = 103).  Symptom severity was ranked on a 0 (not a problem) to 10 (interfered heavily with my lifestyle) scale (M = 4).  Based on each week’s symptoms and related health management questions, the SMMS generated an evidence-based information Toolkit tailored to each patient’s symptoms and concerns.
Results and Discussion: Development and evaluation activities are discussed, including web mining to identify patterns in testers’ symptoms and information behaviors.  Individual-level and system-level data collected through portal activity logs included login time, time on-page, reported symptoms, and information resources used in support of symptom self-management.  Data analysis has helped troubleshoot design and system interaction problems.  Research findings are also used to improve the SMMS’s functionality, promoting more effective cancer symptom self-management support for patients.

My notes (Apologies for their quality! Contribute your additional thoughts and related resources in the comments!):

  • What it is: a web-based interactive system development and assessment.
  • Cancer is no longer an acute disease. People are living with cancer for longer periods of time. Survivorship begins with diagnosis!
  • Cancer survivors have significant needs.  The cancer symptom management system created to meet these needs. It is multidisciplinary.
  • It is designed as a database to log symptoms and manage information.
    • (Research shows that increased knowledge helps with coping.)
    • Unique and complicated needs in a very difficult time.
  • Provider and patient sign up together.  Providers get dings when symptoms reach a threshold, but they can also sign in to track/trend their patients’ symptoms.
  • There is also a piece for caregivers (family, etc.), and this is the piece an insurance company bought.
  • Various usability features modified as it was seen how the site was used.
  • Caregivers are linked to the patient, particularly important where there is geographical distance.
  • Evaluation of pilot – who what when where why and how
  • Looked at case trends, toolkit (which provides supplementary info) usage.  Reading skills, health literacy are important.
  • 1 patient was more engaged. They tried to figure out why, but it was difficult with the lack of information in the system.  The next test will be modified to capture more behavior.
  • Project has raised new questions:
    • How do symptoms drive useage patterns?
    • How is the information toolkit used in decision making?
  • Continue to engage with users to “target rather than tailor.”
  • Challenges:
    • Consents
    • Recruitment, needed people with Internet
    • Multisite
    • HIPAA failures
    • System crash, had to be monitored.
    • Michigan and Indiana are arguing about who owns what, who does what, publication rights.
  • Advantages:
    • Web portal
    • Established content
  • Developed various best practices around methodology, testing, developing structure, developing team, usability, funding.

Paper Presentations: Stephanie Schulte’s “Teaming Up with Nursing to Put Evidence into Action at an Academic Medical Center”

First, the abstract:

Teaming Up with Nursing to Put Evidence into Action at an Academic Medical Center
Michigan, 11:00am-11:50am
Presenter: Stephanie J. Schulte, Assistant Professor, Education & Reference Services Coordinator, OSU Health Sciences Library, Columbus, Ohio

  • Stephanie J. Schulte, Assistant Professor, Education & Reference Services Coordinator, OSU Health Sciences Library
  • Susan Bejciy-Spring, Director, Nursing Evidence Based Practice and Standards, The Ohio State University Health System
  • Jill Niese, Manager, Nursing Evidence Based Practice and Standards, The Ohio State University Health System

Evidence in Action (EIA) Rounds is a clinical nursing initiative at The Ohio State University Health System that provides unit-based interactive forums to assist nurses in exploring best practices in the management of a selected patient. Facilitators of EIA Rounds include two health system nurse leaders in evidence based practice (EBP) and a nursing liaison librarian. Facilitators team up with unit nurses caring for the patient to define evidence-based practice, use an evidence-based approach to answer clinical questions, and explore the best available evidence related to a specific patient. Using nursing sensitive indicators and the Iowa Model of Evidence Based Practice as a guide, the facilitators review details of the case and note clinical questions from the care team, search appropriate internal and external resources for evidence, and return to discuss their findings. The evidence, or lack thereof, is placed in the context of the selected patient. Gaps in policies and procedures and evidence from the research literature are all discussed in a non-punitive manner. If gaps are identified, the EBP nurse leader facilitators have the authority and means to revise policies or create new policies if needed. This presentation will explore the librarian’s role in this unique collaboration aimed at putting best practices into action. It will buy lasix online usa also discuss the outcomes and challenges encountered in the process.

What follows are my notes from Stephanie’s awesome talk on her experience working with staff nurses in “Evidence in Action Rounds.” (Disclaimer: I took these on my 1st gen iPod Touch.  I’ve tried to clean them up somewhat.  If the presentations get posted at some point, we’ll be sure to link to them!  And if you attended the session and want to add anything, please feel free to do so in the comments!)

At Stephanie’s institution:

  • Culture of EBP
  • various nursing practices and positions and programs to support.
  • Clinical practice guidelines committe (Stephanie is on).
  • Lots of educational initiatives.

Stephanie provides nursing CME support.

“Evidence in Action” (EIA) nursing rounds:

  • A way to integrate internal & external best practices
  • These are non-punitive, which needs to be made very clear because there is some fear.
  • How it works: nurse leader identifies a unit to work with through staff nurse contacts.
    • Day 1: nurse leader and librarian meet with unit manager, who identifies a patient. Together they create clinical questions while looking at chart, using indicators. EBP nurse leader and librarian “divide and conquer” to search the literature.
    • Day 2: return with results, review indicators etc, with the unit nurses. Go over answers to the clinical questions and the resources used.  Usually there are still lots of gaps at the end – these can be addressed through policy changes etc.

EIA tools:

  • Nurse sensitive indicators
  • Iowa model of EBP: forming a question, forming a team (top half of model)
  • Johns Hopkins nursing EBP scale

How she got involved:

  • Result of construction, she had to get out of the space which provided an excuse to get out on the floors.
  • Contacted the director of EBP.

Example: “The power of 1”: one patient can influence the care of many.  Nephrostomy tube example led to policy change and a poster with the nurses involved.  The poster is being presented at national nursing conference!


  • Scheduling!! Turnaround time for searches is FAST.

Welcome Reception

Meeting and Greeting

This evening a good time was had by all. The evening began with the Meet & Greet for mentors and mentees. Lots of great conversation. Then the action moved to the Exhibits area for the Welcome Reception with the vendors. There viagra online canadian pharmacy were sweet treats galore and door prize drawings. All good.

Indulge your sweet tooth!
Librarians love door prizes!

For more fun conference photos, check out Flickr photos tagged midwestmla11. And watch for more photos!

Kurt Vonnegut Memorial Library

“All my jokes are Indianapolis.  All my attitudes are Indianapolis.  My adenoids are Indianapolis.  If I ever severed myself from Indianapolis, I would be out of business.  What people like about me is Indianapolis.” —Kurt Vonnegut, 1986

Kurt Vonnegut Memorial Library

One of my places that I want to visit in Indianapolis but have not yet is the Kurt Vonnegut Memorial Library, opened last year. It is open daily (except Wednesday) 12pm-5pm and located at the “corner” of Senate, Indiana, and Vermont streets. From the hotel, walk towards downtown a block to Senate (the street where the capitol building is), then turn left (north) and go four blocks. It will be on your left.

340 N. Senate Avenue
Indianapolis, IN 46204