Knowledge Warrior

Heather Holmes, information services librarian since 2003 for the medical library at Summa Health System, a community-based academic health-care system in the Akron, OH, region, studied philosophy as an undergrad. There isn't much of a market for a professional philosopher in our high-tech, information-saturated world. But a "knowledge warrior" with a good bedside manner might just be in high demand.

At Summa, Holmes developed an innovative clinical medical librarian (CML) program that takes her on daily teaching rounds at the Akron City Hospital with a general internal medicine team to provide point-of-care reference service. "I serve as an immediate expert to consult evidence-based resources and can often answer clinical questions the team has 'at the bedside,' " says Holmes, who also works at St. Thomas Hospital.

This "context-embedded" service "moves information service beyond the library walls...to elicit and meet information needs at the point of care potentially to shape patient outcomes," says Susan Lessick, formerly the director of the Grunigen Medical Library at the University of California, Irvine (and the one who dubbed Holmes a "knowledge warrior").

"This is extremely rare.... Most CML programs, if not all," says Lessick, "have taken place in academic health-care settings, not at the community hospital level."

All librarians like to believe they have a positive impact on patrons, but in Holmes's realm, that impact can be lifesaving. A few years ago one very ill patient was admitted to the hospital in multi-organ failure. Though her condition improved within a few days, her liver function tests (LFTs) continued to indicate a high level of toxicity. "I did a search for causes of elevated LFTs in the absence of other known toxins and combined it with our patient's symptom history, which immediately led the team to order testing for arsenic poisoning," Holmes recounts. "The test results were positive. The patient made a full recovery after being removed from the ­exposure."

Today, it's common for physicians from other departments to stop Holmes in the hall to ask for help. "Library awareness is way up, and I'm busier than ever," says this knowledge warrior.

Vitals Heather Holmes, Summa Health System, Akron CURRENT POSITION Information Services Librarian DEGREE MLIS, University of Pittsburgh, 1998 AWARD Biomedical Informatics Fellowship FOLLOW @LaMedBoheme73