Value of Libraries Planning Study
About
The goal of the Value of Library and Information Services in Patient Care planning study is to develop a research plan and proposal to measure the value of the health sciences library, library services, and librarian. The idea for a study on the value of libraries came from a discussion of the NN/LM MAR's Regional Advisory Committee (RAC), held at New York University Medical Center on November 17, 2006. At the meeting, a focused yet freewheeling discussion of academic health sciences library directors and leaders of the four RML standing committees of Outreach, Library Improvement, Technology and Resource Sharing, centered on the issues of importance to health sciences libraries today. Out of that discussion emerged the issue of establishing the value of health sciences libraries to administrators in hospitals, academic health sciences centers and other organizations where librarians work.
One frequently cited study in the RAC discussion was the "Rochester study". In that study, a sample group of 448 physicians in 15 hospitals were asked to request information related to request some information related to a current clinical case and then to evaluate its impact on the care of their patients. Senior medical staff or administrators acted as study facilitators in each of the fifteen participating hospitals. As a result of the information provided by the library, 80% of the 208 physicians who returned their questionnaires said that they probably or definitely handled some aspect of patient care differently than they would have handled it otherwise. Changes in the following specific aspects of care were reported by the physicians: diagnosis (29%), choice of tests (51%), choice of drugs (45%), reduced length of hospital stay (19%), and advice given to the patient (72%). Physicians also said that the information provided by the library contributed to their ability to avoid the following: hospital admission (12%), patient mortality (19%), hospital-acquired infection (8%), surgery (21%), and additional tests or procedures (49%). The physicians rated the information provided by the library more highly than that provided by other information sources such as diagnostic imaging, lab tests, and discussions with colleagues.
The impact of the hospital library on clinical decision making: the Rochester study. Bull Med Libr Assoc. 1992 Apr;80(2):169-78.
In discussing both the need for a value of libraries study, and the impact of the Rochester study - cited over 95 times since its publication in 1992 - the RAC came to the conclusion that before engaging in the research study itself considerable time, effort and thinking needed to go into what a research study would look like. We needed a plan.
At the April 30, 2007 RAC meeting, a proposed plan was presented and approved. Julie Sollenberger, an original participant in the Rochester study, agreed to be the Principal Investigator for the Value of Libraries Planning Study. An initial core group of planners - Karen Brewer, RML Director and Kathel Dunn, RML Associate Director and Joanne Marshall, the author of the Rochester study and an educator, researcher, author, consultant and advocate of health sciences libraries - drafted the objectives for the study.
Objectives:
- To inform the research plan by seeking input from health sciences libraries of various types and sizes and in various geographic locations within MAR
- To determine the value domain(s) to be measured: patient care (information for providers, patients), education, research, administration, community health
- To determine the library products or services to be evaluated, and to identify key activities that are directly related to the quality of those products or services.
- To identify and outline the outcomes to be measured.
- To develop a study design and timeframe for the study.
- To determine MAR participants in the initial research study.
- To develop a plan that is replicable, and to suggest methods for replication.
- To determine likely sources of funding for the research study.
Approved by the RAC, Julie Sollenberger then recruited a Committee to begin the work of planning a value of libraries study.
Value of Libraries Planning Committee
Email the Committee at valueplan@library.med.nyu.edu
Core Group:
Joanne Gard Marshall, Ph.D, Consultant,
Alumni Distinguished Professor
School of Information and Library Science,
University of North Carolina at Chapel Hill
Chapel Hill, NC
SILS: (919) 843-7883 Research Office: 843-9968Julia Sollenberger, Principal Investigator
Associate Vice President and Director, Medical Center Libraries and Technologies
University of Rochester Medical Center
Rochester, NY
Phone: (585) 275-5194Kathleen Oliver
Associate Director
National Network of Libraries of Medicine, Middle Atlantic Region
New York, NY
Phone: (212) 263-4197Kathel Dunn
National Library of Medicine
8600 Rockville Pike
Bldg 38, 2N-19
Bethesda, MD 20894
Phone: (301) 435-4083
Additional Members:
Karen Brewer, PhD
Consultant
256 w. 10th st
New York, NY 10014
Susan K. Cavanaugh.
UMDNJ Camden Campus Library
Cooper University Hospital
Camden, NJ
Phone: (856) 342-2522Sharon Easterby-Gannett, MLIS, AHIP
Associate Director, Medical Libraries
Lewis B. Flinn Medical Library
Christiana Care Health System
Newark, DE 19718
Phone: (302)733-1164Mary Lou Klem, Ph.D
Librarian, Health Sciences Library System
School of Nursing
University of Pittsburgh
Pittsburgh, PA
Phone: (412) 383-9947Lynn Kasner Morgan
Associate Dean for Information Resources and Systems/Library Director
Mt. Sinai School of Medicine
New York, NY
Phone: (212) 241-7892
Publications
Sollenberger, J. Value of Libraries Study Update Presentation (PDF) NN/LM MAR Regional Advisory Committee meeting, Feburary 27, 2009, New York, NY.
Dunn K, Brewer K, Marshall JG, Sollenberger J. Measuring the value and impact of health sciences libraries: Planning an update and replication of the Rochester Study 2009; J Med Libr Assoc 97(4):
Cavanaugh S. Measuring the Total Package: the Value of Libraries Research Study. Poster 7. International Congress on Medical Librarianship, September 2009, Brisbane, Australia.
Project Timeline, Meeting Dates and Minutes
April 2007
Project discussion at RAC meeting.
May 2007
Recruitment of additional members and Fall meeting date
determination
May 2007
MLA Philadelphia: Core Group
Pre-meeting
Summer 2007
Teleconference Call
Fall 2007
Focus Groups: Will encourage participation by all types
of MAR health science librarians, including hospital
librarians
Facilitated by Elaine Martin
Philadelphia - Oct. 11 or 12
Rochester (for any and all upstate NY librarians) - time
TBD
Late Fall 2007/Winter 2008
In-person meeting
Planning Committee will process focus group report, plan
study design. Meeting will take place at NYU/RML
offices.
Core Group will write draft research proposal and send
to Planning Committee
February 2008
RAC meeting: Presentation of status of planning study
Spring 2008
Completion of planning study report.
Other "value of libraries" studies in progress
There are a number of active studies currently taking place throughout the country that are examining the value of libraries, the role of librarians in having an impact on patient care.
National Network of Libraries of Medicine
The NN/LM, particularly the Regional Medical Libraries, are taking an active role in research as well as developing and promoting tools that demonstrate library value.
The NN/LM MidContinental Region (NN/LM MCR) is working on value of libraries studies throughout the MidContinental Region (Utah, Colorado, Wyoming, Kansas, Nebraska, Missouri). The research project is led by the J. Lottes Health Sciences Library at the University of Missouri Columbia. Staff for the research project consists of library staff and a consultant: the Principal Investigator, Deb Ward; Mary Ellen Sievert, Research Consultant; Dirk Burhans, and Barb Jones. The study will survey library users to establish how they use the library and how their library supports their patient care, teaching and research. There is a core set of questions which each library participating in the study will use, but the survey is flexible enough to include additional questions should the library conducting the survey wish to add them. The survey has been tested with three clinical departments at the university and with users of the state-wide MAHEC Digital Library. It will later be implemented at three hospital libraries in Missouri, the health sciences library at the University of Colorado, and three hospital libraries in Colorado.
The MidContinental Region also developed tools for health sciences library use – a Value Library Services Calculator (http://nnlm.gov/mcr/evaluation/calculator.html) adapted from the Massachusetts Library Association and then adapted for the web by Chelmsford Public Library that provides a monetary assessment of the worth of a library to an institution. Using a web-based form, libraries can enter the number of uses of a resource multiplied against the estimated cost of providing the resources to determine a value of the resource against its use. Another tool that they are offering on their web site is a Cost Benefit and ROI (return-on-investment) (http://nnlm.gov/mcr/evaluation/roi.html) calculator, where libraries can use a web-based form to assess the benefit to the institution for the money spent on library resources.
The New England Region (NN/LM NER), the Regional Medical Library replicated the Focus Groups that NN/LM MAR held for its needs assessment of the Value of Libraries Planning Study in summer 2008. The Focus Groups asked librarians to interview hospital administrators and ask them what they valued in library services.
Independent Researchers
There are also independent researchers who are actively involved in value of libraries studies that are in process as this article is written. Beth Hill, of Kootenai Medical Center, a member of the Vital Pathways Task Force and a doctoral candidate in Education is implementing a replication of the Rochester study in critical access hospitals (rural – 25 beds or less) in the states of Washington, Alaska, Montana and Idaho (WAMI). There are 123 CAHs in the area in total and as this article is being written, Ms. Hill has reached agreement with 100 of them to distribute the survey to their active staff of physicians, physician assistants and nurse practitioners. The survey instrument includes features of the Rochester Study instrument, the University of Wales Aberystwyth survey, and the NNLM/MAR planning group’s survey.
Christine Urquhart, University of Wales, author of many studies on the value of libraries, is working with Alison Weightman in the development and refinement of the United Kingdom Value of Libraries Toolkit.
Medical Library Association Vital Pathways for Hospital Librarians
The MLA Vital Pathways Task Force is charged to review existing data and trends in the status of hospital librarians, collect data on the links between libraries and quality and financial outcomes, and develop an action plan for MLA to use this information to influence hospital decision-makers and key leaders in the health care field.
Public Libraries - Return on Investment Studies
- Taxpayer Return on Investment [ROI] in Pennsylvania Public Libraries
- Taxpayer Return on Investment [ROI] in Florida Public Libraries: Summary Report
Bibliography
Five databases - PubMed, Library Literature, LISA, CINAHL and Web of Science - were searched using some combination of the concepts of value/price/economics and patient care and outcomes and librarians. The bibliography is updated periodically. To suggest articles for inclusion or questions about the methodology, email Kathel Dunn (Kathel.dunn@gmail.com)
The total results of 800 citations and abstracts were then filtered, eliminating non-relevant articles and reducing the number to 150. The article,
Weightman AL, Williamson J; Library & Knowledge Development Network (LKDN) Quality and Statistics Group. The value and impact of information provided through library services for patient care: a systematic review. Health Info Libr J. 2005 Mar;22(1):4-25.
and examined the 32 studies they found to validate the search results. The search results found 14 of the 32 studies Weightman and Williamson identified. The search was refined PubMed was searched again using a slightly changed search strategy. Still, several articles Weightman and Williamson identified were not found either through the first or the second, revised search strategy.
After a second review for non-relevant articles, there were a total of 106 articles.
Kathel Dunn