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Award Report: Value of Library and Information Services in Patient Care Study

The Value of Library and Information Services in Patient Care Study (hereafter referred to as the Value Study) is a research project designed to understand the value of the health library, information services, and the librarian in patient care. The study employs mixed methods to investigate 1) the use and value of the print and electronic resources provided by the library and 2) the information services (mediated or assisted information requests/searches) provided by the librarian that aid in clinical decision-making. The Value Study has been funded by in part with federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract #N01-LM-6-3501 from the New York University Middle Atlantic Regional Medical Library Program. Additional support is provided by the Hospital Library Section of the Medical Library Association (MLA), the NY/NJ Chapter of MLA; the Philadelphia Chapter of MLA; the Upstate New York and Ontario Chapter of MLA; the New York State Reference and Research Library Resources Councils and the Donald Lindberg Research Fellowship from MLA.

The study builds on previous research, notably that of the Rochester study conducted in the Rochester, NY, area in the early 1990s. The current study updates the Rochester study and recognizes the changed environment in which librarians and library users and non-users seek and find information to make clinical decisions.

The Value Study employed a multi-stage research design with a pilot phase involving 7 libraries and a full phase involving 49 libraries. The University of North Carolina at Chapel Hill (UNC) was awarded a contract to conduct:

  • A survey of physicians, residents and nurses affiliated with participating libraries to assess the value of the library and information services in patient care.
  • Interviews with selected physicians, residents and nurses from participating sites to understand the role of the library resources and the librarian in providing information related to patient care.

The study included a web-based survey of physicians, residents, and nurses. The survey explored the information services used by patient care providers and the impact of the health information on patient care. Similar to the Rochester study, the survey employed a critical incidence approach, whereby respondents were asked to recall a recent occasion an occasion in the last six months when they looked for information resources for patient care (beyond what is available in the patient record, EMR system, or lab results) and to answer questions regarding this occasion.

A pilot study was conducted to ascertain the effectiveness of study design, survey content, structure, and delivery method. The pilot test was conducted in the NN/LM Middle Atlantic Region.  Seven health libraries participated in the pilot test. Participating librarians were responsible for publicizing the survey to their physicians, residents, and nurses. The research team provided the librarians with templates of survey communication: publicity flyer, survey notification, invitation, and three reminders. The web survey was available from September 13, 2010 to November 19, 2010. The survey had 3,217 responses.

The second phase of the pilot test involved qualitative interviews with physicians, residents, and nurses. The goals of the interview were to understand the search behaviors of health professionals, the impact of self-guided searches on patient care, and the value of the librarian in searching and the value of health information (no matter where obtained) in patient care. The research team has conducted 23 interviews from the 201 respondents that were willing to be interviewed.  The research team has transcribed the interviews and uploaded them into an NVivo database for analysis.

For the full study, minor modifications were made to the methodology. The team invited health libraries in U.S. and Canada to participate in order to strengthen the study findings. The study enrolled 108 libraries in the study. Fifty-nine libraries dropped out of the study due mostly to timing and staffing issues. Forty-nine libraries participated in the full study. As in the pilot phase, the participating libraries were asked to complete a brief questionnaire to capture organizational characteristics. Survey Science Group was contracted to administer the web-based survey of physicians, residents, and nurses, both in the pilot phase and full study. Participating librarians were responsible for publicizing the web-based survey to their patient care providers. The research team provided a communication packet for the libraries. The full launch survey was available from March 17, 2011 to May 2, 2011. Over 15,000 providers responded to the survey. The UNC research team has just received the final data set and plans to complete the remaining tasks using the funds from the Donald Lindberg Research Fellowship from the Medical Library Association.

Joanne Gard Marshall
University of North Carolina, Chapel Hill

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