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Value of Library & Information services in Patient Care Study


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This project has been funded in part with federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. N01-LM-6-3501 from New York University and under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh, Health Sciences Library System, (NNLM MAR). Additional support is provided by from 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.

About the Study

The purpose of the Value of Library and Information Services in Patient Care Study (referred to the Value Study hereafter) is to understand the value of the health library, information services and the librarian. The Value Study is a partnership of the Network of the National Library of Medicine, Middle Atlantic Region and the University of North Carolina at Chapel Hill.

Value Study Overview video


The idea for the study on the value of libraries came from a discussion of the Network of the National Library of Medicine, Middle Atlantic Region (NNLM MAR) 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. A major issue identified was determining the value of health sciences libraries to administrators in hospitals, academic health sciences centers and other organizations where librarians work. A planning group was established to further investigate research possibilities, and Joanne Gard Marshall, from UNC Chapel Hill, was invited to join the group.

The resulting study builds on previous research notably that of the “Rochester study” conducted in the early 1990s by Marshall and a study team from the Rochester, NY area. 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. 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.

Marshall, JG. The impact of the hospital library on clinical decision making: The Rochester study. Bulletin of the Medical Library Association. 1992 Apr;80(2):169-78.

Value Study Design

The planning group spent considerable time considering changes in the health sciences information environment since the Rochester study was conducted. The goal of the resulting study is to assess the value of the library and information services in patient care. This study updates the Rochester design and methods. The study employs multiple methods, both quantitative and qualitative. 

The Value Study employed a multi-stage research design with a pilot phase involving 7 library sites. The full study included 56 library sites serving 118 hospitals. NNLM MAR membership was not required for participation.

The research employed:

  • An extensive planning process that involved focus groups and discussions with consultants, practitioners, and researchers.
  • A survey of physicians, residents and nurses at participating sites to assess the value of the library and information services in patient care.
  • Interviews with selected physicians, residents and nurses to gain an understanding of the role of the library resources and the librarian in providing information related to patient care.