What Becomes of a Hospital After it Closes the Library?
We all have heard of EPA library closures and other hospital and medical libraries closing, and many of us work very hard to try to prevent these situations from happening in our libraries. However, despite our best work and intentions the powers that be sometimes close the library. I remember at the HLS meeting in Philadelphia Mary Fran Prottsman mentioned that Joann Marshall was updating the Rochester Study. I think that is wonderful and helps arm us with more information to show administrators our impact on patient care.
However, I am also curious as to what happens to a hospital that loses their librarian. How does it affect patient care? How does it affect doctor and employee information services? I know of an instance where a librarian retired and the hospital chose not to replace her. The library is essentially gone, they have five journals and haven’t bought a book since the librarian left a few years ago. Online resources are nonexistent, the two people who “manage” the defunct library were not even aware of PubMed until recently. The hospital is a part of a larger regional hospital system and it has an agreement with another hospital library to provide literature searches and article requests for a fee. The regional system is trying to become a more cohesive unit and negotiate system wide online resources to all of the hospitals within that group. Who negotiates for that hospital? Who pays for the resources for that hospital? Who educates the employees of that hospital about all of the resources they will be getting? With the defunct library’s budget close to nil will the hospital even agree to by the online resources the others within the system are buying? What happens if that hospital balks at the cost of its share of the resources and decides to opt out of the system wide consortia?
I realize many of us have similar stories about hospital closures. However does anybody have more than just anecdotes, does anybody have any other evidence of what becomes of a hospital that closes the library? All I can think is that patients as well as employees suffer as a result, but I don’t have any “real” proof. Yet, if the people “running” a hospital library don’t even know what PubMed is, I have got to believe that hospital has some serious problems finding evidence based care.
However, I am also curious as to what happens to a hospital that loses their librarian. How does it affect patient care? How does it affect doctor and employee information services? I know of an instance where a librarian retired and the hospital chose not to replace her. The library is essentially gone, they have five journals and haven’t bought a book since the librarian left a few years ago. Online resources are nonexistent, the two people who “manage” the defunct library were not even aware of PubMed until recently. The hospital is a part of a larger regional hospital system and it has an agreement with another hospital library to provide literature searches and article requests for a fee. The regional system is trying to become a more cohesive unit and negotiate system wide online resources to all of the hospitals within that group. Who negotiates for that hospital? Who pays for the resources for that hospital? Who educates the employees of that hospital about all of the resources they will be getting? With the defunct library’s budget close to nil will the hospital even agree to by the online resources the others within the system are buying? What happens if that hospital balks at the cost of its share of the resources and decides to opt out of the system wide consortia?
I realize many of us have similar stories about hospital closures. However does anybody have more than just anecdotes, does anybody have any other evidence of what becomes of a hospital that closes the library? All I can think is that patients as well as employees suffer as a result, but I don’t have any “real” proof. Yet, if the people “running” a hospital library don’t even know what PubMed is, I have got to believe that hospital has some serious problems finding evidence based care.
2 Comments:
My hypothesis is that hospitals that either don't have a library or have closed their library do "okay." That is, there's nothing dramatically bad about the quality of care they deliver that would lead to an investigation resulting in a finding that the lack of up-to-date information resources was a determining factor. I suspect that we operate in the nebulous region between okay care and excellent care.
Still, it seems to me that it would be possible to study this. With the increasing availability of various types of hospital "scorecards" it ought to be possible to do a comparison of hospitals that have librarians, those that never did and those that did at one time and don't any longer, and see whether or not there are actually statistical differences in those indicators. If one could show that, it would be extremely compelling evidence.
I'm not sure that even a few years ago it would have been possible to gather the data for such a study, but it seems to me we are getting to the point where somebody might be able to pull it together.
I am glad to hear that the Rochester study is being updated. I hope that she considers asking a question or two that directly relate to patient safety.
I also think that its important to begin discussing how to measure this so some "before" and "after" numbers can be used. How do we know the affect the closing of a library had on patient outcomes if we didn't ask questions on the impact of that library and the professional that runs it BEFORE they were gone?
I know these are tough ideas to measure, thou - especially given the variety of ways that information is accessed and disseminated -- but its a good topic for us to noodle around.
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