Hospitals With Libraries vs. Hospitals Without Libraries
About a year ago I asked the question, "What becomes of a hospital after it closes library?" I posed this question in response to the EPA library closures and other hospital and medical libraries closing. We all have horror stories about a hospital library that was closed or hospital that chose to replace the departing librarian with an overworked secretary who had never heard of PubMed. I was curious as to what happens to a hospital that loses their librarian or library. How does it affect patient care? How does it affect doctor and employee information services?
In the comments section of my post, T. Scott Plutchak said, "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."
That is probably the case. However, given the choice of having your cancer treated at top hospital providing excellent care or a good hospital with okay care, what do you think most people are going to choose? In the past, it was little more difficult to know what was a top hospital and what was an okay hospital. Things are changing. Recently there has been a lot of chatter with rating doctors and hospitals. Even Angie's List is adding physicians, dentists, chiropractors, and other healthcare providers to their ratings list. Angie's list and others like HealthGrades, offer the average consumer to look at and rank their healthcare.
Recently I read the Medical Librarian Maven's blog post about her concerns regarding a transition (layoffs) that her hospital and her health system are dealing with. She is afraid there will be cuts to the library staff. Two of the hospitals in the system were recently ranked in the top 15 for major teaching hospitals. Both hospitals have larger libraries with more than one professional librarian on staff. She believes, "in order to be an excellent center for clinical practice and education you need an excellent knowledge-based information center (aka - library) with excellent professional librarians to help clinicians find the best, most appropriate information in the time the need it."
Her post got me thinking again about the value of the library within the hospital and whether there is a correlation between hospital libraries (or lack of) and the hospital's quality of care. How could one study that? Wouldn't information like that go hand in hand with an updated Rochester Study to show our value? I wonder if you could compare hospital rankings within selected states of hospitals with and without libraries. I think you might have to adjust for size and revenue. You could also compare hospitals according to the outcomes of various common standard procedures.
Being new to research and writing, I am not sure if a study like this is even feasible or how I would go about doing it. But, I think in addition to an updated Rochester Study we need to start looking at the quality of hospitals and whether it correlates with having a library. I think if we were to have that type of research it could go a long way in justifying our existence to administration and the medical community.
posted by The Krafty Librarian @ 12:37 PM
6 comments
6 Comments:
What a great idea! It seems like you could just check for a statistical correlation between "library/no library" and "hospital success." There are lots of quality measures for hospitals, including the consumer sites like Angie's list, HHS's Hospital Compare, California Hospital Compare (and I'm sure other states have their own), Press-Ganey, the Healthcare Market Guide, NRC Consumer Choice awards, etc.
For more advanced analysis you could even measure various levels of library service and staffing and see if there's any relationship to hospital ranking.
OK,OK, all you librarians seeking in academic medical centers. You're supposed to be doing research. How about taking this on. Apply for a grant to fund it. (I wonder if the hospitals would agree to share outcomes data. Some of that is going to become public soon.) Great idea. Also, magnet nursing status. Should hospitals without a librarian even be considered for it? If you're going to be doing evidence-based practice and nursing research you are going to need access to a librarian IMHO. I've seen a few articles that discuss the importance of access to a library and a collection to the Magnet proces and I know that NAHRS section is surveying about this. Let's build our case for hospitals with libraries with real librarians (not secretaries with those responsibilities).
I can see possibly working with the American Hospital Association (or comparable individual state groups, if you want to start smaller) to get a handle on issue ...
There are so many other variables that could impact "hospital success," though (and how is hospital success defined, anyway?). How would you control for them? It's the same issue when we try to show our impact on patient satisfaction or patient care- we can only show inroads into certain aspects, but cannot show direct correlation overall.
I am aware of the MAR's plans to conduct a Value of Libraries Study- a modification of the original Rochester Study. Because of changes in user behavior, many healthcare professionals are doing their own searching. But we know from academic library research studies that users will accept the first few pieces of information they find, whether or not it is current, or evidence-based. Just because they ARE searching more doesn't mean the searches are of quality, or that they really have time to do them in the first place.
I am looking into the feasibility of replicating the Rochester Study in a western state, and I plan on using the original study design for two reasons:
1. So that I can perform a comparative study, and use their already validated survey instrument.
2. So that we can get current information on how our services really are perceived to impact clinical decision making right now.
What is our main "claim to fame"? It's that we know how to locate, access, filter, synthesize, etc. the literature so that our users can provide excellent evidence-based patient care.
I agree there are a lot variables and I am not sure if it is feasible, that is why I asked.
Maybe if we get our feet wet looking at it, perhaps we can see ways that we can measure.
We cannot account for every variable, and if there is an article written on this, that should be noted. But isn't it worth looking to see if our opinions and our hunches that great hospitals have libraries might be right even if we can't account for every variable?
Just wondering
This is good - Angie's List for Dr's.
Might have helped me fire this lousy oncologist we had.
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