The Business of Hospital Libraries

Earlier last week people on medlib-l discussed (The  perfect library storm) closures of hospital libraries.  They are seeing a contradiction between Evidenced Based Medicine imperatives vs budget and resource demands on hospital libraries.  Some are seeing how the increase in pricing and bundling practices have caused the hospitals to “throw it back to the physicians and staff” causing libraries to close.  I interpret this statement to be that the hospitals are no longer willing to provide monies for institutional support of resources (the library) and require doctors and staff to buy their own resources.

This email conversation is very timely.  It turns out this week I will be in Tulsa, OK teaching the class, “The Evolving Librarian: Responding to changes in the workplace and in healthcare.”  Technology changes, social changes and healthcare changes have forced hospital librarians to step back and really change the way we do things.

Personally, we hospital librarians need to start treating our library like a hospital department and not a library.  I mentioned this in my medlib-l post. I know this statment sounds odd because you might think we do that already.  I think we could do better.  I think librarians not only need to align their goals to the hospitals, but they need to make the hospital’s goals their goals.

With the Affordable Care Act, hospitals stand to lose 1% of their Medicare payments in penalties if patients with specific conditions are readmitted within 1 month of discharge.  By 2015 it will be 3%.  That is billions of dollars.  To put it in perspective, Barnes-Jewish Hospital in St. Louis will lose $2 million dollars according to Kaiser Health News. Dr. John Lynch the chief medical officer of Barnes-Jewish says they could absorb the loss this year but not over time if penalties continue to accumulate.

You better believe all of the other hospital departments in your hospital are working toward the hospital goals.  Aligning the library to demonstrate specifically (hard numbers) how it can help the hospital achieve their goals is essential.

I thought long and hard about my post to medlib-l before I sent it.  The reason was I didn’t want to lay blame for hospital libraries closing on the librarians.  I didn’t want to imply that they weren’t doing their jobs or that if they “could’a, would’a, should’a” they would still have their jobs.  That wasn’t my intent.  Although, one person responded on the list saying they found it “disheartening that sometimes when a library staff is downsized or actually closed, that a too common belief is that if  only ‘that library’ had been doing more, building a stronger case, demonstrating their worth in concrete ways, etc., etc., this would not have happened.”

Who knows what the situations were at those hospital library closures or downsizings?  However, I firmly believe if you don’t start looking at your library as a business arm of the hospital and align your goals to support the hospital achieve its goals, then you are going to have a very rough time.  Because if an institution as established and good as Barnes-Jewish is dealing with these things, then it can, and is happening everywhere.  Where do you think the library stands when the institution has to deal with a $2 million dollar loss one year? Repeatedly?  Where do you think it stands if you do not illustrate exactly with hard numbers how your department has helped prevent that loss.

I think everyone (administrators, doctors, nurses, etc.) can agree that the idea of a library is good.  But when faced with money demands, that idea  needs concrete specific support.  That support must be generated from within.  Administration doesn’t care about the library in terms of JCAHO standards. Administration doesn’t care about the Rochester study or newer updated similar published research.  Administration cares about what your library is doing now.  Those studies, standards, etc. aren’t going to change your administration’s mind, you are.  They don’t care if you give them every flipping article under God’s green earth saying that a library will save them money and help them cure every disease known to man.  Administration only cares about you, your library, what you are doing, and how it benefits them.

I am not alone in thinking that hospital librarians need to change they way they think and do “library business.”  The Mid Atlantic Region will be running a CE webinar series starting May 31, 2013, entitled “Running Your Hospital Like a Business.”  Some of the things the series will address are: writing a business plan, art of negotiation, and proving your worth/adding to your value.  All of these things are those business skills that I ran away from in college but now am kicking myself as I realize I really need them today and could’a, should’a taken a business class back then.

Oh well, time to beef up now.

 

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