Hospital Libraries are More than a Cost Center

The cost of health care is expensive. Hospitals want to treat patients in a cost efficient manner without sacrificing patient care. It is a balancing act. The hospital librarian can help with that balancing act.

An article published in Health Information & Libraries Journal, describes how clinical librarians providing information to hospital staff in the critical care unit can improve patient care, time savings, and may generate a positive return on investment.

The study was conducted in the United Kingdom, so there may be differences depending on the country your hospital library is in. Over the course of 15 months, they found that librarian intervention and activities generated a positive ROI of £1.18–£3.03 for every £1 invested. (For the American readers that is a ROI of $1.49-$3.83 for every $1.26 invested, depending on currency values.)

The clinical librarian spent 15 hours per week split across a 5 day work week (Monday-Friday) providing the following intervention services/activities.

  • Pop-up library (rounding on the floor/wards)
  • Academic study support
  • Evidence searching support
  • Noticeboard
  • Journal club
  • Facebook group.
  • Online journal club
  • Book box

In an email interview for this blog post, Victoria Treadway, the clinical librarian in the study, said the intervention activities were done in accordance to the needs of the week. So one day, time might be spent helping with Journal Club while the other day, time spent might consist of rounding.

So it appears that with a little bit of time, 15 hours out of a 40 hour work week, dedicated to providing services within the critical care unit, the hospital was able to see a positive return on investment. Additional benefits to having a clinical librarian were; time saved for clinical staff (1563 hours 85% of which was nursing), professional development support, and improved patient care. This not not only impacted the budget in terms of cost savings for the NHS but led to an increase in evidence based medicine culture, and improved clinical decision making. (figure 1 of Hartfiel N article)

Libraries and librarians are often thought of an expense rather than a benefit that actually reduces expenses and improves patient care. More of these types of studies are needed, “the development of a core set of validated outcomes would enable a direct comparison of results of future studies.”(Hartfiel N) The ability to compare the results with other institutions librarians would help librarians better illustrate their impact on the hospital, clinical staff, and patients.

Unfortunately, as with most things, due to changes in personnel and Covid-19 this clinical librarian program no longer exists within the hospital impacting the clinical staff. In email correspondence with Dr. Girenda Sadera, “Covid put a dampener on things. Once Victoria left the trust we were not able to replace her on the unit. At present I am aware that the nursing staff are having limited success with obtaining help from the library.”

But there is a silver lining, Treadway mentioned this research had a “wider impact on embedded librarianship at a national level, as it helped to inform the Health Education Gift of Time report which makes a case for expanding embedded librarian roles across England.”

Hopefully the role of the embedded librarian is expanded in England and we see more studies reporting on the impact medical librarians have on increased support of clinical staff, and improved patient care.

For more articles on the impact and value of medical librarian please read:

The value of library and information services in patient care: results of a multisite study. Marshall JG, Sollenberger J, Easterby-Gannett S, Morgan LK, Klem ML, Cavanaugh SK, Oliver KB, Thompson CA, Romanosky N, Hunter S.J Med Libr Assoc. 2013 Jan;101(1):38-46. doi: 10.3163/1536-5050.101.1.007.PMID: 23418404

Measuring Return on Investment in VA Libraries. Jemison K, Poletti E, Schneider J, Clark N, Stone RD. Journal of Hospital Librarianship. 2009 Nov;9(4):379-390. doi: 10.1080/15323260903253803.

Assessing return on investment in health libraries requires lateral thinking. Urquhart C. Health Information and Libraries Journal. 2020 Mar;37(1):1-4. doi: 10.1111/hir.12298

Tools:
Evidence you can use to communicate library value. Medical Library Association. https://www.mlanet.org/page/evidence-you-can-use. Last accessed 6/26/22.

References:
Hartfiel N, Sadera G, Treadway V, Lawrence C, Tudor Edwards R. A clinical librarian in a hospital critical care unit may generate a positive return on investment. Health Information & Libraries Journal. 2021;38(2):97-112. doi:10.1111/hir.12332

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