There are more uses to a hospital library than just providing clinical information. For example we support education and development for the entire workforce. This might mean doctors but it might also mean customer service, ICT, cleaners improving skills for life, senior management etc etc

That’s a reasonable point.

One the one hand: Perhaps I would, in future revisions, remove the word “clinicians” and replace it with “patrons.” I also might replace “health information” with “information (mostly health information).”

On the other hand: While a hospital library does (and should) assist with non-clinical information needs, I still think that serving clinical information needs is (and should be) the primary focus and priority of a hospital library).

Also the physical space is not just a repository – it is a place where things happen. People meet on neutral territory, they can concentrate and take time to think away from interruptions etc etc. We are also the easiest way for many staff to get on to the hospital network to access all our lovely e-resources or to engage in e-learning.

Amen. Absolutely. No disagreement here. Did I give the impression that I thought the hospital library’s value as a physical space was decreasing? If so, I apologize- I certainly don’t believe that’s the case.

I am currently involved in a group considering what the healthcare library / knowledge service might look like in 2011 (UK based). The idea being it is easier to get somewhere if we know where we are going. You can read the background paper on the National Knowledge Service page here http://www.nks.nhs.uk/2011.asp

A couple of points

There are more uses to a hospital library than just providing clinical information. For example we support education and development for the entire workforce. This might mean doctors but it might also mean customer service, ICT, cleaners improving skills for life, senior management etc etc.

Also the physical space is not just a repository – it is a place where things happen. People meet on neutral territory, they can concentrate and take time to think away from interruptions etc etc. We are also the easiest way for many staff to get on to the hospital network to access all our lovely e-resources or to engage in e-learning.

I am very interested in comment 13 (unlucky for some?) particularly in what standards of service are offered to those buying in the service – is there somewhere I could read more about this?

Some hospitals in our area have closed their libraries, but none have stopped offering library services. All have outsourced to us, an academic medical library. Many smaller institutions that could not afford libraries now offer library services through us. The results: we’ve hired more librarians and more library assistants to keep up with demand.

So what happened to the libraries that closed? They employed older librarians and library assistants who refused to keep up. Not only did they refuse to change technologically, they refused to keep current with every aspect of their careers. If you want to be taken seriously as a professional, you need to look the part, talk the part, act the part. If you have the same haircut you did when you were 14 years old, if you are wearing sensible shoes, NO ONE thinks you’re capable. That does not mean that once you’re over a certain age that you’re past it. People take Alan Greenspan and Warren Buffett’s opinion seriously, and they’re both ancient. But whether or not you like it, you have about 15 seconds to make an impression. If your appearance is outdated, if you can’t talk tech to techies, economics to economic people, marketing to marketers, etc. then you will not be taken seriously. Period.

If you think somehow all learning should have stopped when you graduated from library school in 1977. If you are mad because your clients don’t learn “the right way” of doing things, then don’t blame me or IT if you find yourself unemployed.

The ‘golden age’ of the medical library as a place was the 1970s and 80s when not only did we house the evidence base but we provided an unique service in support or use of this resource via our medicated Medline search services – you had to have you librarian perform your Medline searches for you (Greatful Med was first introduced in 1984 but end user searching did not become significant until the World Wide Web took of in the 1990s). Then, in the mid 1990s the Web exploded and the shift of the medical evidence base from print to digital began. When evidence-based medicine was first introduced by Sackett in the mid 1990’s the end users ability to build their own subject bibliographies via online versions of Medline was all that was possible. Then the next five years saw the emergence of web based versions of print based journals and books. Over the last 10 years we have seen the emergence of web based resources that are able to take advantage of the Web and that do not have print equivalents. Point of care products such as UptoDate, ACP PIER, MDConsult and Dynamed are important examples of this. Clinicans have neither the time, access or skills to efficiently evaluate the primary literature and, in the days of the print based evidence, frequently turned to text and reference books for quick answers to questions. The new web based products have gone much further by taking advantage of the technologies ability to not be limited by space and time. The new resources have few limits as to their size and are updated frequently. So where does this leave medical librarians?

I want to go back to my original point that our basic mission is to facilitate access and use of the clinical evidence base in support of quality of care. We need to understand that this is not only our role but our expertise – whether in the training of student clinicians in how to access and use evidence or in supporting practicing clinicians practices by facilitating and supporting their use of evidence. This is the context in which I read David’s Blog. Hospital librarians have to see themselves as the leading experts in their institutions in developing and supporting access to and use of clinical evidence in the quality of care provided by the institution. This, and not the physical room(s) the library is located in is what the hospital library is. David has very apply shown the implications of this on how hospital librarians must view themselves and what they do in the era of the digital evidence base. And, if we do not believe in the importance of what we do in improving the quality of care provided by our hospitals and that we, as a profession, can do this better then anyone else in the hospital then, as Nonnie fears, traditional hospital libraries as places with books and journals and mediated Medline searches will probably not be around in 10 years.

I have to disagree. I believe that good managemement skills are not nearly enough.

Nikki-

That’s so awesome. Thanks!