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- 20 May 2017
See also Canadian health and hospital library closures 2013
"...Print is about logic, context. "E" is about convenience, hyper-connectivity"
"...Law libraries and KM departments have been hit as hard as everyone else by the disruption in the legal market. Law librarians and all legal professionals have witnessed the widespread decentralization of knowledge resources, the relentless pressure to cut costs and shrink physical footprints, and even the incursion of underemployed associates into territory previously inhabited solely by librarians. Now it's time to respond to these changes and gain control over the evolution of functions involving content management and its associated roles in KM, IT, client services, and analytics."
"...there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries, who have the laws in their favor; and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it..." — Machiavelli's "The Prince" quoted in NY Times
"...The Internet tends to push everything toward a self-service model. It happened in retail, banking, government services, and of course libraries. If you've worked in or used libraries for more than twenty years, try to think of all the things patrons once needed personal assistance with but which is now self-service. For example, librarians once mediated the searching of bibliographic databases on behalf of patrons, but since the advent of institutional licensing and IP-based authentication, today's users jump right in and (for better or worse) do all their own searching." — Hutchison, 2013
"...For a physician, knowledge may be acquired by reading a journal article. Wisdom is interpreting what was read in such a way that it can be incorporated into daily clinical practice. How one filters the information—the relevancy of this one journal article in the context of the millions of other pieces of information out there—that is where wisdom plays a central role in altering behavior..." — KevinMD blog Sept 2013
- society is transformed by information technology; library users want (expect) information to be free
- users want information available at their fingertips wherever they are in real-time; information foraging;
- it's essential for librarians to understand how the landscape is changing, the driving factors of change are and how this has affected providers, creators and users
- the new digital information landscape from iphones and e-readers to the future of information and how/whether it will be controlled are perennial issues
- four core areas of information production: storage, distribution and consumption, grappling with cutting-edge issues such as: trends such as mass broadband; crowdsourced information production in social media, open access, cloud computing
- informal, digital methods of information distribution such as Twitter, RSS and webcasting provide options and threaten the future and purpose of libraries, publishers and newspapers
- new information literacies and pivotal role of information professionals
- in response to the worldwide economic downturn, libraries are "undernourished" in terms of funding
- in some academic library systems, units are being folded into each other, multi-site library buildings are being merged, and services are going online
- subject libraries are being eliminated in favour of single "all subjects" libraries
- library positions are changing focus from subject-based to functional-based
- public services are merging with several departments - liaison librarians, instruction, reference, digital services & learning spaces
- seems to be a novelty of functional over subject organization, but many issues are still outstanding
- eBooks are useful and convenient when easily-accessible
- in subscribing to ebooks, medical librarians can provide information across hospital sites
- users are not required to come to library; can look up books themselves
- some ebooks can be viewed 24/7 online or "taken out" by more than traditional print books
- despite what you hear, not all books are online; transition to online is different with books and from e-journals
- use a smartphone? be prepared for additional logins with ebooks
- ebooks are often stuck in publisher silos; cannot be be searched effectively
- physicians don't know to go directly to platforms to search for ebooks
- ebook companies have some titles to be downloaded to mobiles but are too expensive
- medical libraries BUY e-titles but don’t have good circ models (ala public libraries)
- large publishers with ebooks expect lots of money but we can’t download to mobiles
- book publishing is foundation of capitalism; one unit = one unit of profit
- medical librarians know online texts are more expensive than print because they can be viewed by many; however, if an online title is 1/3 of my book budget, I can’t buy it no matter how much I want it
- medical librarians have fewer dollars to spend on resources; we can't “try” products; can’t afford without dropping something
- eBook platforms should work on laptops AND be downloadable to mobiles (not web enabled)
- we need core titles that aren't available; AccessMedicine, MDConsult, Ovid get your ebook platforms; we are open to new circulation models
- public libraries do it and their patrons understand it, it's a form of renting not borrowing
- we need collection of decent medical titles; not pittance of specialty books; Harrison’s, Hurst’s, DeVita’s, etc. real medical books
- eliminate barriers; we maintain access to online resources (license agreements require it)
- we know better what our users want so let us do our jobs and stop putting up extra burdens on us. This will certainly make us obsolete
Thoughts in brief
- reconciling distance and geographical concentrations from the eventual facility
- transportation from viewpoints of users (primary, official & unofficial), staff, visitors, suppliers, servicers (including maintenance) students etc
- safety: personal, equipment, print collection, and of the space itself -location, access what's nearby (and what is not)
- access and convenience (in realistic terms) - availability of water, lavatory, quiet study areas
- immediate environment: lighting, power outlets, layout as adaptable to your collection's equipment, furniture & personnel needs & uses
- equipment, spaces appropriate and adaptable for anticipated timeframes, accommodation for users' various devices
- copy equipment: de-emphasize machinery (copy machines, public availability of institutional property, paper, missing issues of journals at binding time)
- think ahead in terms of needs or opportunities for new equipment
- if you go electronic - med students, physicians & residents like it - space needs are minimal but be prepared to do a lot of teaching
- print can be consolidated in central location, duplicates, outdated information removed etc.
- model is just in time; discard anything older than 5 years
- electronic solves issue of all sites having same access whereas before site A had some books not at site B, causing problems
- some faculty say "as much as I hate to say it medical books are dead"
- in a shared setting, each maintains a few journals and books on site in the Medical Staff office
- print journals are diminishing; books have a future, especially until they get the licensing/access issues resolved, and until a greater percentage of books are available electronically at a cost-effective price
- currently print version is still the most cost-effective; perhaps different locations could specialize, with various foci
- nursing, peds, orthopedics, surgery, internal med, etc. This would eliminate some duplication and allow a deeper and broader total collection
- some library directors want 95% virtual library; not all resources are available online so going virtual might force you to do without some things
- more likely the case with non-medical resources; if cost is no issue modern medical library's resources can be virtual, though you need librarian to negotiate contracts, provide instruction, perform lit searches, facilitate ILLs, etc.
- if there is a tight budget having a completely virtual library would be difficult; online journals offer discounted rates to print subscribers, and subscribing to print alone is more cost effective; additional charges to subscribe to back files, which may be important for core content
- building collections is difficult as cost is higher; books on reading lists for students are not all available electronically; if they are, you get access to online content using code on front cover of print so you still need physical shelving
- an important consideration when deciding if you can go virtual, especially if you have contracts, service agreements or quality standards
Words of wisdom about collections
- Funding: Last fall about 25% of my library space was removed to create a new patient registration area. As part of the agreement, I requested and received about $23,000 to support the purchase of more online resources, given the reduction in space. Unfortunately, it was only one-time funding so I couldn't use it towards any subscriptions, but the new ebooks have been greatly appreciated by the patrons. By the way, the finance person involved referred to that kind of money as "construction dust," so small in their overall budget for the project
- Funding: ask for what you would really want (with justification, anticipated statistics, business case) in terms of additional funding to support electronic content in smaller physical space -- get commitment for annual funding so you can get subscription items or new items each year
- lots of push from higher-ups to go completely online without understanding that many books people are not available online at a price they are willing to pay; some things are not available online
- We don't ILL books...just too complicated to receive and mail across the state, then hope we get them back. Most people can live without that service
- Not all resources are available online even today
- The final thing I have learned is please ask the users what they want from the library.
- Perhaps some space should be kept for core collections, collaborative space, technology, computers, scanner, fax (yes, fax machine), printer, photocopier, etc, software, headphones, projection screens, etc
- create a "collaboratorium" or "collaboration centre"
- library space can be used by all kinds of people, so defend it that way; key is to keep it flexible; partitions, multifunctional furniture, good lighting (track lights including those that raise and lower), electrical outlets, wireless access
- don't give up space too quickly, keep public access computers and chairs
- admin wants to go completely virtual without understanding that many books are not available online at a price we can pay
- some things are not available online at all
- make a case for library as place; maybe we don't need journal stacks but a lab and study carrels and tables and reading rooms with space for people to work when they are away from their offices
- libraries provide multifunctional space, for collaborative work, small groups, contemplative thought and study, work on projects, etc; community spaces; personal spaces
- document delivery has been centralized already which slows down the delivery
- keep at least minimal staff presence; librarians can move from libraries into offices, with a bookshelf
- priority is to be more involved in clinical teams and part of the clinic; option is to embed librarians in departments
- staff and physicians at 4 hospitals have website access to books, journals & databases; call, email or fax for literature searches and articles M-F, 8:00-4:30
- questions about staffing: with no library or librarian would there be a liaison to collect questions? Would that person serve as a gatekeeper?
- Who would provide instruction on how to use resources?
- Would it fall to librarian working in main library (organize & maintain collection, perform searches, order articles and materials, teach and train staff how to use resources)?
- When would he or she travel to the other facilities or would they have time to do so?
- concerns about staffing: have person on site to train physicians to use resources; librarian and tech, not possible in remote locations
Standards & accreditation requirements
- Joint Commission had standards years ago that required (or at least suggested) libraries were needed
- today, Magnet designation is those hospitals with libraries and librarians to assist with evidence-based practices
- what should be considered is needs of users; JCAHO requires access to information resources but not to physical library
- if your organization is going for Magnet designation a library is a big consideration
- can central library serve several facilities? as it's more practical
- some librarians are part of one facility supporting four hospitals and 100+ clinics throughout county/region
- we can provide library services from a single location with geographically-dispersed audiences; other MLA and SLA members with similar geographic service areas
- global corporates have single or few sites for library staff, but patrons/employees distributed around region, country, or world
- some medical libraries serve two smaller, affiliated hospitals as well as their own onsite; literature searches and document delivery via e-mail and fax; send books through courier (though books are rarely requested); hospitals are close to librarian for teaching
- Changes include unstaffed smaller library space; more promotion is needed as so many people have said "um, no it is just unmanned, did you read your emails, or those umpteen signs around the hospital?"
Magnet status for hospitals
- should "Magnet status be recommended for Canadian hospitals" - some say “not yet for Canada”
- ethical aspect to Magnet status is nursing unions (in unionized facilities) are excluded from Magnet
- recent criticism of ANA standards (in relation to the ANCC and Magnet certification) was published in the Journal of Nursing Administration
- not a condemnation of Magnet, nor should it be (Scott & Craig, 2008)
- nurses and administrators wait for data; JONA article leads to critical debate and awareness of issues
- positive indications that Magnet will develop into what nurses hope it will be; support Canadian Nurses Association’s collaborative efforts to plan for nursing’s future position in healthcare
- nurses should not return to undue reliance on employers’ control over employment issues, as could be the case with Magnet hospitals
- arguments are clear on both pro and con sides; important to pay attention to wording because they frame discussion (Branham & Meany, 1998)
- in presenting arguments against Magnet in Canada, there is literature to support it
- a variety of sources to develop each argument showing strengths and weaknesses of opposing views presented
- nurse satisfaction is important in favour of Magnet; nurse’s description of experiences did not reflect satisfaction
- descriptions of nurses’ actual experiences were relevant to debate
- Magnet qualities are desirable; aspects are not all recommended for Canada. Magnet is a complicated issue
- Barrett F. An analysis of reference services usage at a regional academic health sciences library. J Med Libr Assoc. 2010 Oct;98(4):308-11.
- Browne R, et al. International trends in health science librarianship: part 1 - the English speaking world. Health Info Libr J. 2012 Mar;29(1):75-80.
- Daniels K. Got value? Journal collection analysis is worth the effort. Med Ref Serv Q. 2010 Jul;29(3):275-85.
- Homan JM. Eyes on the prize: reflections on the impact of the evolving digital ecology on the librarian as expert intermediary and knowledge coach, 1969-2009. J Med Libr Assoc. 2010 Jan;98(1):49-56.
- Hull D, Pettifer SR, Kell DB. Defrosting the digital library: bibliographic tools for the next generation web. PLoS Comput Biol. 2008 Oct;4(10):e1000204.
- Léon G, Ouimet M, Lavis JN, Grimshaw J, Gagnon MP. Assessing availability of scientific journals, databases, and health library services in Canadian Health Ministries: a cross-sectional study. Implementation Science. 2013;8:34.
- Lynn VA, FitzSimmons M, Robinson CK. Special report: symposium on transformational change in health sciences libraries: space, collections, and roles. J Med Libr Assoc. 2011 Jan;99(1):82-7.
- McMullen KD, Yeh F. Adapting to change: a survey of evolving job descriptions in medical librarianship. J Hosp Librarianship. 2013;13(3):246-257.
- Plutchak TS. Searching for common ground: public access policy and the Scholarly Publishing Roundtable. J Med Libr Assoc. 2010 Oct;98(4):270-2.
- Schott M. Medical library downsizing (review) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324780/ & TOC http://books.google.com/books/about/Medical_Library_Downsizing.html?id=4bvYGkQ9dAUC
- Starr S. Maintaining parallel systems. J Med Libr Assoc. 2010 Oct;98(4):269.
- (Re)Defining the Library, Part 2: How? [Scholarly Kitchen] http://scholarlykitchen.sspnet.org/2012/09/12/redefining-the-library-part-2-how/