Purpose & Goals
Providence Library Services provides electronic resources and professional library services to employees and affiliated medical providers of a large not-for-profit health system consisting of 52 hospitals and affiliated clinics geographically distributed throughout 7 Western US states. Library patrons include employees in all number of job roles, but predominantly from clinical positions such as physician, nurse, or pharmacist. One of the most heavily used services is the literature search service where Librarians search databases and grey literature for evidence to support patient care delivery. The Providence Library did not have a systematic way to gather feedback from our users regarding our literature search service. While we receive many grateful responses to our literature searches, we need more detailed, consistent information about our impacts to inform leadership and improve our services. Previous studies have documented the importance of library services in hospitals, and the impact librarians make on quality patient care. As a small team we need to carefully evaluate the effects of our work, share successes, and gather information that will help us improve. We conducted this IRB approved quality improvement project to understand whether our professional literature review service impacts patient care and saves clinicians’ time in a large integrated health system.
Design & Methodology
We adapted, with permission, the survey instrument and methods of a recent quality improvement project authored by Siemensma, et al (2021) in the Journal of Hospital Librarianship.
Our quality improvement project received IRB approval in late 2022. Throughout 2023, we sent the adapted survey to all employees who requested literature searches. When a librarian completed a search and sent results to the requestor by email, they noted the requestor’s email address in a REDCap form. Each Friday we ran a report of all email addresses that received literature searches two weeks prior. Using a generic email address associated with our private SharePoint site we sent an email with instructions and the survey link to requestors. Because the purpose and results of each search were different, employees received an email with the survey link each time they requested a new search. We used Excel to compile summary statistics, documenting: survey response rate, respondents’ primary roles, impact on practice, perceived quality of the literature review, and time saved.
Findings
Data collection closed in January 2024 after one full year. 1048 emails were sent to 924 unique clinicians/employees, with a response rate of 22.61%. Respondents came from across all Providence regions, with the top job roles being Nursing Staff (22.89%), Medical Staff (15.14%), Administration (12.68%) and Educator (12.32%). 203 respondents said our search added to their knowledge base, 208 said it modified or confirmed their current clinical practice, 89 said it modified or confirmed current policy, 44 said it improved their productivity, and 38 said it impacted advice given to their patient. Perceived quality of literature search results were overwhelmingly rated as Very High (84.98%) or High Quality (13.3%). Most respondents (59.83%) indicated that they saved 4 hours or more by using the literature search service. Overall, we received very positive feedback from users and nearly everyone perceived our search quality to be high or very high. Results show that our literature search service saves clinicians’ time and the information provided impacts both patient care and policy. However, one limit to our study is the possibility of voluntary response bias, whereby only satisfied users answered the survey. These results are not generalizable outside of our organization, but our project builds on a body of literature that demonstrates the value of professional library services in medical settings.
Action & Impact
These survey results allow us to carefully evaluate the effects of our work and gather information that will help us improve. Direct feedback from clinicians will be used to inform leadership and make a case for growing our services. We plan to share these results with health system leadership, at nurse research councils across the enterprise, and in the greater professional librarian community to encourage other libraries to evaluate their service impacts.
Practical Implications & Value
Hospital libraries are non-revenue-generating departments and are at risk of closure as the healthcare industry faces financial constraints. A librarian-mediated literature search service can positively impact patient care, save clinician time, and align with health system objectives. Projects like ours demonstrate the tangible value of these services to healthcare leadership and other stakeholders. Additionally, they build on the existing literature adding to the evidence base and strengthening the value proposition of hospital and health system libraries. The methods outlined in this project could also be applied to other special library or information services contexts where librarians are providing literature search services to a professional patron base.