Version
This is the Accepted Manuscript version. This version is defined in the NISO recommended practice RP-8-2008 http://www.niso.org/publications/rp/
This is the accepted version of the following article:
Suggested Reference
Browne, R., Lasserre, K., McTaggart, J., Bayley, L., McKibbon, A., Clark, M., . . . Murphy, J. (2012). International trends in health science librarianship: part 1 - the English speaking world. Health Information and Libraries Journal, 29(1), 75-80.
doi:10.1111/j.1471-1842.2011.00973.x
CopyrightItems in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
http://olabout.wiley.com/WileyCDA/Section/id-820227.html http://www.sherpa.ac.uk/romeo/issn/1471-1834/
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
For Peer Review
International Trends in Health Science Librarianship: Part 2 – The English Speaking World
Journal: Health Information and Libraries Journal Manuscript ID: Draft
Manuscript Type: Regular Feature
Keywords: Comparative study, Australia, Canada, New Zealand, United States of America (USA), National strategies
Abstract:
This is the second in a series of articles exploring international trends in health science librarianship in the first decade of the 21st century.
The invited authors were asked to reflect on developments in their country – viz. Australia, Canada, New Zealand and the United States.
Future issues will track trends in Northern Europe, the Nordic countries, Southern Europe and Latin America. (JM)
For Peer Review
Trends in the last 10 years in Australian Health Librarianship
Ruth Browne (UQ/Mater McAuley Library, The University of Queensland), Kaye Lasserre (Hargrave-Andrew Library, Monash University) & Jill McTaggart (PACE Health Sciences Library, The University of Queensland)
Changing health policy and practices and technological advancements in the past decade have created huge challenges and opportunities for Australian health libraries. Local issues and trends have often reflected international trends particularly in the areas of workforce planning and the ability of librarians to acquire the new knowledge and skills required to keep pace with the evolving environment.
Australian health librarianship has been influenced by evidence-based practice with this decade featuring clinical librarian programs and the support of systematic reviews. Sladek and others demonstrated an informationist program was feasible in a hospital in South Australia.1 Despite professional development activities, anecdotal evidence indicates lack of time, staff, training and confidence limits the expansion of these services. Some have embraced evidence-based librarianship, hosting workshops presented by leaders in the field.
The Health Libraries Australia (HLA) group of the Australian Library and Information Association (ALIA) funded the preparation of Critically Appraised Topics (CATs) on priority questions in 2003. Librarians have enhanced access to Australian guidelines via Evidence Australia and to palliative care evidence at CareSearch. In 2009 a virtual Centre for Evidence Based Practice Australasia was established in collaboration with clinicians.
HLA has been a driving force for change with a deep concern for the relevance of the health librarian in the changing health and technology environment. They have undertaken two key projects over this period.
• In 2008 the Guidelines for Australian Health Libraries were revised to provide an updated standard. <http://www.alia.org.au/policies/health.libraries.html>
• The ALIA HLA Workforce and Education Research Project has determined the future requirements of the health librarian workforce in Australia2 and will provide direction for the next stage with the introduction of specialised postgraduate education programs, development of competencies and support for these by quality continuing professional development (CPD) programs. This will better position Australian health librarians to become a recognised part of the health professional workforce instead of being relegated to an administrative role.
• Locally and internationally the increased availability of digital content has improved access to online databases, electronic journals and ebooks. Web 2.0 services have impacted on how librarians and health professionals create, use and share information.3 Elearning options and innovations are now offered to health professionals. Mobile and wireless data networks continue to evolve and recent Australian government initiatives in the provision of ehealth will further influence how information and knowledge are
managed.
Australian health librarians, following the example of international colleagues, could play a role in supporting the introduction of electronic health records integrated with evidence- based information for the clinician and the consumer at the point of care. The HLA proposed structured education program will support this extended role.
Page 1 of 7 Health Information and Libraries Journal
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
References
1. Sladek, R.M., Pinnock, C., & Phillips, P.A. The informationist in Australia: a feasibility study. Health information and libraries journal 2004;21:94-101.
2. Hallam, G., Ritchie, A., Hamill, C., et al. Australia's Health Libraries: A Research-directed Future. Library Trends 2010;59:350-372.
3. Cotter, L., Lewis, S., & Wood, G. Web 2.0 and Australian Health Librarians. HLA News 2008:1, 9-11.
Trends in Canadian Health Librarianship, 2000-2010
Liz Bayley, Liz (Health Sciences Library, McMaster University) & Ann McKibbon (Director MSc in eHealth, McMaster University)
Setting the scene
To understand health librarianship in Canada it is important to understand the environment in which health librarians work. Most are still employed in universities or hospitals and while these institutions are accredited by national standards, they are publicly funded at the provincial/territorial level. Canada has no national health library and health librarians have had to build their own national networking and networks which must adapt as governments across the country change their priorities,
The Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada (CHLA/ABSC) has been a major player over the past decade in defining and advocating for the role of health librarians. Their surveys of members in 20011, 20082 and 20103 included a question on issues and trends; the results of these surveys were the major source of trend identification for this article.
Trends
1. Evidence-based practice
Not surprisingly, Canadian health librarians have played a strong role in promoting and supporting evidence-based practice (EBP). For example, starting in 2001 librarians were formally integrated into the How to Teach Evidence-Based Practice Workshop at McMaster University in Hamilton, Ontario, Canada4. Librarians have also played a major role in the PEP (Putting Evidence into Practice) Workshop5 held each year since 2003 in Edmonton, Alberta.
In addition to supporting EBP among healthcare practitioners, Canadian health librarians have also taken a leading role in promoting evidence-based librarianship. They have been actively involved in planning the biannual Evidence Based Librarianship conferences, starting in 2001 with a name change to Evidence-Based Library and Information Practice in 2007. In 2006, health librarians in Newfoundland and Alberta began publishing Evidence Based Library and Information Practice (EBLIP)6 as a peer-reviewed, open access journal.
2. Research support: systematic reviews
Closely related to EBP support is the strong role health librarians have played in producing evidence-based products, particularly systematic reviews that are often further used in producing clinical practice guidelines and health technology assessment reports. Librarians are now integral parts of research teams in universities, hospitals and government agencies.
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
One example is CADTH (Canadian Agency for Drugs and Technologies in Health)7, where the librarians have extended their searching expertise to include the grey literature and statistical data. Health librarians are also frequently co-authors on systematic reviews.
3. Consortial licensing
To address the dispersed nature of funding for health care training and provision, Canadian health librarians have formalized relationships to provide collaborative services and
consortially licensed resources. One of the authors was the President of the Canadian Health Libraries Association in 2000 when the concept of a National Network of Libraries for Health (NNLH) was first proposed.8 By the end of the decade, funding had been secured to develop a Canadian Virtual Health Library9,10.
At the same time as this national initiative was taking place, librarians were also working at the provincial and regional levels to coordinate licensing and support. Two important examples are the launch of SHIRP (Saskatchewan Health Information Resources Partnership)11 in 2005 and e-HLbc (Electronic Health Library of BC) in 200612. Smaller regional consortia have also developed.
4. Accountability
Funding for education and healthcare takes up a major and growing portion of provincial budgets. Because funding increases are not matching institutional needs, health libraries and librarians have had to justify their worth to their institutions. As a result, the evaluation of their services and resources and the demonstration of their effects on outcomes, either educational or clinical, or return on investment for research have become critical.
Canadian health librarians have had to hone their management and their research skills, streamline services, and establish new partnerships with individuals and groups.
5. Role convergence
Finally, the authors have seen a convergence of the roles of hospital and academic librarians. Both groups now support health sciences education as it becomes ever more distributed. Faculty and students are spread across provinces, making off site, online support essential. As university/hospital joint research projects and teams become the norm, both groups are widening their skill sets. And finally, joint licensing of key clinical resources is becoming the norm as described in item 3 above. However, the authors are not seeing an increase in informationist or clinical librarian positions in Canadian healthcare institutions although these responsibilities are sometimes being added to existing positions.
Conclusion
As is the case in most countries, Canadian health librarians have struggled with constrained budgets, the maturation and spread of technology, and ever expanding expectations to do more with less. They have met these challenges by streamlining their work and their institutions; developing and enhancing existing and new skills and services; establishing national, regional and local partnerships; and forging new institutional collaborations and teams. They have become ever more efficient and effective, although often in response to having fewer Canadian health librarians and libraries.
References
Page 3 of 7 Health Information and Libraries Journal
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
1. Ellis, P., Scott, L. & Tripp, T. Taking the Measure of Ourselves. Part II: CHLA/ABSC survey of Canadian health information professionals. BMC. 2002 Winter;24(2):87-92.
Available at: http://www.chla-absc.ca/survey/measure_2.pdf (accessed 26-Nov-11) 2. Kharouba, D., Powelson, S. & Slater, L. The Value of Membership: the CHLA/ABSC
2008 membership survey. JCHLA/JABSC. 2008;29:47-50. Available at:
http://pubs.chla-absc.ca/doi/pdf/10.5596/c08-011 (accessed 26-Nov-11)
3. Dingwall, O., Dorgan, M., Raworth, R. & Ticoll, M. Taking the Pulse of Canadian Health Information Professionals: Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada (CHLA / ABSC) 2010 survey JCHLA/JABSC.
2011, 32:(1) 11-15. Available at: http://pubs.chla-absc.ca/doi/pdf/10.5596/c11-012 (accessed 26-Nov-11)
4. Crumley, E., Bayley, L. & Bhatnagar, N. Librarian Integration into McMaster's 2001 'How to Teach Evidence-Based Clinical Practice' Workshop. Hypothesis: Journal of the Research Section of MLA. 2002 Spring; 16 (1): 1, 4. Available at:
http://research.mlanet.org.libaccess.lib.mcmaster.ca/hypothesis/hyp_v16n1.pdf (accessed 26-Nov-11)
5. Putting Evidence into Practice (PEP). Available at: http://www.pep.ualberta.ca/
(accessed 26-Nov-11)
6. EBLIP. Available at: http://ejournals.library.ualberta.ca/index.php/EBLIP (accessed 26- Nov-11)
7. CADTH. Available at: http://cadth.ca/ (accessed 26-Nov-11)
8. Bayley, L., Beckett, G., Brault, C., Henderson, J., Mikoski, K., Prior, T. & Wyndham L.
National Network: Implementing a national network of libraries for health. BMC. 2000 Spring; 21 (3): 23-5.
9. Ellis, P. & Bayne, J. Canadian Virtual Health Library / Bibliothèque virtuelle canadienne de la santé (CVHL/BVCS). JCHLA/JABSC. 2010; 31: 127. Available at: http://pubs.chla- absc.ca/doi/pdf/10.5596/c10-036 (accessed 26-Nov-11)
10. CVHL: http://cvhl.ca/ (accessed 26-Nov-11)
11. SHIRP (Saskatchewan Health Information Resources Partnership):
http://www.shirp.ca/aboutshirp (accessed 26-Nov-11)
12. e-HLbc (Electronic Health Library of BC): http://ehlbc.ca/about-us (accessed 26-Nov-11)
Trends in Health Science Librarianship in New Zealand in the 21st Century Megan Clark (Library Manager, Medical and Health Sciences, University of Auckland University, Faculty of Medical and Health Sciences)
Health care in New Zealand is mostly publicly funded from three predominant sources - the Ministry of Health, The Accident Compensation Corporation (ACC), which provides no-fault personal injury cover, and the Ministry of Education. In the primary care sector the
government pays for basic services through the general medical services benefit, although in many practices, the patient pays an additional part charge, the amount depending on their socioeconomic status. The secondary and tertiary care sector is organised into 20 District Health Boards (DHBs), each of which delivers services in its region from public funding, which is supplied according to a complex model based on the age, socioeconomic status and size of the population served. DHBs have discretion as to how to spend their allocation, although the government sets performance standards and accountabilities. New Zealand achieves better health outcomes for lower spending than many developed countries.
Two universities provide medical education and several universities and technical institutes provide nursing education. The two universities deliver preclinical training in Auckland and Dunedin, but maintain clinical teaching units in a number of hospitals throughout the country.
The preclinical and larger clinical schools have well-resourced medical libraries, while smaller hospitals maintain their own libraries. The geographical spread and the number of 3
4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
DHBs in New Zealand for a population of only 4.2 million people increases parochialism and transaction costs, and limits opportunities for economies of scale.
Trends in health librarianship to meet these challenges include:
1. Greater collaboration and use of consortia
Librarians in New Zealand have a long history of collaboration to reduce costs, share knowledge and provide better services for their customers. In the late 1990s New Zealand Health Librarians re-formed a special interest group (Healthsig) affiliated to the New Zealand Library Association, LIANZA, to “provide a forum for health sector library and Information professionals”. Members of Healthsig are active in improving their collective health information knowledge and skills.
New Zealand libraries were early adopters of digital technology and electronic resources and there has been a rapid uptake of collaborative purchasing consortia. The first consortium (2001) provided access to key medical databases for all hospital employees for a reduced unit price, and the Consortium has recently begun to provide consortium based journal access. Many DHBs are also moving to adopt a shared services model to reduce unit costs and free funds for core health services.
2. Increase in electronic only resources uptake
Health Libraries have been slower to move to a solely e-access model than academic libraries in New Zealand, which have moved to electronic only serial provision in order to reduce space costs and provide better desktop access. Hospital libraries continue to purchase key titles in print but are now reviewing the retention of both print and electronic versions of journals. There is still concern among the medical libraries about the instability of aggregated products, the mobility of journals between publishers and the fear of losing access due to the cost of titles. Rising costs of e-journals is putting enormous pressure on health library budgets, resulting in some shared purchasing of key titles across the sector.
Arrangements such as to the one that provides NEJM on all hospital desktops have been a success, but any gain is being eroded by greater-than-inflation increases in consortium charges for such arrangements.
3. Greater emphasis on professional development
Healthsig holds regular study days for the professional development of health librarians.
They cover technical issues, searching skills, management skills and enhancing knowledge in the sector to ensure better use of resources.
The global recession has affected New Zealand as it has everywhere. The maintenance of funding levels for health care in New Zealand has meant that the downsizing that has affected many UK and US institutions is not yet present. However, DHB budgets are very constrained as the organisations try to cope with rapidly escalating costs in healthcare along with the desire to deliver more services within the same budget. As a result, many libraries are facing static or decreasing budgets.
Whither the Money? Key Trends to Follow for Health Sciences Libraries and Librarians in the United States
Gerald J. Perry, Director Health Sciences Library, University of Colorado, President Medical Library Association (2011-2012)
Page 5 of 7 Health Information and Libraries Journal
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
As we all know, money makes the world go around. And for most US health sciences libraries, money is in short supply and will remain so for the foreseeable future. The “Great Recession” <http://en.wikipedia.org/wiki/Great_recession> that began in 2008 and whose effects are still lingering has had a profound impact on national, regional and local funding priorities. These priority shifts are resonating throughout the economy, reaching deep into our libraries. For the next decade it will be more critical than ever for health sciences libraries to demonstrate value for money and relevance. Rather than see this as a threat, it would be wise to embrace the challenge and reimagine how health information services are delivered.
The value proposition question, and thus the question as to what role health sciences librarians will play in defining their own futures, is expressing itself through a number of critical trends:
• Team Science: Private corporations and Federal research funding agencies are
demanding value from their investments and are increasingly impatient with the long lead times between discovery and innovative practice. This has led to an emphasis on
collaborative research initiatives, such as the Clinical and Translational Science Awards
<https://www.ctsacentral.org/> funded by the US National institutes of Health. The emerging expectation is that researchers and stakeholders will work in large aggregate teams, crossing boundaries of institutional affiliation and discipline, to bring diverse perspectives and economies of scale to solve big problems that are important to the most people. The resulting emphasis on team science provides opportunities for health sciences librarians to consider new roles and services in support of this paradigm shift.
Facilitating the development of networks of researchers and leveraging our informatics and data management skills are options to consider in support of this trend.
• Consolidation: Health insurance reform in the US led by President Obama remains a lightning rod topic. While the US Supreme Court considers the constitutionality of the legislation, the nation’s providers are positioning themselves for a challenging decade. A key response has been the growing emphasis on consolidation of care networks to reduce expenditures and grow revenue in order to compete. As with team science, this is another example where an economies of scale approach is being applied, with a strong element of demand for accountability. The notion of accountable care organizations1, 2 has thus emerged, being an approach to payment tied to outcomes improvements. In the future we should expect to see funders of healthcare refuse payment for avoidable hospital readmissions and hospital-sourced infections. Quality improvement will be incentivized and transparency of outcomes will be a strong driver.
Librarians engaged in hospital and health system environments will need to consider what roles they will play in enhancing patient care safety and quality. Our skills in bringing just the right information needed at just the right moment will be powerful assets.
• Scholarly Communications: As Open Access evolves into another business model, the crisis of affording access to the biomedical knowledge base will remain an ongoing challenge. The lingering “Great Recession” and related mortgage crisis in the US has resulted in dramatic cutbacks in funding for higher education, resulting in reduced funding for library collections. While many publishers restrained price increases for Financial Years (FY) 09 and 10, US academic health sciences libraries started to see significant increases in FY 11 and 12 despite flat and often reduced budgets.
Leveraging economies of scale, this past decade many libraries deployed “big deal”
approaches to licensing in order to provide access. The days of the big deal, however, may be numbered as librarians are forced to find savings and defend the value
proposition of these e-journal bundling arrangements. What will the next decade bring?
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
For Peer Review
Will e-journal licenses go away, replaced by a pay-for-view model where libraries
subsidize access at the article level? The biomedical journal has been with us since the early 1600’s. Will it die in the next decade? Is that question relevant in this “new
normal” economy?
• Aging Workforce: For the past decade, societies such as the Association of Academic Health Sciences Libraries (AAHSL) and the Medical Library Association (MLA) have been preparing for the mass retirement of “Baby Boom” generation librarians. The US National Library of Medicine with AAHSL has developed a successful program to expedite the recruitment of the next generation of library directors3, and the Leadership and Management Section of MLA has been orchestrating programing around career track advancement and leadership4. Health sciences librarians need to consider how best to bring forth a new generation of committed and passionate librarians, and we need to think “outside the box” when it comes to succession planning and what constitutes leadership. Agility, innovative thinking, and technical acumen will be the leadership qualities of the next decade. Are we prepared in our organizations to support these skill sets? Given the trends outlined above, it would so behoove us!
References
1. Accountable care organization (AC), Wikipedia article,
<http://en.wikipedia.org/wiki/Accountable_care_organization> (accessed 25-Nov-11) 2. Accountable Care Organizations (ACO), US Department of Health and Human Sciences, Centres for Medicare and Medicaid Service <https://www.cms.gov/ACO/> (accessed 25- Nov-11)
3. NLM/AAHSL Leadership Fellows Program, Association of Academic Health Sciences Libraries <http://www.aahsl.org/mc/page/leadershipfellows> (accessed 25-Nov-11)
4. Leadership and Management Section blog. The title of the study is: “25 Counterintuitive Principles of Leadership: Medical Library Association Member Perceptions”.
<http://lms.mlanet.org/?page_id=338> (accessed 25-Nov-11)
Contact Details
For details on how to contribute to this feature please contact:
Jeannette Murphy, Senior Research Fellow University College London, Centre for Health Informatics & Multiprofessional Education,
Archway Campus, Highgate Hill, London N19 5LW Tel +44 (0)207 288 3044 E-mail: [email protected] Page 7 of 7 Health Information and Libraries Journal
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
