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The information needs of practicing physicians in northeastern New York State.

The information needs of practicing physicians in seventeen counties of upstate New York were surveyed by questionnaire. A 45.6% response, or 258 usable replies, was obtained. Computer-aided market analysis indicated that the areas of greatest need for improved information were new developments in specialties and government regulations relating to health care. Sources most frequently used were journal papers, colleagues, and books, in that order. Specialty-related differences occurred with both specific information needs and source use. Degree date, geographical location, and type of practice (hospital, nonhospital, private, and so on), and involvement in research or education were also analyzed in relation to information needs and sources. Implications for library service are discussed.

Computers

Total quality management (TQM) in a hospital library: identifying service benchmarks.

Hospitals are turning to total quality management (TQM) to lower costs of providing care. A hospital library in a TQM environment needs to embrace corporate goals while maintaining its accountability as a contributor to quality patient care. Alliant Health System (AHS) Library at Norton Hospital and Kosair Children's Hospital in Louisville, Kentucky, conducted a study to establish TQM benchmarks and to examine the significance of its role in clinical care. Using a methodology designed to allow both library user and nonuser to respond, 2,091 surveys were distributed to physicians and nursing and allied health personnel. Areas surveyed included frequency of library use, impact of information received on clinical judgments, cognitive value of the information, and satisfaction with library products and services. Results confirm that the library has a substantial clinical role. Eighty-eight percent of reporting physicians agreed that information from the library contributed to higher quality care. Nursing and allied health were less convinced of the importance of the library's clinical role. Sixty-nine percent of nursing personnel and 58% of allied health personnel agreed that the library contributed to higher quality care. Nursing and allied health personnel also used the library less frequently than physicians. With these results as benchmarks, improving the clinical role of the library will take commitment to the TQM process and a willingness to change.

Attitude of Health Personnel

A dental library current awareness service.

A simple, manual current awareness service at the University of Southern California School of Dentistry, designed to provide the user with photocopied tables of contents from selected journals, is described. Other available current awareness and selective dissemination of information services are discussed, and a general comparison and cost analysis is made between the USC program and SDILINE. The service was evaluated by means of a questionnaire distributed to the 30 faculty participants. Results indicate that the service is of value in the teaching and research programs of the school, and has a high degree of user acceptance. Cost of the service is minimal considering the benefits to the faculty.

California

Library and information services for small hospitals.

The quality of medical care is dependent on effective and expeditious information services for physicians and other health workers. Small hospitals have been at a particular disadvantage in this respect, mainly because unit costs of library services have been quite high when delivered on a small scale with traditional resources and methods. The importance of this problem is suggested by the fact that more than half of the US hospitals have less than 100 beds, and that library services have been primitive or nonexistent in most of these institutions. Certain recent developments will permit most of these smaller hospitals to provide creditable information services at modest cost.

Costs and Cost Analysis

The medical libraries of Vietnam--a service in transition.

The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation, they have somehow managed to provide a sound basic level of information services for health care professionals.

Communism

New library buildings: the Augustus Long Health Sciences Library of the College of Physicians and Surgeons, Columbia University.

A brief historical sketch, tracing the development of the College of Physicians and Surgeons and its library from the Royal charter date of 1754, is presented. Little is recorded of library development prior to 1928, when the departmental libraries were united with the Reference Library to form the core of the present library. The planning processes for the new library are discussed, noting the involvement of the entire library staff. Four floors in a twenty-story tower are devoted to library services, and each floor is described. Several of the major compromises made during the planning process are documented. Photographs and floor plans of two of the floors help illustrate the text.

Communication

The CHIPS project: a health information network to serve the consumer.

CHIPS (Consumer Health Information Program and Services/Salud y Bienestar) is a Library Services and Construction Act Title I-funded project that has as its major goal the formation of a health information network to serve the consumer, the public library client, and the hospital patient. Funded for two years, 1976-1978, this bilingual project coordinates efforts of the Los Angeles County Harbor General Hospital Regional Medical Library and the Los Angeles County Carson Regional Public Library to provide health information resources and services to the public. The target population is over two million people of diverse ethnic backgrounds. This paper discusses the project's objectives and encourages an active role for all libraries in the consumer health education movement.

California

The MERMLS leadership institute for hospital librarians: a new concept in extension service.

This paper describes a pilot Leadership Institute conducted by the Mid-Eastern Regional Medical Library Service (MERMLS) and a consultant group from Temple University. The purpose of the institute was to instill some basic group leadership techniques in a selected group of geographically dispersed hospital librarians. The institute was conducted in two sessions totalling three days, with two months separating the two sessions. Extensive evaluations by participants at the end of both sessions resulted in general endorsement that the institute's objectives had been attained and that more institutes of this type should be provided.

Academies and Institutes

The circuit rider librarian.

Many hospitals are unable to maintain a full-or even half-time professional librarian to support the professional and nonprofessional hospital staff, and to assist with the development of education programs. To answer this need, the Cleveland Health Sciences Library has developed the "circuit rider librarian" concept. A designated librarian from the staff visits a group of hospitals and, for a fee, provides library service which the hospital could not or would not readily supply for itself. The only limitations on the expansion of such a program are the interest of the hospitals, their geographic proximity to each other and to the resource library, and the ability of the latter to handle the increased demand.

Economics, Hospital

The changing status of hospital libraries 1984 to 1989: characteristics and services in Region 7 of the National Network of Libraries of Medicine.

Economic and political factors have had far-reaching effects on hospital libraries in the last decade, but quantitative evidence of these changes is not readily available. Through periodic evaluation surveys within its multistate region, the Pacific Southwest Regional Medical Library Service, the Regional Medical Library for Region 7 of the National Network of Libraries of Medicine (formerly the Regional Medical Library Network) has monitored hospital library changes over the years. This paper compares data from a 1989 survey with similar information gathered in 1984. Longitudinal analysis was performed on responses from 188 hospitals that responded to both the 1984 and the 1989 survey, as was cross-sectional analysis of all responses from both surveys. Results showed a small decrease in the number of hospitals with separate library collections. Staffing patterns had changed considerably, with a drop of approximately one entire full-time salaried equivalent per library and a decrease in libraries managed by a librarian with an M.L.S. The libraries that provide all of a set of predefined core services and resources decreased from 61% in 1984 to 44% in 1989. Libraries with M.L.S. staff were more likely to have core services than those without professional staff.

Cross-Sectional Studies