Evidence-based medicine at the point of care: student utilization and faculty implications

Evidence-based medicine (EBM) practiced at the point-of-care (POC) requires a specific skill set and appropriate resources. In this paper, we report medical student use of EBM resources in a novel simulated clinical exercise. In addition, we discuss three quality EBM resources, most available through the Sanford School of Medicine of The University of South Dakota library system, and we encourage faculty to incorporate these resources in their daily practice and clinical teaching.

Journal usage in NHS hospitals: a comparison report of total usage at an acute NHS Trust and a specialist NHS Trust in the North West of England

BACKGROUND

Health care libraries spend a large amount of their non-pay budgets on the purchase of scientific, technical and medical journals. In a typical hospital library in the National Health Service (NHS) North West Strategic Health Authority (SHA), this can represent between 80 and 90% of the collection development budget.

METHODS AND RESULTS

Data were collected from 1 December 2005 to 30 November 2006 using COUNTER-generated usage statistics obtained from publishers' administration tools. Between the two trusts included in the study, 93 376 full-text article downloads were recorded; of these, 15 952 or 17.1% articles were downloaded from national core content journals via Proquest. Photocopies made by users for their own use were recorded whenever this data were available.

CONCLUSIONS

NHS staff at the sites included in this study recorded a high volume of journal usage. There was a marked difference in usage patterns between the acute and specialist trusts in the study. The journals provided by national core content represented a much higher proportion of total usage at the acute trust (29.9%) compared with the specialist cancer trust (4.5%). This study supports the view that the local purchasing of journal titles is an important component of the overall journal-based information provision to NHS staff.

Conducting a user-centered information needs assessment: the Via Christi Libraries' experience

PURPOSE

The research sought to provide evidence to support the development of a long-term strategy for the Via Christi Regional Medical Center Libraries.

METHODS

An information needs assessment was conducted in a large medical center serving approximately 5,900 physicians, clinicians, and nonclinical staff in 4 sites in 1 Midwestern city. Quantitative and qualitative data from 1,295 self-reporting surveys, 75 telephone interviews, and 2 focus groups were collected and analyzed to address 2 questions: how could the libraries best serve their patrons, given realistic limitations on time, resources, and personnel, and how could the libraries best help their institution improve patient care and outcomes?

RESULTS

Clinicians emphasized the need for "just in time" information accessible at the point of care. Library nonusers emphasized the need to market library services and resources. Both clinical and nonclinical respondents emphasized the need for information services customized to their professional information needs, preferences, and patterns of use. Specific information needs in the organization were identified.

DISCUSSION/CONCLUSIONS

The results of this three-part, user-centered information needs assessment were used to develop an evidence-based strategic plan. The findings confirmed the importance of promoting library services in the organization and suggested expanded, collaborative roles for hospital librarians.

Empowering your institution through assessment

OBJECTIVES

The objectives of this study are to describe the process of linking Association of Academic Health Sciences Libraries (AAHSL) data with 2002 LibQUAL+ data and to address four analytical questions created by the AAHSL Task Force on Quality Assessment that relate both to user satisfaction and to services provided by AAHSL libraries.

METHODS

For the thirty-five AAHSL libraries that participated in the 2002 LibQUAL+ survey, nested-effect of variance was analyzed using a linear mixed model. Using the Pearson correlation coefficient, this study explored four questions about the effect of user demographics on perceived levels of satisfaction with library services.

RESULTS

The supposition that library user satisfaction may differ according to library institutional reporting structure was unsupported. Regarding effect on mean overall satisfaction, size of library staff is not significant (P = 0.860), number of constituents is slightly significant (P = 0.027), and ratio of staff to constituents has a moderate and significant effect (P = 0.004).

CONCLUSIONS

From a demographic perspective, the 2002 LibQUAL+ survey represents the largest cross section of AAHSL libraries. Increased understanding of how qualitative assessment can supplement quantitative data supports evidence-based decision-making and practice. It also could promote changes in data collection and usage.

Librarians collaborating with nurses

Nurses have the potential to be one of the largest groups of users a medical library can serve. In recognition of this fact, librarians at St. John's Health System embarked on a journey to collaborate with nurses and increase this group's use of the medical library. In 2004, a nursing outreach plan was developed by librarians, with input from non-physician health care employees. The nursing outreach plan will be reviewed along with the barriers and successes encountered during implementation of the plan. Innovative strategies for reaching nursing personnel were accomplished by partnering with nurses to reach nurses.

A survey of users and non-users of a UK teaching hospital library and information service

BACKGROUND

The Lancashire Teaching Hospitals NHS Trust was formed in 2002 with the merger of two existing trusts. The library services unified to create a new expanded service with 11 staff.

OBJECTIVES

The librarians wanted to test out users' opinions of the service, as a basis for a developmental strategy. They also wanted to find out to what extent they were offering a multi-disciplinary service, available to all staff. Therefore it was decided to include both users and non-users in the survey.

METHODS

A twenty-question questionnaire was sent out to a 10% sample of registered users in all staff categories. The same questionnaire was sent out to a 10% sample of non-users, with the help of the Human Resources Department.

RESULTS

The library staff and facilities were generally well regarded. The stock needed expansion in various areas, especially allied health and biomedical science. Non-users were in fact often occasional or remote users. Other non-users needed informing that they were entitled to use the service.

CONCLUSIONS

Further research is required, especially concerning the information needs of allied health and scientific staff. There is a need for stock expansion. A marketing strategy is required to capture the interest of potential users.

Value of hospital libraries: the Fuld Campus study

OBJECTIVE

The paper demonstrates the value of the Health Sciences Library/Fuld Campus to the organization and shows how responses from patrons aligned themselves with the categories of the taxonomy of contributions of library and information services (LIS) to hospital and academic health centers devised by Abels et al.

METHODS

Over a period of thirty-two months during 2001 to 2003, patrons' literature searches and interlibrary loans were followed up on by sending patrons letters, which included a question asking for feedback as to how the information was used. The comments from users were analyzed according to Abels et al.'s taxonomy of LIS contributions in hospital and academic health centers.

RESULTS

Results of this study substantiated previous research showing that health sciences LIS contributes to patient health care. Feedback also demonstrated other areas where LIS contributes to the mission and goals of the organization and how these align themselves with Abels et al.'s taxonomy.

State of the art of expert searching: results of a Medical Library Association survey

OBJECTIVES

Medical Library Association (MLA) members were surveyed to gather background about the current state of expert searching in institutions. The survey results were intended to guide the recommendations of the Task Force on Expert Searching for promoting the importance of expert searching and implementing those recommendations.

METHODS

MLA members were surveyed, and data obtained from the survey were compiled and analyzed to answer three general questions: what is the perceived value of searching skills to the institution, how do health sciences librarians maintain and improve their searching skills, and how are searching services promoted and/or mandated in the institution.

RESULTS

There were 256 responses to the survey. Over 95% of the respondents saw their expert-searching skills were of value to their institutions, primarily through performing mediated searches and search consultations. Over 83% of the respondents believed that their searching skills had improved over the past 10 years. Most indicated that continued training was very important in maintaining and improving their skills. Respondents promoted searching services most frequently through orientations, brochures, and the libraries' Web pages. No respondent's institution mandated expert searching. Less than 2% of respondents' institutions had best practice guidelines related to expert searching, and only about 8% had guidelines or policies that identified situations where expert searching was recommended.

CONCLUSIONS

The survey supports the belief that health sciences librarians still play a valuable role in searching, particularly in answering questions about treatment options and in providing education. It also highlights the need for more expert searching courses. There has been minimal discussion about the perceived need for expert-searching guidelines in the institutions represented by survey respondents.

The information needs and information seeking behaviour of family doctors

AIMS

To explore the information needs and information seeking behaviour of family doctors, identifying any differences in attitudes and behaviours deriving from membership of a training practice and investigating the impact of a practice librarian.

METHODS

A case study of general practitioners (GPs) in Aylesbury Vale incorporated a quantitative study of use of the medical library, and two qualitative techniques, in-depth interviews and group discussions.

RESULTS

A total of 58 GPs, almost three quarters of those in the Vale, participated; 19 via individual interviews and a further 39 via two group discussions. Family doctors are prompted to seek information by needs arising from a combination of professional responsibilities and personal characteristics. A need for problem-orientated information, related to the care of individual patients, was the predominant factor that prompted these GPs to seek information. Personal collections remain the preferred information resource; electronic sources rank second. The study demonstrated low use of the medical library. However, both vocational training and the employment of a practice librarian impacted on library use.

CONCLUSIONS

The study illuminates the information needs and preferences of GPs and illustrates the contribution that librarians may make at practice level, indicating the importance of outreach work.

Identifying and communicating the contributions of library and information services in hospitals and academic health sciences centers

OBJECTIVE

This article introduces a systematic approach to identifying and communicating the value of library and information services (LIS) from the perspective of their contributions to achieving organizational goals.

METHODS

The contributions of library and information services (CLIS) approach for identifying and communicating the value of LIS draws on findings from a multimethod study of hospitals and academic health sciences centers.

RESULTS

The CLIS approach is based on the concept that an individual unit's value to an organization can be demonstrated by identifying and measuring its contributions to organizational goals. The CLIS approach involves seven steps: (1) selecting appropriate organizational goals that are meaningful in a specific setting; (2) linking LIS contributions to organizational goals; (3) obtaining data from users on the correspondence between LIS contributions and LIS services; (4) selecting measures for LIS services; (5) collecting and analyzing data for the selected measures; (6) planning and sustaining communication with administrators about LIS contributions; and (7) evaluating findings and revising selected goals, contributions, and services as necessary.

CONCLUSIONS

The taxonomy of LIS contributions and the CLIS approach emerged from research conducted in hospitals and academic health sciences centers and reflect the mission and goals common in these organizations. However, both the taxonomy and the CLIS approach may be adapted for communicating the value of LIS in other settings.

Access for all? A survey of health librarians in the north-west of England on provision of information to patients

This study examined the role that health librarians could play in helping patients to find information. A questionnaire survey was sent out to 50 health librarians in the north-west of England. It examined the following: the type of library and users, access to information for patients, librarians' attitudes to provision of information to patients and their knowledge of other sources available to their users. Ninety-seven per cent of librarians said that they could recommend quality information sources to patients, but many suggested that there were practical problems in allowing patients to use health libraries due to lack of appropriate resources, facilities and funding. Advantages of health library involvement in patient information include having a local point of contact for patients and the ability of librarians to find, evaluate and organize good-quality resources. However, health library staff may not have enough time to answer enquiries from the public and may lack training in dealing with patients. Innovation, especially in developing on-line services, could offer a way to provide a service without overloading the physical requirements of a library. Librarians could also collaborate with other staff to improve patient information.

Reading factor: a bibliometric tool to manage a virtual library

Among the many bibliometric criteria used to evaluate biomedical journals, the impact factor is the most commonly used. Despite its limitations, it quantifies the influence of a journal on secondary publications. It does not however evaluate the practical usefulness of primary documents. Usefulness is field-related and varies greatly among specialities. We introduce a new bibliographic criterion, the "reading factor", and define it as the ratio between the number of electronic consultations of a particular journal (i.e., number of clicks on a hyper-link) and the mean number of electronic consultations of all the journals studied (itself calculated by dividing the total number of electronic accesses by the number of journals in the database). We describe its observed distribution, relative to that of the impact factor, based on electronic consultation records from our University Hospital medical digital library, where full-text electronic versions of 45 major biomedical journals have been available since December 1997. From this analysis we found no correlation between the 1999 reading factor and the 1998 impact factor of these 45 journals, and we observed a dramatic change in the hierarchy of journals upon using the reading factor as the yardstick rather than the impact factor. Moreover, we describe how using the reading factor has helped in managing the collection of our University Hospital's virtual library. The selection of journals to be discarded from the virtual library for the year 2001 was based on journals' RF values and this process will repeated over the coming years. The reading factor also permits a cost-analysis of a virtual library.

CONCLUSION

The measurement of the reading factor is highly automated, practical and efficient. It appears as a new tool for electronic collection management by librarians, well fitting with economical data.

Health sciences libraries in Kuwait: a study of their resources, facilities, and services

The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made.

Study to assess the compensation and skills of medical library professionals relative to information technology professionals

PURPOSE

The study seeks to determine how medical library professionals performing information-technology (IT) roles are compensated and how their positions are designed compared to information technology staff in their institutions.

METHODS

550 medical library directors in hospital and academic medical libraries were surveyed. The data was then compared to survey data from other compensation studies of the IT industry.

RESULTS

There is a gap in compensation between medical library professionals and IT professionals performing similar functions using information technology. Technology-intense library jobs are compensated at higher levels than more traditional jobs.

CONCLUSIONS

To compete with IT salaries, managers of medical library professionals will need to be ever more cognizant of the employment practices of IT professionals in nonmedical library disciplines. It is typically in the medical library's best interest to ensure that IT-related jobs, accountabilities, and capabilities of the medical library are known and understood by others, especially in the human resources and information technology staff departments.

GaIN (Georgia Interactive Network for Medical Information) study on health professionals' search requests and continuing education needs

Health sciences librarians are being called upon to be more proactive in their institutions' continuing education efforts. In an effort to identify whether search requests indicated CE needs, a study was conducted by a group of members of GaIN (Georgia Interactive Network for Medical Information). MEDLINE requests from health care professionals for subject specific clinical topics were collected during a six-month period via a standard search request form created for the study. Copies of all completed requests were collected and broad ICD-9 codes assigned to the search topics. Institutional reports were generated for each participating library to share with hospital CE coordinators. They were also compiled for the group as a whole, and reflected the "hottest" topics requested during the study period for physicians and for non-physicians (nurses, allied health, administrators). A survey to hospital librarians and CE educators showed some value in the reports, but greater potential for further collaboration between librarians and CE coordinators.

Improving usage of pediatric information on the Internet: the Virtual Children's Hospital

OBJECTIVE

Digital health sciences libraries (DHSLs) bring order to the chaos of the Internet by making authoritative medical information easily and conveniently available to patrons. The goal of this project was to perform a baseline usage analysis of the pediatric-related information in a general DHSL and to determine whether reorganization of the pediatric-related information into its own pediatric DHSL could increase the usage of the pediatric-related information.

METHODS

From March through August 1997, a baseline analysis of a general DHSL (Virtual Hospital) was conducted using computer server log file analysis programs. The quantity of pediatric-related information in the general DHSL and its baseline usage were determined. In September 1997, the pediatric-related information was reorganized into its own pediatric DHSL (Virtual Children's Hospital), and server log file analyses were conducted of the pediatric DHSL from September 1997 to August 1998. Statistical analysis was performed by time series autoregression.

RESULTS

During the baseline, the general DHSL and the pediatric-related information received a monthly average of 2 320 782 and 141 444 qualified hits, respectively. After the intervention, the general DHSL and the pediatric DHSL received a monthly average of 2 765 454 and 256 998 qualified hits, respectively. This is an increase of 19. 2% for the general DHSL and 81.7% for the pediatric DHSL. These changes were statistically significant at the P >.0001 level. The most requested pediatric-related content in the pediatric DHSL did not change substantively from preintervention to postintervention.

DISCUSSION

On the Internet, as in real life, children's services must have their own distinct identity and must be differentiated from adult services. Therefore, pediatric-related information will receive increased usage if it is part of a pediatric DHSL rather than part of a general DHSL. Others can use this process and the lessons learned to develop and enhance their own pediatric-related information on the Internet. Internet, pediatrics, digital health sciences libraries, digital library, medical library.

[The libraries of the public hospitals in Spain. An economic analysis. The Research Group on Libraries]

BACKGROUND

The continuous increase in scientific knowledge in the health field, the development of new technologies and the rising cost of publications means that libraries are essential for patient care, medical education and research. In Spain some deficiencies have been seen in hospital libraries, and their cost is unknown.

OBJECTIVE

To analyze the cost of public hospital libraries in Spain and to estimate the cost of adapting them to international standards.

METHODS

Cross-sectional survey of public hospitals larger than 100 beds, or smaller public hospitals with teaching accreditation. Information on the variables of interest was collected by questionnaire mailed to the libraries and followed up by telephone. Data collection was completed in 1996. The information on costs is for 1994. A sensitivity analysis was done to examine the effects of imprecise estimates and assumptions.

RESULTS

Of the 314 hospitals identified, 211 (67.2%) had libraries. The 1994 cost of the of the 211 libraries was 3,060 million pesetas (mean cost: 14.5 million pesetas). Personnel costs were the most important item (38% of the total), followed by the cost of subscriptions (29%). The cost of hospital libraries represented 0.08% of national public expenditures on health. The cost of correcting inadequacies in accordance with international standards would increase spending by about 400 million pesetas the first year (0.01% of public spending on health).

CONCLUSIONS

The cost of hospital libraries represents only a small fraction of public spending on health. Correction of the observed deficiencies and the importance of libraries in the health system would require increasing spending to about 0.1% of public spending on health.

Using biomedical databases in everyday clinical practice: the Front-Line Evidence-Based Medicine project in North Thames

The aims of this project were to assess the feasibility of using biomedical databases in everyday clinical settings, and the infrastructure needed to support such practice. Fourteen firms or units whose lead clinician was enthusiastic for the principles of evidence-based medicine were provided with 24-h access to databases in their clinics or offices. All members of the firms were trained in the principles of evidence-based practice and in the use of databases for finding evidence. The firms were volunteers from a variety of specialties in both hospital and community Trusts in North Thames Region. Assessment of changes in practice was carried out by questionnaire and interview. Also, any changes needed to improve the use of primary research data in everyday clinical settings was investigated. Seven firms found that the project had made their journal clubs and their clinical discussion meetings more structured and focused, with research evidence for and against interventions discussed. The use of evidence in a case-related form was limited by the time available. The other seven firms were: dissatisfied with their training, dissatisfied with their computer facilities or lacked time. The changes necessary to improve the utilization of research data included: closer collaboration with librarians, continuing training and fast delivery of documents. The limitations of this study are that initial data were not recorded and the assessments made were subjective. Using biomedical databases in everyday clinical practice could be feasible provided that there is a coordinated implementation strategy, which requires a significant commitment of time and resources from all parties involved (clinicians, other health care professionals, librarians and managers).

Innovation and survival: a case study in planning medical library services

In the information age, information utilities like libraries are as sensitive to the stresses of change as any other organization. This article is a case study of a small, specialized medical library as it attempted to understand, and cope with, the complex simultaneous challenges of serious budgetary constraints, technological change, and shifting user demands in the mid 1990s. To support planning decisions in a period of declining use statistics, the Medical Library at Women's College Hospital, Toronto, carried out a user survey that posed choices about priorities among services. Conclusions drawn from the survey and its related planning process may help similar organizations design an appropriate service blend for future users.

Using scientific evidence to improve hospital library services: Southern Chapter/Medical Library Association journal usage study

BACKGROUND

Journal usage studies, which are useful for budget management and for evaluating collection performance relative to library use, have generally described a single library or subject discipline. The Southern Chapter/Medical Library Association (SC/MLA) study has examined journal usage at the aggregate data level with the long-term goal of developing hospital library benchmarks for journal use.

METHODS

Thirty-six SC/MLA hospital libraries, categorized for the study by size as small, medium, or large, reported current journal title use centrally for a one-year period following standardized data collection procedures. Institutional and aggregate data were analyzed for the average annual frequency of use, average costs per use and non-use, and average percent of non-used titles. Permutation F-type tests were used to measure difference among the three hospital groups.

RESULTS

Averages were reported for each data set analysis. Statistical tests indicated no significant differences between the hospital groups, suggesting that benchmarks can be derived applying to all types of hospital libraries. The unanticipated lack of commonality among heavily used titles pointed to a need for uniquely tailored collections.

CONCLUSION

Although the small sample size precluded definitive results, the study's findings constituted a baseline of data that can be compared against future studies.

A study of hospital and medical libraries in Riyadh, Kingdom of Saudi Arabia

The study reported examined the status of hospital libraries, their sponsoring organizations, their staff, the academic qualifications of the head of the library, collection size, available space, buildings, and services. The study was limited to the hospitals with libraries for staff in Riyadh, the capital of Saudi Arabia. The data were collected through questionnaires sent to a sample of fifteen hospitals with medical libraries. Twelve libraries responded. This is the first study of its kind in Saudi Arabia, and it is hoped that similar surveys will be done covering the whole kingdom.

Hospital library service and the changes in national standards

Two important sets of standards affecting hospital libraries were significantly revised in 1994, those of the Medical Library Association (MLA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). As part of its continuing efforts to monitor library services within its region, the University of California, Los Angeles Biomedical Library, Regional Medical Library for the Pacific Southwest Region of the National Network of Libraries of Medicine (NN/LM) conducted a survey in late 1994, in part to determine the effects of these revised standards on regional hospital libraries. Data from the survey were also used to provide a view of hospital libraries in the Pacific Southwest region, and to make comparisons with similar data collected in 1989. Results showed that while libraries remained stable in overall number, size, and staffing, services, especially those associated with end-user searching and interlibrary loan, increased enormously. With respect to the MLA standards, results show a high compliance level. Interesting differences were seen between the perceptions of library staff concerning their rate of compliance with the JCAHO standards and their actual compliance as measured by the MLA criteria. While some libraries appear to measure up better than their own perceptions would indicate, others may be fully aware of their actual compliance level.

The hospital library as provider of consumer health information

The health care environment of the 1990s demands that hospital libraries develop creative strategies for providing consumer health information (CHI). Librarians at the Reuben L. Sharp Health Sciences Library at Cooper Hospital/University Medical Center have developed a multifaceted approach to the problem. Using a combination of institutional resources, private funding, and cooperative arrangements with public libraries, the Sharp Library helps to serve the consumer health information needs of the southern New Jersey community.

The 'market' for medical and health information in transition: the case of the Hong Kong Hospital Authority libraries

The last few years have been a period of transition not only for hospitals and their governance but also for post-graduate medical education in Hong Kong. Both trends have a direct impact on the information market place. This article starts by studying the provision of medical and health-related information in Hong Kong. The two university medical and dental libraries, together with the hospital and health sciences libraries in government hospitals and the Department of Health, house the major collections on medicine and health care. The demand for medical and health care information is increasingly felt with the takeover of 39 hospitals by the statutory Hong Kong Hospital Authority in 1991. The major problems and issues in planning for library information services are the historically uneven development of libraries, discrepancies in funding, the changes in organizational and management structure, and the competition with higher development priorities within the organization. In view of current technology and the availability of rich external resources, the adopted strategies tend towards the formation of 10 library service networks, development of integrated library information systems on the Health Authority-wide area network, and the devolution of management responsibilities. The future challenges in store for the information professional are examined.

Selection of library services by post-registration nursing, midwifery and health visiting students

This paper describes a small-scale survey undertaken with 300 nurses, midwives and health visitors on post-registration courses and registered for the ENB Higher Award. The aim was threefold: first to examine reasons for electing to use particular libraries; second, the relationship between workplace, home, teaching site and choice of library services; and third, the use of library enquiry services. There was a 56% response rate to the postal questionnaire and results indicated that the key factor in selecting a library was availability of resources rather than convenience to home or workplace. The third largest group of respondents worked in community organizations with little or no on-site access to resources and were dependent on access to other libraries. Most who used the library for literature searching needed to seek help in spite of preliminary user education sessions. Similar levels of assistance were needed to locate journals and use the computerized book catalogue. The paper recommends explicit information on strategic entry points, necessity of a broad central collection, integration of information retrieval into post-registration courses, use of self-study packs, better trust/university liaison and recognition of the need for resource transfer from teaching to learning.

Implications of the UNNDERPIN study at St George's Hospital, Morpeth, Northumberland

UNNDERPIN (University of Northumbria at Newcastle DEvelopment of and Research into the Provision of Information to Nurses and nurse educators) was an 8-month research project at St George's Hospital, Morpeth, Northumberland. The general aim of the project has been to undertake an examination of library and information services in a climate of change where user information needs are changing and demanding changed services to be provided to meet those needs in order to support patient care and clinical developments. The paper gives an overview of the project describing its background and presenting a summary of the research findings, conclusions and wider implications of the work.

Promoting an awareness of retractions: the Louisiana State University Medical Center in Shreveport experience

The current mission statement of the Medical Library Association states that it is "dedicated to improving health through professional excellence and leadership of its members in the ... provision of information services and educational programs ..." With this goal in mind, retractions offer medical librarians a professional challenge to become involved in the scientific process. Through results of a survey conducted among the consortium of South Central Academic Medical Libraries (SCAMeL), this paper reveals opinions on the importance of retraction awareness and who is responsible for disseminating this knowledge. The paper also reports what the Louisiana State University Medical Center at Shreveport Library and other SCAMeL member libraries are doing to promote awareness.

Health Facts Information Centre, Frenchay Hospital, Bristol: five years 1988-1992

The Health Facts Information Centre at Frenchay Hospital, Bristol was officially opened in March 1988. It provides information in lay terms about illness and self-help groups for patients, the public and health professionals. Enquiries are made by letter, telephone or personal visit.

A survey of patient access to hospital and medical school libraries

The American Medical Association (AMA) Library and Information Management Division conducted a survey of 481 randomly selected hospital and medical center libraries. Data were obtained from 307 libraries (63.8%). The tabulated results showed that 58.1% of responding libraries allow patient access without restrictions. Another 19.9% allow patient access with restrictions, such as physician approval (13.4%) or various other limitations (6.5%). Many of the surveyed librarians (67%) said their institutions have separate nontechnical libraries for patients. Medical library access was strongly or somewhat supported by 89.6% of the respondents; 6.1% were somewhat opposed, and 4.3% were strongly opposed to patient access. Approximately 10% of the libraries surveyed provided no patient education forum. The AMA trustees used the results of the survey in deciding whether to encourage hospitals and medical schools to make their libraries accessible for use by patients and their families.

Security in health service libraries--a survey in North West Thames Region

My aim is to discuss the results of a survey of health service libraries in North West Thames Region undertaken in November 1990 as part of a more detailed study of library security. Widely varying patterns of losses were discovered. The ways in which librarians have tried to resolve these problems are described and a number of possible solutions are proposed. A brief review of the literature is also included.

Reader activity in a multidisciplinary health sciences library: a case study at St George's Library

This paper reports on a survey of user activity in a London teaching hospital with a multidisciplinary health sciences library. Library users were asked to complete a simple survey form on each visit to the library over a week long period. Information was required to help establish a formula for funding. The user survey examined reasons for visiting the library, frequency of visits, length of visit and also asked for comments and suggestions. Finally there is discussion regarding the effectiveness of the survey in terms of the practical framework utilized and of the gains obtained.