One year had passed since I,
Sandra Kendall, had become the director of the Sidney Liswood Library at
Mount Sinai Hospital in Toronto. I had spent the time upgrading the library's
electronic and print collections to ensure that they addressed the core
medical information needs of our clinicians. Now it seemed like a good
time for an "annual checkup." Our resources, library services, and staff
skill sets were fulfilling the baseline for a small hospital library. But
how could we be better? How could we increase our visibility within the
hospital? With a team of four staff members and a very limited budget,
I knew that some creativity would be required.
|For this hospital library to be
repositioned, we had to develop a deliberate strategy for success.
A part of my responsibilities
was to contact each chief of service to find out what he or she would want
from his or her medical library. (A chief of service is the senior physician
in charge of a specific medical department.) We had to make sure that our
library addressed the basic needs and subject specialties of this hospital.
I was surprised to learn that our users were not aware of many of our new
acquisitions.It became clear to me that our users needed to be reintroduced
to our updated skills and services. For this hospital library to be repositioned,
we had to develop a deliberate strategy for success.
Diagnosis and Treatment
Mount Sinai is a small,
community-based, city teaching hospital with approximately 465 beds. Each
department has its own subject specialty, and therefore its own unique
information needs. It is easy to lose sight of the individual information
needs of each group. Although our staff had created a comprehensive intranet
site that included all of our new resources, we were receiving feedback
from our patrons that they didn't know which resources they
needed to use. Our users wanted to have access to their own personalized
intranets as opposed to the library's all-encompassing intranet. But of
course, creating individual intranets is not practical. However, applying
what I'd learned as a consultant made me realize that the only way for
a library to be seen as relevant to each group within a diverse organization
is to create the illusion that each department is our only customer—in
essence, to focus on the "customer of one."
In order to accomplish this
task, we incorporated a myriad of traditional and cutting-edge communications
methods to get the message out to the hospital community that the library
did not just take a cookie-cutter approach to everyone's information needs.
So, the library began to treat each department with the same standard of
excellence and customer service focus as the hospital uses to treat each
of its patients.
To demonstrate our commitment
to customer focus, we needed to start by redesigning our actual library
space. In truth, the entire library staff area was anti-customer service.
We didn't have an adequate reference desk. We also did not have enough
computer terminals for either staff or users, and we had no facilities
for group training. But we didn't have any funding for this project, so
I worked out a deal with Informatics (our hospital's IT department) to
create a computer learning lab in a corner of the library reading room.
Space is always at a premium in our hospital, so exchanging part of our
valuable library area to create a shared computer lab was a big move. But
it put us in a better position to offer training and gave us new equipment
at no cost.
In this partnership, we
did relinquish some prime real estate. But we gained an immediate reputation
for being flexible, and demonstrated an ability to address the hospital's
bigger needs. Best of all, we did not have to pay for the nine new computers,
printer, or redesign of our reading room. Our new space is now an accessible,
welcoming environment, giving a visual facelift that corresponds to our
commitment to change.
To inform our users about
the new features of the library, we published an article in the in-house
hospital newsletter. We peppered the article with testimonials from regular
library users from various hospital departments, and included a sidebar
highlighting features of the intranet.
We also set up traditional
cork bulletin boards outside of the library with instruction materials
on how to use key resources and hints on how to access the library's intranet
24/7. In a related initiative, we made each library staff member responsible
for highlighting a library service in our hospital newsletter or library
news Intranet section. Basically, we try to ensure that one service is
highlighted each month in either publication. I have been attempting to
coordinate our library news with relevant activities and special programs
featured throughout the hospital.
After I reviewed our salary
budget, I saw that I could afford a one-day-a-week position, so I was able
to hire a part-time library marketing consultant. When Susan Massarella
joined the library in this position, we quickly realized the short- and
long-term successes we could create from continuing the "customer of one"
service idea. Now she works for us every Monday, and that's when we focus
on our marketing projects. This means that every Monday we update our intranet
site and work on our marketing and communications issues. After our space
redesign, we decided that we were ready to repackage our content for our
Partnerships with Nurses
The Sidney Liswood Library
had been established as a medical library—the existing collection and intranet
were designed primarily for physicians. But the nursing department used
the library heavily without the appropriate support materials. Nursing
reference questions, training sessions, and interlibrary loans were a growing
percentage of library usage.
Without any prospective
funding available from the library's budget, I chose to draft a collection
development proposal for the nursing department. I wanted to address its
core print and electronic needs, and I offered to create a specific nursing
intranet site. I had one of our volunteers compare our existing print collection
against the Brandon-Hill List for Nursing and Allied Health, a benchmark
collection guide for nursing resources. Based on the results of the analysis,
I presented nursing with a list of recommended titles, both print and electronic,
that was required to create a basic collection. Consequently, the library
was funded and we acquired the print and electronic content reviewed by
our clinical nurse specialists, with the proviso that in return for the
funding, the library would market the collection and offer training on
how to use the nursing resources.
Once the content was in
place, we again needed to look at the packaging. Merely providing access
to content was not going to solve the information needs of our nurses.
The resources were already scattered under various headings (databases,
e-journals, e-books) on the existing library intranet. So Susan began to
create the e-nursing intranet site, a subset of the library intranet. She
created a single-point search solution where all of the nursing resources
and corresponding instruction guides were gathered together. When it was
ready, we put an "e-nursing" button on the library intranet to direct nurses
right to "their" section.
Now we're implementing a
customized marketing launch and outreach for our nurses. Clinical nurse
specialist Patricia Hynes Gay and I have dedicated ourselves to going to
each nursing station to announce and demonstrate the new e-nursing site.
Our initial visits to nursing stations occurred during Nursing Week, and
thus became part of the larger publicity in the hospital surrounding the
This marketing launch has
followed the same communications pathway as the library's strategy to market
our other services throughout the hospital—using careful individualization
according to the information needs of each group. When we visited the nursing
administration group, we gave the members a complete demonstration of e-nursing,
along with tips and guidelines on library services they'd find useful.
Since the nursing administration department is an office environment, not
a patient care center, they could schedule time into their day for our
presentation. On the other hand, when Patricia and I visited the nursing
station in the emergency department, the nurses there were coping with
victims from a car crash, and we were not able to give a demonstration.
We left pamphlets and assured the nurses that they could contact us for
further information as their schedules permitted. In the neonatal unit,
we had yet another experience: We gained access to the nursery where the
staff was tending to the premature babies. I used the computer in the room
to highlight the e-nursing site. I would explain the screen information,
and then wait until each and every nurse nodded that she had noted the
information. Sometimes it took several minutes for each nurse to view the
information, as they continued with their work.
|Serving each group of nurses in
their own work areas, in their own time frames, proved that we were serious
about supporting their information needs.
By going to the nurses in
their work areas and at the same time respecting their work with the patients
and adjusting our presentations accordingly, we emphasized that e-nursing
is a tool designed to work for the nurses. However, this marketing approach
would not have been possible without the cooperation of the nurses and
their willingness to learn more about research tools specific to their
Designing Group Therapy
In addition to acknowledging
the diverse information needs within the hospital structure, within each
department individuals have varying experiences with computers. Individual
skill needs must be addressed through training initiatives, so that everyone
can benefit from the resources on the intranet. Again, focusing on the
concept of the "customer of one," we started to develop training plans
for all learning types.
Some of our clients were
used to searching electronic resources and wanted desktop access and online
guides to using the sources. Others had limited computer skills and would
need help even searching the Internet, let alone understanding how to access
and use specific clinical resources. Of course, other employees had computer
skills, but were weak on searching clinical electronic resources. Effective
training is one of the most valuable promotional tools of an electronic
collection, because training helps to limit anxiety associated with electronic
We developed a series of
hands-on workshops to train people to search specific tools; they're conducted
onsite in our new joint training lab. We also offer one-on-one training,
which is vital for clients who need extra help.
We also provide the option
of arranging for group presentations in a given department. By going into
a department, participants have training that's arranged to fit into their
work schedule, and that's adapted to meet their group's specific information
needs. Again, by being flexible and by offering a variety of training sessions,
we are marketing our electronic collection to the community as accessible,
usable, and relevant.
For people who are more
experienced with computers but need point-of-use help, we took advantage
of Help files created by the vendors themselves. We procured vendor brochures
and made them available throughout the library. Product brochures are an
excellent first step to marketing resources, since you get a professional
information guide for free.
Our library made the Help
guides even better by having our senior researcher create PowerPoint Help
files for each resource, using examples specific to the Mount Sinai Hospital
community. The PowerPoint Help files are accessible from the intranet 24/7,
which also offers the added bonus of fitting training into people's busy
schedules outside of library hours.
|... the only way for a library
to be seen as relevant to each group within a diverse organization is to
create the illusion that each department is our only customer—in essence,
to focus on the 'customer of one.'
I got another great promotional
opportunity when I was invited to participate in Grand Rounds. Grand Rounds
are monthly learning sessions where specialists present leading-edge case
scenarios for continuing education accreditation and lifelong learning
in a given specialty. My role here is to sit with the presenting doctor
and, at the appropriate times, introduce our resources, research skills,
and services into the scenario. This shows doctors how the library can
support their information needs in patient cases and help them give the
best possible care. This type of participation reaches an audience seeking
knowledge of specific clinical information, so it's an opportunity for
me to promote tools that are specific to clinical practice.
Alternative Medicine: Trying Out PDAs
In trying to identify various
departmental needs of a hospital library, I found that not only do these
departments have diverse content needs, but that some of the departments
also have specific format preferences. For example, our hospital does not
currently have remote access to our intranet. Our response is to pursue
new licensing of Web products, thus helping the users who need intranet
access from home.
I also discovered that our
pharmacy department was paying for Micromedex, and knew that other departments
could benefit from access to the product. I worked with the pharmacy to
alter its license so that Micromedex could be positioned on the library
and pharmacy intranet, available to the entire Mount Sinai Hospital community.
But the Mount Sinai Hospital
Critical Care Unit best exemplifies how we're applying library content
and technology to specific job and departmental requirements. Dr. Stephen
Lapinsky, associate director of the Critical Care Unit, has determined
that in his daily work practices, he requires quality content at the bedside.
Personal digital assistants (PDAs) are the preferred method of delivery.
The reference question "Can you get me good, quality medical content on
my handheld?" started almost a year and a half ago, but the products weren't
available then. I had inquired about the specific resources that Dr. Lapinsky
wanted to access, but found that these resources relied on remote access
to large, central databases, and were not formatted for hand-held devices.
|Effective training is one of the
most valuable promotional tools of an electronic collection, because training
helps to limit anxiety associated with electronic searching.
In order to address the
dearth of quality medical content formatted for PDAs, I took a proactive
approach by contacting the vendors directly and telling them what information
the critical care team needed to complete its daily tasks. As an incentive
to the vendors to make the information available, I arranged to beta test
our pharmacopeia, and was excited to be a beta site for Ovid@Hand
this past summer. (Ovid@Hand is the mobile-device version of Ovid's electronic
resources.) As a result, Dr. Lapinsky will be able to gauge the benefit
of using PDAs in the Critical Care Unit as tools for accessing essential
My relationship with our
vendors has changed. A librarian must communicate with vendors to drive
the delivery of their content to address our end-users' requested needs.
Do tell your vendors what your users want, and what you need. By working
closely with vendors, we are in essence ensuring that our needs are going
to be addressed.
Giving Out Referrals
Our library does not have
an extensive academic collection; we have focused on resources that complement
the hospital's specialties. But our library staff has ensured that we have
connections to outside sources. With limited staff and budget, we cannot
be experts to everyone. But, we can be experts in our referral process.
The University of Toronto and the Health Science Information Consortium
of Toronto are our best allies in supplementing our resources and clinical
information needs. The referral process assures our users that we are the
one place to go for information, and makes our collection appear limitless.
Prescription for the Future
Since embarking on the
project to better position the Sidney Liswood Library within the Mount
Sinai Hospital, I have received additional staffing and an increase in
my budget that could be calculated at over 50 percent (including input
from partners, etc.). We've also had the pleasure of getting the volunteer
assistance of a number of librarians, library technicians, retired business
professionals, and university students from our volunteer office. And finally,
our pathology department has hired a contract librarian to support a project
we're working on at its request.
We've been inundated with
requests from other departments to create focused sites for them akin to
e-nursing, so we've begun an organized process of adding client-driven
one-stop buttons to our intranet site. To date we have added social work,
business and administration, and we're now launching e-clinician. This
will be a pathfinder for evidence-based resources within our library for
physicians. We will continue to work with specific departments and add
to our resources.
We have also been added
to the schedule of the orientation for hospital interns. In this way, we
will be able to target all of the interns who have not been exposed to
the library services. At the same time, we have retooled our segment in
the general employee orientation session. We now present the resources
available on our intranet, as opposed to our previous practice of giving
new employees a tour of the library. Thus, the Sidney Liswood Library is
seen as a content provider rather than a physical space.
Our goal now is to ensure
that our information efforts do not get stale. We can't let the prescription
lapse beyond its expiry date—we have to keep our marketing efforts going.
By continually updating our intranet site and our training, and by keeping
the library prominent in the hospital newsletter, we will ensure a healthy
future for the Sidney Liswood Library.
Use traditional print
methods (bulletin boards, pamphlets, newsletters, posters) to advertise
Take advantage of any
Position the library
intranet well on the organizational home page.
Give departmental presentations
that make the library's services relevant to the participants' work.
Re-emphasize the diverse
nature of the library by celebrating staff and volunteer efforts.
Emphasize your work to
the hospital and the larger community.
Get out of the library!
Market outside of your library, outside of your organization, outside of
Find and analyze your
Constantly look for opportunities
to partner on projects.
Refresh your library's
Use vendor marketing
materials to highlight your resources.
Customize your library
brochure for your users.
repeat on an ongoing basis, even if usage seems healthy.