Krafty Librarian

A few years ago I got started down a path thanks to a library director friend in Oklahoma who asked me to teach a class specifically for hospital librarians.  While he worked in an academic medical library he noticed that hospital librarians in his area needed some help thinking of different ways to prove their value or justify their existence, especially in light of the Affordable Care Act (which was very new at the time and nobody knew what would happen…but they knew it would have a pretty big impact).

In preparation for the class, I did a lot of research on the ACA.  I was and still am not an authority on the ACA but I did learn a lot about the changing landscape that hospitals would be (and now are) dealing with.  The biggest change was moving from a fee for service model to a value based model of providing healthcare services.

(Gross over simplification of the ACA coming next….if you want more info click here for a very detailed LibGuide on it.)

Traditionally hospitals were paid on how many procedures they did and billed.  If you had a heart attack were admitted, then released, and then readmitted a few days later…they were paid for the services they provided each time you were admitted.  The ACA now penalizes hospitals that have readmission rates for certain conditions, procedures, etc. In the heart attack example the hospital would still be paid for the services they provided BUT they would also incur a penalty if their readmission rate for heart attacks was too high.  In the beginning these penalties happened for just a few conditions such as heart failure but it has evolved to include more conditions AND acquired hospital conditions like infections.  Every hospital is ranked on these things and those with the poorest score are penalized.  Those with the best score are rewarded.

Not only are hospitals in competition with each other over their reimbursement rates. But they are also in competition for patients.  Now days it is very common for patients to have a very high deductible for care.  If a patient has to spend $4000 before their insurance kicks in, they are going to look for and compare the costs of hospitals.  Both patients and insurance companies are doing this.

So what does this mean for the librarian and why on earth did I focus on this in my class in Oklahoma?  It means that hospitals have to completely change their financial and caregiver goals.  This also means that they are looking at EVERY department in the hospital to see how it fits into these new goals of the hospital.  So cardiology, environmental services, IT, and yes the library all are judged by administration as to how they help the hospital meet their goals.  Clinical departments have a leg up on departments like the library because they can point directly to numbers to tell hospital administration what they are directly doing to impact the hospital goals.  Heck even environmental services has a leg up on the library.  “Was your room clean?” is a question on the HCAHPS hospital survey that patients receive to rate their hospital experience…..which also directly impacts ACA reimbursement.

So while other departments are able to point to specific data to illustrate to the administration how their department helps the hospital achieve its goals, the library has no such data.  Sure we do literature searches and support the caregivers, but what data do we have to show that those searches impact the hospital’s goals?

I recently attended a meeting where hospital administration explained the hospital’s strategy and goals and then explained how the clinical departments fit into those goals.  The administrator then explained how they will be working with non-clinical departments in the near future to develop appropriate measures to support the hospital goals.  DING DING DING At least the administration realizes the value of the non-clinical departments and will be working with them to create MEASURABLE goals that help the hospital meet its goals.  I am not so sure every hospital administration is reaching out to their non-clinical departments like this.

After hearing of the hospital administration mentioning non-clinical departments accountable for providing measurable data that supports the hospitals goals, I had a flashback to my Oklahoma group 2 years ago and to the other ACA and the library classes I taught after them.

Hospital administration wants to know specifically how you help them meet their goals.  They are asking “What have you done for me lately?”  I hope for your sake you just don’t tell them you do literature searches to support the doctors and nurses who treat patients.  Because while that is true….they are going to need to know in a 3 bullet point slide how literature searches lead to their hospital goals being achieved.  It is not their job to fill in the blanks as to how the lit searches do that.  It is your job.

I know I owe you all part 2 post on Life and MLA President but I have gotten delayed.  My 1 yr old puppy, Chewie (as in Chewbacca of course) was diagnosed with cancer and had to have his leg removed.  That kind of sucking away all of my available free time.

While Chewie doesn’t have much to do with medical librarianship, I have to say the little dude has inspired.

I’m baaaaaaaaaack.

It has been a while since I have posted.  I want to thank all of the guest posters who have written and kept things going while I took a year off.  You guys were great.

So, one of the questions I have gotten over the year is what is like to be President of MLA.  I want to take the time to answer that question.  I will try to provide as much information without getting so wordy that it becomes the longest blog post ever.  With that in mind I am going to make this a two part series.  The first part is going to focus on my experiences while the second part will get into the nitty gritty of time and how things are done.

First and foremost it was an awesome experience.  I wish everyone who wants to run as President will get to be President.

Meeting Librarians:

Attending the Chapter Meetings and the CHLA/ABSC meeting provided me with a rich opportunity to meet more librarians than I would have ever met in my lifetime.   Meeting people and sharing stories and experiences, brainstorming ideas, learning from each other is the one thing, hands down, that made the whole Presidential term great.  Unfortunately I wasn’t able to attend every Chapter’s meeting, they all overlap a great deal.  However, I want to still attend every Chapter’s meeting at least once.  I learned so much from different groups that I feel like it will do me good to step out and go to a different Chapter every once and a while.  I think we are sometimes so wrapped up in our own groups that we don’t always know what is going on elsewhere and big MLA annual meeting can sometimes be information overload.  I kind of got this idea from a librarian friend whose child was graduating college during her Chapter meeting.  She decided to go to her child’s graduation and then go to a different Chapter’s meeting (which didn’t conflict with the graduation) and present a poster.  So a few years down the road if I happen to be at your Chapter meeting, I am just branching out and expanding my boundaries.

Capitol Hill Visits:

I was both equally nervous and excited when I joined the AAHSL and MLA Joint Legislative Task Force in Washington DC.  Because NLM and the NIH are government entities they cannot lobby on behalf of themselves.  Who is to lobby for the things we medical librarians use? Well, medical librarians will lobby on their behalf.  The first day we met to learn and discuss all of the most relevant and timely issues that we needed to make our Senators and Representatives aware of.  We were given packets and created talking points.  The next day we were set loose in 3 teams of 3-4 people.  We met with the staffers responsible for health affairs for the Senators or Representatives of our states.  It helped to be in a group because the members in your group chimed in and provided support while you were talking with your state’s staffer.  It was such a cool experience walking the halls of the Senate and House buildings.  I felt a part of the governmental process that I learned about when I was a kid in school.

MLA Historical Marker:

I got to be a witness to library history.  Last November I went to Philadelphia to attend the unveiling of the MLA Historical Marker  at 1420 Chestnut Street (later designated 1420-1422 Chestnut Street).  MLA is the world’s oldest association of medical librarians and information professionals!  To be a part of such a respected and long standing association and to see it being recognized by the Pennsylvania Historical and Museum Commission was humbling and wonderful at the same time.

MLA Business:

I am still honored that I was elected by the membership to serve as President and to guide MLA forward as an association.  Associations and organizations are changing rapidly.  It was a great privilege to be a part of the process as MLA members, Board members and staff worked to help the association evolve to meet the needs of future medical librarians.  All of us worked together to look at things from a different perspective and not rely on the old “we always did it that way” principle.  Rome was not built in a day and we have had some hiccups along the way but to be a part of the evolutionary process is something that I hold near and dear to my heart.  As I went to the Chapter meetings, Board meetings, and spoke or emailed with so many people in the association, I always did my best to try and understand people and perspectives and to help the association. I love the people in this organization and I believe that we all are working to make things great.

Family:

If you were at the Toronto meeting you might have noticed that I teared up a little and my voice cracked when I thanked my family for their support.  I am not a crier.  I’m a suck it up kind of person. Being MLA President provided a wonderful personal experience for me as well.  My kids have always known that I help doctors and nurses find information to help treat patients.  During my term as President they were able to see medical librarianship beyond my day to day job.  They would see me chatting on Twitter with other librarians from all over the world (*see funny story below).  When I left for Chapter meeting I would tell them where I was going and what I would be doing.  My trip to Philadelphia for the historical marker gave me the opportunity to talk to them about the history and evolution of medical librarianship.  Finally, they were able to hear about their mom going to Washington DC to talk to our elected officials (well their staffers) to try and influence positive change. Through all of this they saw first hand of what “Oh, the Places You’ll Go!” can be.

My experience as MLA President will stick with me forever.  I enjoyed and learned so much during my time.  However, I am glad to slow down just a bit and be the past President now.  My kids will be sad that they won’t get as much Garrett’s popcorn, but I am ready for the next phase of my career (whatever that may be) to begin.

*Funny story*
One Thursday evening while participating in the #medlibs chat, my son asked me who I was texting.  I told him I was Tweeting and talking with other medical librarians around the US and the world.  He paused a second then asked if I knew every medical librarian in the US in the world.  I said no of course not.  He then asked if I had met the people I was chatting with.  I told him that I had met some but not all.  He looked at me and said, “I thought you told us we weren’t supposed to chat online with people we haven’t met in real life. You should be careful Mom.” -I got a dose of my own internet safety speech from my kid.

In 2014, the Virginia Commonwealth University (VCU) Libraries administered the Ithaka S+R Local Faculty Survey to our faculty to measure their changing needs and perceptions of library resources. The survey, consisting of seven modules including the health sciences module, was distributed across our campus. The health sciences module targets faculty with patient or clinical care responsibilities. At this time, few health sciences libraries have used this instrument. Survey questions focused on attitudes and skills related to evidence-based scholarly resources as well as access and use of other library services and resources.

Of course we all know students’ research skills especially in finding evidence based scholarly research are often lacking. This came out clearly from the results of the Ithaka survey. Again we were not surprised to see that faculty also see these research skills as a very important aspect of the students’ learning. However, it is still amazing that a large number of faculty did not see teaching the skill of finding evidence based scholarly materials and research skills as primarily the librarians’ function. A timely reminder for us to continue informing our faculty that we indeed have are more than capable to teach students research skills especially when it comes to evidence based practice. What a great opportunity for us to collaborate with our faculty and remind them about everything else we bring to the table!

Hopefully more health sciences libraries will use this survey instrument to measure their faculty perceptions because I think it would be interesting to compare the VCU’s Tompkins-McCaw Library’s findings with other libraries that have surveyed their health sciences faculty.