Myths about Library Services and TRUTHS

Myth: Quality of Patient Care is Unaffected by Library Services TRUTH: Research has shown that libraries improve patient care Weightman states: Research studies suggest professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals.

Source Weightman AL, Williamson J. The value and impact of information provided through library services for patient care: a systematic review. Health Information And Libraries Journal 2005;22(1):4-25.

Myth: Most Patients Value their Doctors Opinion over other Sources of Information TRUTH: Of the 278 million Internet searches conducted every day, 12.5 million are health- related. Patients are becoming better informed about their health and want their doctors and nurses to have access to current research.

Sources Eysenbach G. The impact of the Internet on cancer outcomes. CA Cancer J Clin 2003; 53: McMullan M. Patients using the Internet to obtain health information: How this affects the patient-health professional relationship. Patient Educ Couns 2006.

Myth: Everything is available for Free on the Internet TRUTH: Only 30% of the medical literature is freely available on the Web or less than one-quarter of the medical and biomedical journals are freely available. Only 60% of the article content published since 1992 is available electronically.

Source McVeigh ME, Pringle JK. Open access to the medical literature: how much content is available in published journals? Serials 2005 Mar; 18(1): Miccioli, G. Researching medical literature on the Internet Update. [cited 26 Sep 2006].

Myth: The Internet is a Highly Reliable Source of Information TRUTH: There is an overwhelming amount of information on the Internet, but people need information training and skills to understand what constitutes valid information. Training a librarian provides

Myth: Google Scholar Is an All Encompassing Database TRUTH: Google and other Internet search engines access only 7% of available health-related information. Google and other Internet search engines cannot perform searches using a controlled vocabulary and extensive limits and do not search databases that reside behind firewalls or sites requiring internal searches.

Source Henderson J. Google scholar: A source for clinicians? CMAJ 2005;172(12):

Myth: Todays Health Care Professionals are Savvy Information Seekers TRUTH: Many recent studies have shown that a majority of health care professionals do not have: Time to seek information Searchers find what they need less then 50% of the time. Feldman (2003) Training to do expert searches Many healthcare professionals may waste hours wading through utterly useless information. Darves (2004) Knowledge of multiple information resources Workers duplicate information 90% of the time. Feldman (2003)

Sources Darves B. Strategic searching. Med Net 2004;10(5):1-4. Feldman S. Enterprise search technology: information disasters and the high cost of not finding information. Portals Mag 2004:27-28.

Myth : Physicians and nurses can quickly find the same information as a librarian TRUTH: Information retrieval is a complicated, time consuming, multi-step process Librarians are more proficient searchers, reducing the time spent on information retrieval and evaluating search results

Sources Darves B. Strategic Searching. Med Net 2004;10(5):1-4. Williams L, Zipperer L. Improving access to information: librarians and nurses team up for patient safety. Nurs Econ 2003;21(4):

Myth : Technology has replaced librarians TRUTH: Databases vary in their design, currency, content and search features. In some cases, print resources might still be the best option. Librarians are trained to extract information from a wide variety of electronic and print sources.

Sources Craig JV, Smith RL. The evidence-based practice manual for nurses. London: Churchill Livingstone; Feldman S. Enterprise search technology: information disasters and the high cost of not finding information. Portals Mag 2004: Gorman PN, Ash J, Wykoff L. Can primary care physicians' questions be answered using the medical journal literature? Bull Med Libr Assoc 1994;82(2): Perkins E. Johns Hopkins Tragedy: Could Librarians Have Prevented a Death? infotoday.com 2001.

Myth: Money will be saved if there is no physical collection TRUTH: The institution will no longer meet the IM.5 JCAHO standard. The hospital may no longer be eligible for interlibrary loan and may have to purchase materials, or use commercial document delivery services, increasing costs.

Source Joint Commission on Accreditation of Healthcare Organizations. CMAH comprehensive accreditation manual for hospitals: the official handbook. Illinois, Oakbrook Terrace: JCAHO, 2006.

Myth: Electronic resources require no on- site administration TRUTH: Administration of electronic journals is one of the most work-intensive aspects of providing library services: Negotiating Licensing Agreements Maintaining Serials Management Systems Fixing Technical Problems Continual Training

Sources Ashcroft L, McIvor S. Electronic journals: managing and educating for a changing culture in academic libraries. Online Inf Rev 2001;25(6): Tenopir C. Moving toward electronic journals. Libr J 2000;125(12):36,38. Woodward H. Electronic journals: myths and realities. OCLC Sys & Serv 1997.;13(4):

Myth: Electronic resources can be managed easily by IT departments TRUTH: Library/Information Science and Information Systems professionals have different roles. - IT professionals are concerned with logistics and security. Library/ Information professionals are concerned with content and access

Myth: Database purchases cost the same with or without a librarian TRUTH: Librarians are trained to select the best databases by comparing content, usability, functionality and cost. They may actually save money for the institution. Librarians join consortiums for greater purchasing power. By negotiating in a consortium, cost savings are greatly increased.

Source Bergstrom TC. Free labor for costly journals? J Econ Perspect 2001;15(4):

Myth: One database can supply all needed journal articles TRUTH: No one database offers access to all available electronic journals–in fact, there is little overlap between databases. Proprietary databases include few, if any, Open Access journals. Many authoritative sources are still only available in print. Librarians have the training to access and organize journals from a variety of databases.

Source King D. After migration to an electronic journal collection: Impact on faculty and doctoral students. D-Lib Magazine 2002;8:212.

Myth: Evidence-based medicine can be practiced with point-of-care software TRUTH: The purpose of Point-of-Care software is to provide quick reference to summaries for answers to common clinical questions. Complex questions are not appropriate for Point-of-Care software and quality, content and currency varies by product.

Source Glanville J, Lefebvre C. Identifying systematic reviews: key resources. Evid Based Med 2000;5:68-69.

Myth: Libraries and librarians are not essential for evidence-based medicine Myth: Libraries and librarians are not essential for evidence-based medicine TRUTH: EBM cannot be practiced without library resources and librarians-expertise in refining the search question and then producing and evaluating relevant results rests with the medical librarianNursing Economics, 2003 Difficult MEDLINE searches require the skills of librarians trained in evidence-based methods… – Annals of Emergency Medicine, 2002 Answers to complex clinical questions require access to primary literature.

Sources Williams L, Zipperer L. Patient safety. Improving access to information: librarians and nurses team up for patient safety. Nurs Econ 2003 Jul-Aug; 21(4): Gallagher PE, Allen TY, Wyer PC. How to find evidence when you need it, part 3: A clinician's guide to MEDLINE: Tricks and special skills. Ann Emerg Med 2002;39(5):

Myth: There are no regulations regarding library services TRUTH: Both the Joint Commission on Accreditation of Healthcare Organizations and the Medical Library Association have regulations and standards. For more information, see: JCAHO IM.5.10 Joint Commission on Accreditation of Healthcare Organizations. CAMH: comprehensive accreditation manual for hospitals: the official handbook. Oakbrook Terrace, IL: JCAHO, Standards for Hospital Libraries, Medical Library Association,

Myth: Libraries are a luxury only a few hospitals can afford TRUTH: When MEDLINE searches are conducted early in hospitalization; hospital costs, charges and lengths of stay are significantly lower then those whose searches are conducted later. These organizations drive the need for quality library services: State Medical Association Continuing Education Committees Accreditation Council for Graduate Medical Education American Nurses Accrediting Center (changed order) Medical Library Association Benchmarking Network

Source Klein MS, Ross FV, Adams DL, Gilbert CM. Effect of online literature searching on length of stay and patient-care costs. Acad Med 1994;69(6):

Myth: Closing the library will save money TRUTH: Information provided by librarians decrease unnecessary diagnostic tests, affect treatment decisions and improve patient care. Librarians improve proficiency by providing easy access to information.

Sources Cuddy TM. Value of hospital libraries: the Fuld Campus study. J Med Libr Assoc 2005;93(4): Gluck JC, Hassig RA. Raising the bar: the importance of hospital library standards in the continuing medical education accreditation process. Bull Med Libr Assoc 2001;89(3): Klein MS, Ross FV, Adams DL, Gilbert CM. Effect of online literature searching on length of stay and patient-care costs. Acad Med 1994;69(6): Marshall JG. The impact of the hospital library on clinical decision-making - The Rochester Study. Bull Med Libr Assoc 1992;80(2):

Myth: You can use other libraries if you close your library TRUTH: Many libraries only serve institutionally affiliated people. Only affiliated students, faculty and staff have remote access to library resources. Universities charge unaffiliated people for literature searches Without a library, some health care professionals may simply stop looking for information. Patients expect their physicians to have access to medical literature.

Sources McMullan M. Patients using the Internet to obtain health information: How this affects the patient-health professional relationship. Patient Educ Couns 2006.

Myth: Consolidating library services into a central library is cost effective TRUTH: Costs are shifted from one facility to another The central library must either increase staff or operate less efficiently The collection in the central library needs to be more comprehensive and diverse to meet the needs of all facilities, requiring an increase in materials budget There may be time delays in service

Myth: Outsourcing library services saves money TRUTH: Contracts often require additional costs for added services The hospital has no control over the qualifications, training and experience of outsourced personnel Regular evaluation of services is essential to ensure quality performance; services may be reduced or delayed. Detailed concerns about outsourcing can be found at

Myth: Anyone can buy journals for a print collection TRUTH: Librarians do more than just purchase subscriptions, they: Monitor journal usage Track missing issues Comply with copyright law Shape collection based on the needs of the medical, nursing and allied health staffs Perform physical maintenance of the journal collection, such as binding

Myth: Anyone can buy books for a library collection TRUTH: Librarians do more than just order books, they: Identify core titles Select books based on needs Process and organize of collection Weed collections based on set criteria and keep the collection current

The Bottom Line In-house libraries managed by qualified librarians provide the most cost effective, efficient means to manage and locate quality medical information. A balance between print and electronic resources augmented by interlibrary loan services will best serve the needs of health care professionals. Librarians are part of the health care team. Finding the right information for the healthcare professional is Mission Critical. The end result is improved patient care.