Changing times, Changing needs? Library Program Analysis at the Duke University Medical Center Library & UNC Health Science Library Carol Perryman, IMLS/TRLN Doctoral Fellow

Background  Since JCAHO expanded their definition of patient and family education in 1994, many health science libraries have found reason to increase their provision of information services to patients and consumers.  However, planning for these or other services means balancing questions about resource allocation against a changing healthcare environment.  Staff at two academic health science libraries have expressed uncertainty with regard to the role of consumer health information services, their concerns about access and expertise, and future direction.

Research Questions What are the stated goals of the library, with regard to providing consumer health information services to the general public? What is the capacity of the library to provide consumer health information services to the general public?

Project intentions  Case studies of the UNC Health Science Library and the Duke University Medical Center Library focused upon the capacity for and the provision of health information to health consumers.  The analysis builds upon existing library documentation, with the goal of providing comprehensive data for planning purposes, pointing the way to future development and research.  Address the library’s respective settings and unique realities  Provide a snapshot of the library with a focus on services to the general public

Plan of Action  Initial outline  Plan approval & input  Literature search: Models for program assessment CHI provision in academic, hospital, and public library environments  Planning process: Program logic model  Revise, organize, and annotate outline with pathfinder information  Evaluate data for coverage and currency  Determine best approach for gathering missing data  Compile and write report/s

Areas of Analysis The Library in Context Demographics Hospital University Libraries University Other The Library as an Institution Mission Statement Vision Statement General Description The Library’s Capacity Administration User Services Collections Library Data Staffing Outreach Partners SWOT Environment Organization Politics Who we are Where we’re going The nitty-gritty detail Present & Potential Strategic Summary

Program logic model Program Logic Model concept & design are from Hatry, Harry P. (1996). Measuring program outcomes : A practical approach. Alexandria, Va.: United Way of America.

Problem #1: How do you capture usage? Simple question, questionable answers. UNC Usage = Desk stats + + chatref + outreach + NCHealthInfo + circulation + “other”? DirectionalReference / web Duke / non- Duke Duke/non- Duke / Patients Duke / non- Duke Neither library collected statistics on purpose of visit due to confidentiality issues. Online reference questions are characterized by IP addresses as being campus or non-campus. Duke Usage = Desk stats + + circulation + “other”?

 Data organization  Data analysis  Filling the gaps  What’s known but not documented?  What’s documented but not known? Problems with library definitions (such as those used for gathering statistics) make it difficult to apply standard criteria between libraries or across time, even within the same library. Problem #2: Organizational data-mining

Results & Conclusions (so far)  Results: There is considerable value in working toward a snapshot of a library’s overall resource allocation as it exists to meet program goals.  Conclusions: Though the project was not conceived as an attempt to evaluate or compare two academic health sciences libraries, performing the two case studies highlights differences, and helps to identify questions for further study.

Definitions Consumer health information (CHI) information on health and medical topics provided in response to requests from the general public, including patients and their families. In addition to information on the symptoms, diagnosis and treatment of disease, CHI encompasses information on health promotion, preventive medicine, the determinants of health and accessing the health care system. Patient education a planned activity, initiated by a health professional, whose aim is to impart knowledge, attitudes and skills with the specific goal of changing behavior, increasing compliance with therapy and, thereby, improving health [1]. CHI and patient education overlap in practice, since patient behavior may change as a result of receiving health information materials. Patient education and CHI often differ in terms of the setting in which the process occurs, rather than in terms of the subject matter. Program In outcome measures, a set of related activities and outputs directed at common or closely related purposes that a meaningful portion of the agency’s resources is dedicated to achieve [2] Services collections, staff assistance, and time; all resources which contribute to the provision of support to the general public. Capacity role, e.g.: the library performance in its capacity as a provider of service. Analysis could equally be called environmental scan. That business term encompasses analysis of factors contributing to operations both within and external to the library. However, the project is not prescriptive in nature; it is not intended to evaluate performance or to promote any particular plan of action. 1 Policy Statement by the Medical Library Association and the Consumer and Patient Health Information Section (CAPHISIMLA) Bulletin of the Medical Library Association 1996 Apr;84(2): Hatry, Harry P. (1996). Measuring program outcomes : A practical approach. Alexandria, Va.: United Way of America.