by Nina Pals, Sarah Bush Lincoln Health Center Librarian
Measuring return on investment in a hospital library is difficult, as it is in all types of libraries. The literature (King, 1987; Marshall, 1992) has tended toward a more qualitative, but possibly more accurate, measurement. This is to measure the impact on patient care as a result of information provided by the library.
The Rochester Study (Marshall, 1992) detailed changes in patient care reported by physicians based on the information supplied by the library. Changes reported by the physicians: diagnosis (29%), choice of tests (51%), choices of drugs (45%), reduced length of hospital stay (19%) and advice given to the patient (72%).
Physicians also said that the information provided by the library contributed to their ability to avoid the following: hospital admission (12%), patient mortality (19%), hospital-acquired infection (8%), surgery (21%), and additional tests or procedures (49%).
In April and May, 1996, the Sarah Bush Lincoln Health Center Library conducted a similar survey using nearly the same categories as the Rochester Study. The Library distributed surveys with the information returned to patrons who requested a literature search. based on this information, physicians reported that they changed: diagnosis (22%), choice of tests (44%), choice of drugs (33%), choice of other treatments (65%), reduced length of hospital stay (24%), and advice given to patients (39%).
Physicians also stated that the information provided by the library helped avoid the following events: hospital admission (24%), patient mortality (28%), surgery (18%), additional tests or procedures (24%) and additional outpatient visits (35%).
on the question of dollars saved, one physician stated the the information saved $1,000. Another physician reported that the information enabled him to generate an additional $75,000 in revenue.
The most significant result of this survey for Sarah Bush was not identifying dollars saved or generated. It was the knowledge that the information provided by the library resulted in better care for patients and, 28% of the time, helped save lives.
The age of these results and the current economic pressure on health care suggest the need to revisit the survey. As in all libraries, current ROI and impact measurements of library services are critical in times of economic constraint.
King DN. The Contribution of the Hospital Library Information Services to Clinical Care: A Study of Eight Hospitals, Bull Med Libr Assoc. 1987, Oct; 75(4): 291-301
Marshall JG. The impact of the Hospital Library on Clinical Decision Making: The Rochester Study. Bull med Libr Assoc. 1992 Apr; 80(2): 169-78.