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CHLA Releases Statement on the Importance of Hospital Libraries

May 17, 2021

Statement on the Importance of Hospital Libraries

One of the defining issues of the COVID-19 pandemic has been the frustration of leaders, governments, educators, health professionals and communities over what has been termed an “infodemic.”1 The Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada issued a statement at the beginning of the pandemic on the importance of evidence-based information.

Hospital library workers have been at the forefront of the COVID-19 pandemic and resulting infodemic, supplying urgently needed evidence to health professionals and decision-makers in a rapidly evolving environment. Decision-makers have complained publicly about the problem of misinformation and information overload during COVID-19. However, we continue to see an alarming trend of hospital library closures, budget cuts, and reduction of library staff or redeployment of library staff to other duties, without careful consideration of the impact on timely access to evidence. This access is a high priority criteria for Accreditation Canada2, as well as built into affiliation agreements with medical schools, underlining its importance.

Hospital libraries and their staff are integral to healthcare organizations. We know that using best evidence to inform practice correlates with improved patient outcomes and satisfaction, as well as quality improvement.3-10 Library workers bridge the gap between research and practice, by providing access to best evidence and reducing barriers to evidence-based practice (EBP).5,6,11,12,13 Hospital library workers and resources help improve clinical decision making, prevent adverse events, reduce unnecessary treatments or referrals, aid in informed decision-making about treatment and patient management, and reduce length of stay.7,10,14-21 Evidence-based information often resides behind a considerable paywall21 and university libraries cannot be used to replace hospital libraries and hospital staff access to their subscribed resources, without formal agreements in place to account for resource licensing costs. University libraries are resourced and staffed with a specific focus, and may not have adequate human resources to serve the needs of affiliate hospital staff. Nurses and allied health staff are particularly impacted by these limitations as fewer hold cross appointments and they do not have access to resources through association memberships. In many provinces, hospital libraries are the only specialized health information support options for clinicians and decision-makers.23 Inequity in access to evidence between academic and non-academic milieux also creates inequities of access to information for the most underserved and vulnerable populations, and hospital libraries play an important role in providing access to information for health professionals serving these groups.

At the best of times, it is difficult to understand why decision-makers would choose to cut a valuable health resource given the evidence on the value of hospital libraries. During a pandemic, it is deeply concerning. We ask those managing hospital libraries to carefully consider the vital support these departments offer their organizations before weighing any cuts to the budget or redeploying skilled library staff to perform other duties, particularly during a pandemic. A hospital without a library is missing a key part of the healthcare team, and cannot in good conscience claim to be providing evidence-based care to their patients.

We urge decision-makers to take concrete action, refer to the CHLA/ABSC Standards for Library and Information Services in Canadian Health & Social Services Institutions (2020), and work with health information professionals to ensure that hospital libraries continue to provide access to best evidence and to support healthcare providers in evidence-based practice.

Francesca Frati, President

With support from:

Association des conseils multidisciplinaires du Québec
Contact: Marianne Talbot, President

Corporation des bibliothécaires professionnels du Québec (CBPQ)
Contact: Anne-Frédérique Champoux, présidente,

Health Libraries Association of British Columbia
Contact: Pam Harrison, President

Manitoba Association of Health Information Providers
Contact: Carol Cooke, President

Ottawa Valley Health Libraries Association / Association des bibliothèques de la santé de la Vallée d’Outaouais
Contact: Kelly Farrah, President

Saskatchewan Health Libraries Association
Contact: Lance Fox, President

Southern Alberta Health Libraries Association
Contact: Kathryn Tippell-Smith, President

Toronto Health Libraries Association
Contact: Nazi Torabi, President


  1. World Health Organization. (2021). Let’s Flatten the Infodemic Curve.
  2. Accreditation Canada. (2017). Standards: Leadership. For surveys starting after January 1, 2019.
  3. Garcia JL, Wells KK. Knowledge-based information to improve the quality of patient care. J Healthc Qual. 2009;31(1):30-5. Epub 2009/04/07. doi:10.1111/j.1945-1474.2009.00006.x.
  4. Holst R, Funk CJ, Adams HS, Bandy M, Boss CM, Hill B, et al. Vital pathways for hospital librarians: present and future roles. J Med Libr Assoc. 2009;97(4):285-92. Epub 2009/10/24. doi: 10.3163/1536-5050.97.4.013.
  5. Marshall JG, Sollenberger J, Easterby-Gannett S, Morgan LK, Klem ML, Cavanaugh SK, et al. The value of library and information services in patient care: results of a multisite study. J Med Libr Assoc. 2013;101(1):38-46. Epub 2013/02/19. doi:10.3163/1536-5050.101.1.007.
  6. McGowan J, Hogg W, Campbell C, Rowan M. Just-in-time information improved decision-making in primary care: a randomized controlled trial. PLoS One. 2008;3(11):e3785. Epub 2008/11/22. doi: 10.1371/journal.pone.0003785.
  7. Perrier L, Farrell A, Ayala AP, Lightfoot D, Kenny T, Aaronson E, et al. Effects of librarian-provided services in healthcare settings: a systematic review. J Am Med Inform Assoc. 2014;21(6):1118-24. Epub 2014/05/30. doi: 10.1136/amiajnl-2014-002825.
  8. Westbrook JI, Coiera EW, Sophie Gosling A, Braithwaite J. Critical incidents and journey mapping as techniques to evaluate the impact of online evidence retrieval systems on health care delivery and patient outcomes. Int J Med Inform. 2007;76(2-3):234-45. Epub 2006/06/27. doi: 10.1016/j.ijmedinf.2006.03.006.
  9. Bryant SL, Gray A. Demonstrating the positive impact of information support on patient care in primary care: a rapid literature review. Health Info Libr J. 2006;23(2):118-25. Epub 2006/05/19. doi: 10.1111/j.1471-1842.2006.00652.x.
  10. Brettle A, Maden M, Payne C. The impact of clinical librarian services on patients and health care organisations. Health Info Libr J. 2016;33(2):100-20. Epub 2016/02/19. doi:10.1111/hir.12136.
  11. Bartlett JC, Marshall JG. The Value of Library and Information Services in Patient Care: Canadian Results From an International Multisite Study. Journal of the Canadian Health Libraries Association [Internet]. 2013; 34.
  12. Marshall JG. The impact of the hospital library on clinical decision making: the Rochester study. Bull Med Libr Assoc. 1992;80(2):169-78. Epub 1992/04/01.
  13. Lovasik BP, Rutledge H, Lawson E, Maithel SK, Delman KA. Development of a Surgical Evidence Blog at Morbidity and Mortality Conferences: Integrating Clinical Librarians to Enhance Resident Education. J Surg Educ. 2020;77(5):1069-75. Epub 2020/06/20. doi:10.1016/j.jsurg.2020.03.024.
  14. Brettle A, Maden-Jenkins M, Anderson L, McNally R, Pratchett T, Tancock J, et al. Evaluating clinical librarian services: a systematic review. Health Info Libr J. 2011;28(1):3-22. Epub 2011/02/15. doi: 10.1111/j.1471-1842.2010.00925.x.
  15. Naeem SB, Ahmed S, Rabbani MW. The Impact of Hospital Libraries on Patient Care and Clinical Decision-Making: A Survey of Teaching Hospitals. Journal of Hospital Librarianship. 2013;13(2):120-30. doi: 10.1080/15323269.2013.770381.
  16. Farrell A, Mason J. Evaluating the impact of literature searching services on patient care through the use of a quick-assessment tool. Journal of the Canadian Health Libraries Association/Journal de l’Association des bibliothèques de la santé du Canada. 2014;35(3):116-23.
  17. Marshall JG, Morgan JC, Thompson CA, Wells AL. Library and information services: impact on patient care quality. Int J Health Care Qual Assur. 2014;27(8):672-83. Epub 2014/11/25. doi: 10.1108/ijhcqa-10-2013-0119.
  18. Sakai Y, Sato Y, Sato M, Watanabe M. Clinical usefulness of library and information services in Japan: The detailed use and value of information in clinical settings. PLoS One. 2018;13(6):e0199944. Epub 2018/06/29. doi: 10.1371/journal.pone.0199944.
  19. Mulvaney SA, Bickman L, Giuse NB, Lambert EW, Sathe NA, Jerome RN. A randomized effectiveness trial of a clinical informatics consult service: impact on evidence-based decision-making and knowledge implementation. J Am Med Inform Assoc. 2008;15(2):203-11. Epub 2007/12/22. doi: 10.1197/jamia.M2461.
  20. Urquhart C, Turner J, Durbin J, Ryan J. Changes in information behavior in clinical teams after introduction of a clinical librarian service. J Med Libr Assoc. 2007;95(1):14-22. Epub 2007/01/26.
  21. Banks DE, Shi R, Timm DF, Christopher KA, Duggar DC, Comegys M, et al. Decreased hospital length of stay associated with presentation of cases at morning report with librarian support. J Med Libr Assoc. 2007;95(4):381-7. Epub 2007/11/01. doi:10.3163/1536-5050.95.4.381.
  22. Buranyi S. (2017). Is the staggeringly profitable business of scientific publishing bad for science? The Guardian.
  23. Barrett, A. & Hancock, K. (2021). Access to Evidence-based Research for Unaffiliated Healthcare Providers and Policymakers: a Canada-wide Environmental Scan with Consideration of Options for Nova Scotia.

(Via Canadian Health Libraries Association)

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