The Three Ps of Hospital Library Success

1
The Three Ps of Hospital Library Success

• Be Proactive, Political and Practical!
• Using the MLA Benchmarking Network
• Rosalind. F. Dudden, MLS, AHIP/DM, FMLA
• Health Sciences Librarian
• Gerald Tucker Memorial Medical Library
• National Jewish Medical and Research Center
• Denver, CO

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Outline

• Comments on being Proactive, Political and
  Practical!
• Overview of MLA Benchmarking Network site
• Comments on my new project

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MLA Benchmarking Network

• MLA Benchmarking Network Editorial Board, 04--
• Michelle Velesko, Chair
• Benchmarking Implementation Task Force, 00-03
• Debbie Rand, Chair
• Benchmarking Network Task Force, 96-99
• Bernie Todd Smith, Chair
• Data Collection and Display
• MLA Headquarters team, lead by Kate Corcoran

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Background

• There is Data on the MLA site now! 2001 Data.
• From December 2001 to March 2002, MLA members
  provided data on library services and resources
  using a Web intake form.
• The data was edited.
• Tables representing the aggregate data of 344
  hospital libraries were developed and made
  available to members on MLANET in September, 2002
• In March 2003, an interactive site became
  available to survey participants on MLANET. (For
  a fee to all members)

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Background

• From May 2004 to August 2004, a second Web intake
  of data was collected. ALL types of MLA-member
  libraries were asked to participate.
• 373 surveys were returned.

• 132 - hospital, not in a system
• 184 - hospital, in health system
• Total 316
• 12 - health association
• 16 - research institution
• 12 - college/university, do not report AAHSL
  statistics
• 4 - consumer health information service,
  separate facility

• 1 - AHEC that does not serve primarily as a
  hospital library
• 1 - corporate
• 2 - mental health
• 2 - public health
• 1 - veterinary
• 6 - other - 1 government headquarters, 2
  research hospital, 1 hospital branch of academic
  medical center, 1 cancer center, 1 developmental
  center

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Background

• The 2003 data is being edited.
• Should be on the interactive site later this fall
  or early next year.
• Watch for announcements.

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Be Proactive, Political and Practical!

• The Three Ps of Hospital Library Success
• a forum focused on strategies for hospital
  library survival
• being proactive, political and practical.
• Using the MLA Benchmarking Project as a way to
  communicate the library's value.

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Be Proactive, Political and Practical!

• Be Proactive ? ? ?
• Keep statistics!
• Even if you are not asked to!

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Be Proactive!

• What statistics?
• Use the MLA BN Worksheet and start collecting
  now.

Reference Questions (ps01) Mediated Searches
(ps02) Educational Program Sessions
(ps04) Monographs Circulated (ps06) Item Received
from Outside Sources (Borrows) (ps08) Item Sent
to Outside Sources (Lends) (ps09) Expenditures -
Monographs (a14) Expenditures - Print Serials
(a15) Print Monographs (ts01) Current Print
Serials Titles (ts02) Serials Titles/Electronic
Full-Text Access Only (ts04)
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Be Proactive!

• MLA BN Worksheet 2002

8 Parameters of Size Measures 12 Budget
questions 36 questions that asked for numbers 29
questions that asked for a yes or no answer.
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Be Proactive!

• Use you statistics in an Annual Report, even if
  it is not required.

12
Be Proactive!

• Participate in the MLA Benchmarking Network
  during the next intake.
• Start collecting now and in two years, you will
  be ready to report and participate!

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As an aside,

• As a group of 344 hospital libraries, how
  valuable are we?
• What do we contribute to the national information
  infrastructure?

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AAHSL and MLA BN data

• Future Work towards merging AAHSL and MLA BN
  data. What will that show?

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AAHSL and MLA BN data

• Question How does the of support staff
  compare?

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AAHSL and MLA BN data

• Question How does the of expenditures on
  print serials compare?

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Be Proactive, Political and Practical!

• Be Political ? ? ?
• Does your institution do Benchmarking on a
  corporate level?
• What is your bosss opinion of benchmarking?
• Can he/she educate you or visa-versa?

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Be Political!

• Do other departments benchmark?
• How do they do it?
• Can you support them and/or learn from them?

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Be Political!

• What other evaluation methods are used in your
  hospital?
• Do you participate in QA/TQM?
• Can you use your newly gathered stats to help
  you?
• Do you promote the MLA Hospital Library Standards?

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Be Political!

• Contributions of Library and Information Services
  (CLIS)

21
Be Political!

• Contributions of Library and Information Services
  (CLIS)

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Be Proactive, Political and Practical!

• Be Practical ? ? ?
• Have your streamlined your systems? In ILL
• Are you paperless yet?
• Do you use Quickdoc? (200?)
• Do you use the DOCLINE barcodes and have a
  barcode reader? (75)
• How much time would these inexpensive products
  save you?

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Be Practical!

• Be Practical ? ? ?
• Prioritize.
• You cant do everything.
• Balance

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Be Practical!

• Even if you did not participate,
• Look at the BN aggregate tables
• Figure out if they can be of use to you.
• (not an MLA member? Hey be practical join!)

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Be Proactive, Political and Practical!

• Demonstration of the MLA BN, 2002
• Now available on the MLA members-only
  websitehttp//mlanet.org

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Demonstration

• This slide show will move forward at a steady
  pace.

Text will fad in and out.
I have moved my words into the slide to mimic my
speech.
You can go faster using the right arrow, repeat
with the left arrow.
I hope it works out for you.
Lets start the show!
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What do we do? On average that is

• Problem
• Very large/very small libraries distort the
  average.

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Annual Circulation
The answer for all 242 libraries that responded
! But I have 4 FTEs in my library and I circulate
2,835!
! But I work in a 1 person library and I
circulate 471!

• Problem
• Very large/very small libraries distort the
  average.

The outcomes team developed a system of tables to
display the data to take this variation into
account.
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Vocabulary - Parameters

• Parameter
• A numerical value describing a characteristic of
  a population

• Hospital parameters
• Physicians (pa05)
• Hospital FTE (pa06)
• Patient Discharges (pa07)
• Outpatient Visits (pa08)
• Staffed Beds (pa09)
• Patient Admissions (pa10)
• Library parameters
• Total Library FTE (a01)
• Total Expenditures (a21)

First we identified parameters of size for a
hospital, training programs, and the hospital
library itself.
12 parameters of size are used.
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Distribution of a Parameter
Number of libraries in each parameter range for
Hospital FTEs
The parameters were distributed over 8 ranges to
account for the outliers but not eliminate them.
It is an acceptable statistical method to
eliminate outliers but these very large and very
small hospitals need a chance to benefit from the
statistics. The middle ranges need more
comparable statistics. No outliers were
eliminated from the parameters.
Ranges 1 and 8 Extreme Outliers, top and bottom
- 2.5 Ranges 2 and 7 More Outliers , top and
bottom - 10 Ranges 3 to 6 Remaining 75 divide
into Quatriles
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Vocabulary - Measures

• Examples of the 73 measures of library activity
  collected, as developed by the Benchmarking
  Content Team.

Measures Developed
For each measure, this data is reported Number Me
an Median Third Quartile Maximum Minimum
Reference Questions (ps01) Mediated Searches
(ps02) Educational Program Sessions
(ps04) Monographs Circulated (ps06) Item Received
from Outside Sources (Borrows) (ps08) Item Sent
to Outside Sources (Lends) (ps09) Expenditures -
Monographs (a14) Expenditures - Print Serials
(a15) Print Monographs (ts01) Current Print
Serials Titles (ts02) Print Serials
Titles/Electronic Full-Text Access (ts03) Serials
Titles/Electronic Full-Text Access Only (ts04)
The third quartile or 75 mark, was recommended
for use in TQM or QI programs.
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Measures - by - Parameters

• You put these two concepts together
• number of ILL borrows (ps08) by number of
  hospital FTEs (pa06)
• You produce a table that looks like the next
  slide.
• Note that the each of the 4 middle parameters
  have about 60 libraries.
• The total, or All, line shows 311, which means
  that 311 libraries out of 344 participants
  answered BOTH questions, how many FTEs and how
  many ILL borrows.

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Number of ILL borrows (ps08) by Number of
hospital FTEs (pa06)
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How many tables are there?

• 12 Parameters
• Multiplied by
• 73 Measures
• 876 Tables
• on the MLANET Members Only Website
• Available to all MLA members!
• Each table has 6 columns and 9 rows
• 12 x 73 x 6 x 9 46,089,864 numbers

Which table is going to prove your case, or
inspire you to improve you system?
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Demonstration

• To demonstrate the Benchmarking tools on the MLA
  website, what follows are some slides and screen
  shots from the website.
• First we need a question.
• And we need to know how the answer is going to be
  used.
• You can often find an answer to a question, but
  to interpret the answer, one usually needs to
  know why it is being asked.

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Question

• How does the number of Interlibrary Loan Borrows
  relate to the number of
• Physicians
• Hospital FTEs
• Training Positions?
• Which is the best parameter to use when
  describing my library to the administration?
• Which parameter, if it changes, will impact the
  library workload?

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Benchmarking Access

• Get out your membership card
• Use Internet Explorer as a browser
• Go to URL http//MLANET.org

Click on Members Only
Enter UserID
Enter Password
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Benchmarking Access

• Choose Benchmarking Network
• Note other statistical surveys
• MLA/Hay Group Study
• Salary Survey

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Benchmarking Access

• Interactive Site
• Aggregate Tables - First demonstration

Choose --gt
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Benchmarking Access

• Aggregate Data
• Collected December 2001 to March 2002

Resources available to you
Choose
Composite Hospital Library Tables Index to the
tables Explanation of Statistics Used In-depth
explanation of the tables Methodology Description
to use when asked how the figures were
gathered Worksheet of 2001 Benchmarking
Questions To review to see what data was gathered
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Choose a measure
Composite Hospital Library Tables
This page is divided into five parts We assume
that ILL questions are under Public Service
Measures and scroll down to that area. We get a
list that looks like the next slide.

• Administrative Services Measures (Financial), by
• Administrative Services Measures (Staffing and
  Other), by
• Public Services Measures, by
• Technical Services Measures, by
• Special Services Measures, by

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Choose a measure
This screen shot shows that the tables on the
page selected will show the number of borrows.
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Worksheet of 2001 Benchmarking Data
You could also have found out which section the
question was in by looking at the Data Worksheet.

• Public Service Measures
• Resource Use
• PS07. Interlibrary loaning/borrowing indicate
  whether or not
• your library is an official LOANSOME DOC
  provider.
• PS08. Indicate the approximate NUMBER of items
• OF ALL TYPES your library borrows or receives
• from outside sources annually (include ILL AND
• commercial document delivery services.
• PS09. Indicate the approximate NUMBER of items
• OF ALL TYPES your library lends or sends
• to outside sources annually.

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Choose a parameter
To find the data on these three parameters you
need to link into each parameter separately.
These are the twelve parameters, 6 for hospital
size, 4 for teaching hospitals, and two for
library size.
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To Review the Question

• How does the number of Interlibrary Loan Borrows
  relate to the number of
• Hospital FTEs
• Physicians
• Training Positions?

• Assumptions
• Hospital FTEs
• 1500
• Physicians
• 600
• Training Positions
• 20
• Borrowed items
• 1,245

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To Review Choose a measure

• Administrative Services Measures (Financial), by
• Administrative Services Measures (Staffing and
  Other), by
• Public Services Measures, by
• Technical Services Measures, by
• Special Services Measures, by

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To Review Choose a parameter
Number of Physicians in the Hospital (pa05)
Number of Hospital Full Time Equivalent (FTE)
Employees (pa06) Number of Patient Discharges
Annually (pa07) Number of Outpatient Visits
Annually (pa08) Number of Staffed Beds (pa09)
Number of Patient Admissions Annually (pa10)
Number of Postgraduate Training Positions (pa11)
Number of Medical School Clerkships (pa12)
Number of Nursing Student Positions (pa14)
Number of Allied Health Student Positions (pa16)
Number of Total Library FTEs (a01) Total Annual
Expenditures for the Library (a21)
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Interlibrary Loan Borrows by Hospital FTEs
The average for this hospital (Hospital FTEs
1500) is 1,282.
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Interlibrary Loan Borrows by Hospital FTEs
311 libraries answered both questions. The middle
4 ranges have 58 libraries and over. The merged
data of 58 libraries gives the answers a high
confidence level. The librarian could use the
mean or median. When the data is spread as
widely as this, from 216 to 4,400, generally the
median is a more representative number.
In her range of Hospital FTEs, 1500, the median
number is 1,100 borrows.
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Collecting the Data

• Remember the librarian wants to compare three
  tables.
• She can do this visually, or print them out, or
  she can copy them and put them in a spread sheet.
• The next slides show how to export the data to
  Excel.

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Moving data to a Spreadsheet
Using Internet Explorer -- Highlight the table
and Copy
52
Moving data to a Spreadsheet
Open up an Excel Spreadsheet -- Put your cursor
in the first cell -- Paste
After you paste the three tables into Excel, you
can move the data around to produce comparative
tables.
53
Working in a Spreadsheet
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Median for Each Range
This is the data that produced that chart on the
previous slide.
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Interpretation - The difficult part! - I may be
wrong!

• Question (review)
• How does the number of Interlibrary Loan Borrows
  relate to the number of Hospital FTEs,
  Physicians, Training Positions?
• Interpretation
• Given that the training program figure was not
  only higher but closer to the librarys own
  figure of 1245, any personnel cuts or additions
  in that program would most likely impact the
  workload more than the other two parameters.

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Benchmarking AccessPart 2 - Interactive Site
Go to URL http//MLANET.org
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Benchmarking Access
Choose --gt
58
Benchmarking Access
This takes you to a page where, if you are a
participant, you can login. Any MLA member can
buy access to the site.
59
Benchmarking Network Report Selection
Step One Demographic Selection
You can chose to match your fiscal year to the
results.
You can choose to use only your state or region.
But if you are from Utah, only one person
participated and that person was you.
But if you are from the Midcontinental region,
29 libraries participated.
60
Benchmarking Network Report Selection
Step Two Select One or More Criteria Similar to
Your Institution
You can chose to look as system data . 99
hospital classified themselves as systems.
If being, or not being, a teaching hospital is
important to your operation, this is the only
place to choose this option.
It was not possible to choose this parameter on
the tables.
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Benchmarking Network Report Selection
An example of output from the interactive
tables. By choosing teaching hospital, you are
automatically limiting your retrieval to less
than 225 hospitals.
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Benchmarking Network Report Selection
Step Two Select One or More Criteria Similar to
Your Institution
By choosing the parameter for training positions,
we are limiting ourselves to teaching hospitals,
so we chose I dont care.
We scroll down and choose the three parameters we
want.
Here we have chosen range 5 for number of
physicians.
We would then scroll done choose range 4 for
number of hospital FTEs and range 3 for number of
training positions.
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Benchmarking Network Report Selection
Step Three Data Category Selection
Here you select your set of measures. All the
measures for each section are displayed on the
results page. The results page is too long to
display in a slide show.
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Benchmarking Network Report Results

• Based on your selections, there were 3
  institutions that matched your criteria.
• If fewer than five institutions have met your
  criteria, they are not identified here, for
  confidentiality reasons.
• To increase the number of institutions matching
  specific criteria you choose, go back to the
  selection page and use fewer criteria.

65
Benchmarking Network Report Results
With the three hospitals, one of them must be
you, so you are comparing yourself to only two
other hospitals. With only three results and the
median and maximum the same, one can hypothesize
that two libraries are reporting 1245 and one
fewer than 904.

• Total Number of items received from outside
  sources annually (borrows) ps08

So you go back to the selection page.
66
Benchmarking Network Report Selection
We chose all teaching hospitals instead of a
parameter for number of training positions.
We scroll down and choose the other two
parameters we want.
Here we have chosen range 5 for number of
physicians.
We would then scroll done choose range 4 for
number of hospital FTEs.
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Benchmarking Network Report Results
This time you get nine libraries from around the
country. They are similar in size but do not
necessarily have the same number of training
positions. From this list and others that you
produce, you could select benchmarking partners
to do process improve projects, as described in
the Fact Sheet available on the MLA Benchmarking
website.
Based on your selections, there were 9
institutions that matched your criteria ,
including your own (marked by an asterisk). They
are 1 Pomona Valley Hosp. Medical Ctr. Pomona,
CA 2 Presbyterian Intercommunity
Hospital Whittier, CA 3 St. Vincent
Hospital Worcester, MA 4 Durham Regional
Hospital Durham, NC 5 Medical Center at
Princeton Princeton, NJ 6 Mercy Fitzgerald
Hospital Darby, PA 7 The Westerly
Hospital Westerly, RI 8 Primary Children's
Medical Center Salt Lake City, UT 9 Waukesha
Memorial Hospital Waukesha, WI
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Benchmarking Network Report Results
In these results, even with the large maximum,
the mean and median are not that far apart so
here the median again shows that your number of
borrow compares of others. It is by chance the
same number. Nine teaching hospitals with the
same range of Hospital FTEs and Physicians have
data comparable with yours activity.

• Total Number of items received from outside
  sources annually (borrows) ps08
• Teaching Hospitals Physicians - Range 5
  Hospital FTEs - Range 4

N9
Unfortunately, the chart does not work out as a
visual.
69
Benchmarking Network Report Results
If you go back to the interactive site and try
again, here are some different results.
This time you choose all hospitals to see what
the result will be. This time, 12 hospitals with
the same range of Hospital FTEs and Physicians
have data comparable with yours activity, but
slightly higher.

• Total Number of items received from outside
  sources annually (borrows) ps08
• All Hospitals Physicians - Range 5 Hospital
  FTEs - Range 4

N12
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Interpretation - The difficult part! - I may be
wrong!

• Given 9 teaching hospitals with the same range of
  numbers of hospital FTEs and physicians, the
  number of borrows was similar to ours.
• Given 12 hospitals, teaching or not, the
  indicators are higher.
• Still use the Training Positions as an indicator

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Conclusion

• Have your question in mind all the time.
• Know what questions were asked.
• Take you time surveying the aggregate tables that
  answer your question.
• Use the interactive site to refine your
  parameters of size.
• Use the interactive site to identify Benchmarking
  Partners for process analysis.

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MLA Benchmarking Network
Participate, when asked!
Survey 2006!
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Next Project

• Write a book about the BN
• But, what about other methods of evaluation?

74
Write a book

• How would I have the time or energy?
• Can I really give up Law and Order?

75
Write a book

• Write an NLM Publications grant
• Write it well
• Get the money - 50,000 a year to cover your
  salary and expenses.
• .5 FTE to write the book - grant
• .5 FTE to manage the library - institution
• .10 FTE for advice from a biostatistician

76
Write a book - working title

• Survival Strategies in the 21st Century for Small
  Libraries A How-to-do-it Manual for Librarians,
  Utilizing the Medical Library Association
  Benchmarking Network Survey
• As titles go, its a little long!
• MLA-Neal-Schulman publication

77
Write a book - Objectives

• ? Describe the use of evaluation and assessment
  tools.
• ? Analyze the results of the MLA Benchmarking
  Network survey as applied to practical
  situations.
• ? Demonstrate various evaluation methods for
  librarians using the MLA Benchmarking Network
  data.
• ? Demonstrate useful evaluation tools for
  librarians to defend the total library program.
• ? Demonstrate useful evaluation tools for
  librarians to implement or improve library
  services.

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Write a book - How to do it

• Chapter 6 Program Evaluation
• Chapter 7 Needs Assessment
• Chapter 8 Benchmarking
• Chapter 9 Performance Improvement (PI)
• Chapter 10 Library Standards

79
Write a book - Why evaluate?

• Chapter 1 Introduction
• Chapter 2 Method of Research and Overview of the
  Participants in the MLA Benchmarking Network
  Survey
• Chapter 3 Snapshot of Small Health Sciences
  Libraries Using the MLA Benchmarking Network
  Survey
• Chapter 4 The Ideal Library
• Chapter 5 The Ideal Librarian
• Chapter 11 Conclusion
• CD-ROM with the actual 2004 BN data

80
Write a book - Why evaluate?

• Chapter 4 The Ideal Library
• The question comes up, Is this library service
  delivering the services the customer needs in the
  best possible way? Is the service
  right-on-target? Should we be doing more? Less?

81
Write a book - Why evaluate?

• Chapter 5 The Ideal Librarian
• Competencies for Special Librarians of the 21st
  Century
• MLAs Platform for Change

82
Write a book

• 2004
• Feb 1 - Applied for grant
• Aug 1 - Got good score
• Nov 1 - Receive money and start (perhaps!)
• 2 years - finish and publish, Nov 1, 2006

83
Write a book

• I hope it will be useful for the busy librarian!
• Wish me luck!

84
Conclusion

• There are many roads to success.
• As you have heard here today.
• You are on the right road just be attending this
  seminar.

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MLA Benchmarking Network
Participate, when asked!
Survey 2006!