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June 2007
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August 2007

Hospitals Need Librarians -- Whether They Know It or Not

A couple of days ago a hospital librarian colleague queried me about a situation she was aware of where a nearby university had arranged with a local hospital to provide access to e-resources to physicians at the hospital that they were trying to recruit as adjuncts.  (Medical schools commonly develop these kind of adjunct or "volunteer faculty" relationships with local physicians, who can then serve as preceptors for med students.  Typically, the docs don't get paid for this, so med schools are always trying to come up with perks that will entice them to continue to participate). 

My colleague was concerned about the impact of these sorts of relationships on hospital libraries, saying, "Add all of this to the new change in the JCAHO guidelines and I believe we are in for many more closings ahead." 

This is a tough one.  We've been seeing a decline in the number of hospital libraries for some years now.  It's driven partly by hospital mergers, partly by cost-cutting on the part of administrators who don't see the value of keeping a library when more and more information is available online.   The JCAHO guidelines that my colleague refers to are from the "Joint Commission" which accredits hospitals.  At one time, they required hospitals to have libraries, but that was changed many years ago to a more general requirement that they have some arrangements for providing knowledge-based information.  In the current round of revisions, they may be weakening that requirement even more.  Now, my colleague looks at this relationship between a hospital and a local university and sees one more potential threat.  She wonders what I think about all of this.

I thought about it for a day or two, and then sent her this:

I don't know enough specifics about the situation you describe to comment on whether any of these moves are good or bad for the various organizations involved, but I think you are probably right that we are going to continue to see hospital libraries closing. We're in a time where there is going to be massive restructuring going on, and whenever that happens in an industry there's going to be considerable upheaval.

I just wrote a blog post on outcomes -- something that I'm very focused on these days. In some of the presentations I've been doing lately, I've been arguing that we put too much emphasis on "libraries" and not enough on "librarians".  Much of the discussion within the hospital library community has been preoccupied with keeping hospital libraries open and, heretical though it may be to say this, I'm not at all sure that's where the focus should be.  I do think that every hospital ought to have a good librarian -- I'm not convinced that means that every hospital needs a library.  But for many librarians, that's nonsensical -- what's a librarian without a library?  In my comments on the JCAHO website regarding the proposed changes I didn't talk about the need for a library at all -- but I said that in this very complicated information age in which we live, every hospital needs a specialist who can assess what the information needs of the institution are, figure out the most cost-effective ways of meeting those needs, and then provide the training and support for people to use those efficiently.  I argued that the need for that is greater now than ever before and that a hospital that doesn't invest in a specialist to help them do that is not going to be managing their decision making processes as efficiently and effectively as they need to.

So what does that mean in practice?  The answer is going to be different in every situation, but in some cases it might mean that it is the hospital librarian who recommends developing partnerships with local universities and who suggests to the administrator that "we should quit spending money on our own licenses because we can be more efficient by developing relationships with other institutions, and then putting our energies here into training and support so that people are using things effectively. We should be developing patient oriented resources so that we're sure that when people leave the hospital they know how to find the information they need to take better care of themselves. We should be very carefully targeting our own funds to meet the needs of those within the institution who are not being well served by the resources available through the other partnerships and alliances we can establish."  But the specifics will be different in every case.

I don't know if any of that is applicable or useful to you in your situation, or if it'll just make you more depressed.  (I hope not!)  I've got a good friend who runs a small local bookstore -- the kind that is going out of business all over the country.  He's thriving and, in fact, is actually making a better profit now than he was for the first ten years he was open.  And he can point to many other independent bookstores around the country who are doing the same.  He's done it by radically rethinking his role in the community.  He and I get together every couple of months to drink a bottle of wine and talk about the similarities in the challenges that we face.  We believe that it is still possible for independent booksellers and for librarians to be successful (although there's no guarantee that whatever you do you'll be successful in any particular setting or situation) -- but it does require radical rethinking.

I'd write more, but I've gotta go. Hang in there....

Outcomes, outcomes, outcomes...

We had a workshop on developing logic models a couple of days ago.    I thought it went pretty well, and I'm hopeful that using the logic model process will help us in our planning and implementation.

There's a danger, of course.  Planning tools get a bad reputation when they become ends in themselves and people start to feel that they're spending endless amounts of time filling out forms and going through useless exercises rather than actually doing anything.  Our trainer pointed that out as one of the risks.  It's critical for us that we use the tools efficiently and only to the extent that they're helpful in focusing our attention.

What I'm most interested in is the emphasis on outcomes, and on the measurement of outcomes.  I still cringe when I read discussions among librarians that focus on thinking up things that will get people to come to the library, as if bodies in the library is the goal.  Number of bodies might be an indicator, but only if that is tied to something that is making a positive difference in the lives of the people who happen to come in.   I've said it many times:  my goal is not to build a better library -- it's to figure out what we can do to make a positive difference for the people in our communities.

Despite all of the Library 2.0 talk out there, I still don't see sufficient attention paid to this.  Indeed, we frequently seem to be working from the assumption that libraries are inherently good and necessary, and that our job is to figure out how to raise our profile so that people will appreciate how important our libraries are (and thus, continue to fund them and to keep us employed, by the way).  But we should be trying to prove it, not assume it. 

So all the discussions about "what will keep people using the library" (whether you mean that in the physical or virtual sense) seem to me to be wrongheaded.  The question ought to be, "what can we, as librarians, do to make a positive difference in the lives of the people in our communities?"  If you can't come up with an answer to that question, and then demonstrate that the programs and services that you provide actually make that difference, then, frankly, it would be irresponsible of the people who hold the purse strings to keep funding you.

That's what the logic model process is about -- making sure that we keep our attention focused on the needs of the people in our communities, and then demonstrating that we're making a difference.  Over the next few weeks, we'll be trying to apply logic models to just a few of our major initiatives so that we can get a better feel for how they work and how we can best use them.

The end of the story

Lynn and I had to promise Marian that we wouldn't discuss Harry Potter and the Deathly Hallows without her.   So when Lynn and I finished our copies early in the afternoon on Sunday, we didn't say much more than to agree that it was very satisfying and an excellent finish to the series.    By Monday afternoon, Marian called to say that she'd be finishing it that evening, so could she and Josie come over for dinner the next night so we could talk.

They were at the house when I got home and Lynn was right behind me.  L & M immediately plunged into business talk (the opening is just two weeks away), while Josie "helped" me get dinner on.  I confess that I was getting a little worried that Marian was forgetting why we were getting together in the first place, but once we all sat down she said, with a big grin on her face, "And now...  Harry Potter!!"

Overall, our responses were generally in line with each other.  There were a couple of puzzles one or the other of us was still a little confused about, and we had to go back to the ending of the previous book to work out the wand thing.  Marian and I had slightly different feelings for the last chapter, but there were no significant differences of opinion.  We were all quite satisfied, a little sad that it was finally over, and looking forward to rereading the whole series again sometime.

In recent weeks, I've seen a couple of essays bemoaning the fact of adults spending time on the Harry Potter novels when, I suppose, we're supposed to be reading more "serious" books.  I don't begrudge anybody's opinion on the matter, but it seems like an awfully narrow view of the pleasures and profit of reading to me. 

A couple of years ago, in advance of my first trip to Ireland, I blocked out a long weekend to reread Joyce's Ulysses (for the 4th time), because I think it's a great fun book and I wanted it to be fresh in my mind when I first walked the streets of Dublin.   In the last couple of months I've read (among other things) the new novels by Chabon & Lethem, The Education of Henry Adams (for the 2nd time) -- arguably the best book to come out of the US in the 20th century, Weinberger's Everything Is Miscellaneous (which I found to be a little too facile & glib, although it has some good points), a couple of De Botton's amazing excursions into literature, philosophy and art, Nitobe's Bushido (on the flight to Tokyo) and, oh yeah, the sixth Harry Potter (for the 2nd time) so that I'd be primed for the new one.  So what does that say about my approach to reading?

What I don't do is make much time to watch television.  It struck me when the Emmy nominations were announced that, except for The Daily Show & Colbert (which we put on when we go to bed at night), I haven't seen a single episode of a single series that's been nominated, and I haven't seen a single one of the various specials or one-shot shows that are up for awards. 

This is not a matter of snobbery.  There's a tremendous amount of really good stuff on TV that I know I would enjoy and it pains me that I don't make the time to see it.    On Friday & Saturday nights, Lynn and I will watch a movie or two, or episodes of the new Dr. Who series on DVD (or, sometimes, Xena or X-Files), but that's a special thing that we do together.  Occasionally, I'll then stay up late and watch DVDs of music performances -- David Gilmour, Dylan, U2, the Old Grey Whistle Test, Tom Petty...  But on any given evening, when I've finally got an hour or two to myself, reading always takes precedence.

Do I bemoan the fact that reading for pleasure seems to be declining among adults?  No, actually.  When I was growing up, I didn't have many peers who read much.  My mother reads all the time, but my dad read hardly ever, and my siblings' habits are all over the place.  The fact that we live in a culture where there is such a vast array of media available to stimulate and entertain is marvelous, and I don't know why reading, in and of itself, should get some sort of pride of place.

I wish that people were more thoughtful about the world than they typically are, that they would challenge received wisdom more, that they would question their own motivations and actions and strive constantly to be better people more than they seem to.  Reading widely has helped me to do that, but so will any activity that exposes one to new ideas and different cultures.  Sticking with the familiar, and seeking out only those opinions and ideas that confirm what one already feels -- that's the dangerous route, no matter what the medium is.

On connecting...

Despite the never-ending angst in the biblioblogosphere over the sad state of the culture of librarianship, I remain optimistic about the state of my profession.  It's still hard for me to believe that things are really as dire as some folks seem to think, when I see so much evidence to the contrary all around me.  But then, as I've said before, I know that all organizational/professional/social groups advance on a bell curve, with a relatively small group of innovators on the leading edge, a large middle group cautiously moving along, and a relatively small group of laggards whining and complaining and dragging their feet.  It sometimes seems to me that those among us who are most critical of the state of the profession take the trailing edge as emblematic, while it seems to me that those on the leading edge are the true heralds of where we're going.  But I also know that the shape of the curve itself is never going to fundamentally change.  It's got nothing to do with the "culture of librarianship" and everything to do with human nature.

That being said, when I read all the  fussing and worrying I'm grateful that I ended up in academic medical libraries, rather than general academic libraries.  Anecdotally, at least, there seems to be more innovation, willingness to experiment, and less resistance to change than would appear to be the case in other library sectors.  Part of that, though, is just that we're smaller.  I run a relatively large academic medical library, and it's still only 60 people.  And our association is much smaller than ALA -- we get 3,000 people at our annual conference rather than 20,000. 

The current MLA president, Mark Funk, set up his blog this week, and the social networking taskforce is charging ahead.  The board of directors has been doing much of its work via email for several years, and we're now using a blog to track our discussions of issues.  Most of the sections & committees are experimenting with various online mechanisms for getting their work done (the HLS wiki is particularly good).

What intrigues me the most is how all of this activity changes the way that the organization does business.  Earlier this week, Jane (A Wandering Eyre) posted a typically impatient note on meetings, asking why we insist on having meetings to do things that are easier done on the web.   Jane thinks that people use f2f meetings to hide process and hang on to power.   I suppose there may be some of that,  but my experience, at least, suggests that inertia, inexperience, and the desire to avoid looking like fools account for most of it.  If you read the literature on meetings and group dynamics, you know that there is a life-cycle to groups and that a certain comfort level with the members of the group needs to be achieved before the group can really function effectively.  The primary reason that most meetings & taskforces are so ineffective is that the organizers don't pay attention to that life-cycle.  The process is crippled from the start.

Jane is, of course, quite right that much of what we try to do in physical meetings can be much better done online.  But the same social dynamics process will have to take place.  And now it's not just a matter of exposing yourself to people in a meeting room who you might not know well and who you might not entirely know how to trust -- you've got to do that while there are untold, unknown numbers of other people potentially watching from the wings.  The paradox is that the more transparent you make the process, the more hesitant some people will be to risk putting their best ideas forward, for fear of looking foolish or being criticized.  That's a human hurdle that'll have to be overcome.  I think we'll get there, but there's a learning curve, as the occasional flame wars on the web have shown.  As Mark says at the end of his first post, "Play nice, and no hitting."    Establishing an online culture that demonstrably lives by that is essential.

Guitars on five continents

At dinner the first night in Bouen-Gun, Mr. Choi was telling me about the Koreans and their love of drinking and singing.  "Mr. Scott sings," said someone else at the table.  He was referring to the Bearded Pigs.  "He sings in a rock band."

"A rock band!" said Mr. Choi.  "You'll sing for us?  At dinner tomorrow?"

"I will if you can find me a guitar," I said, laughing. 

"Only with a guitar?  You won't sing without?"

"I can only sing with a guitar," I apologized.  "But if you can find me one, I'll sing."

We were an hour and a half from the nearest town of any size and three and a half hours from Seoul, so I didn't hold out much hope; but they're enterprising folks, and at lunch the next day someone came up to Mr. Choi and whispered in his ear.  He beamed at me, "We have a guitar."

Sure enough, when I went back up to the conference room, there was an acoustic guitar laid out on one of the tables.  I still have no idea where it came from -- when I asked, someone gestured vaguely and I left it at that.  I picked it up and strummed a bit -- close to being in tune, nice sound, good feel to it.  A brand I'd never heard of -- I'm assuming it was Korean made.

Mr. Choi asked me if I wanted to sing something to start off the afternoon session, but I demurred.  Somehow I didn't think it'd set exactly the right tone for Joep's presentation; but I promised him that I'd play something that evening.  When we got to the dining room, the guitar was propped up in a chair front and center.   We sat and ate another fabulous meal, drank more soju and I was ready to play.   I picked up the guitar, propped one foot on the chair, and motioned for Soyeon, my interpreter, to join me for a minute. 

"You don't need to interpret the lyrics -- I just want to tell them what the story is, okay?"  She nodded.  I told them the story of the sad old woman, who looks back at her life and the love that was lost and the bitterness and loneliness that she feels now and how living every day is very hard.   I played  Angel From Montgomery.  Much applause and hoots of approval.  "More!  More!"

I called Soyeon back up.  "I'm just going to play one more.  I'll do one that  I wrote."  And I told them the story of  Little Black Car and how it had been during the time that Lynn and I lived in different cities and that I wrote it to commemorate the way I felt on that long eight hour drive  from  St. Louis to Birmingham.  It's a nice little rockabilly tune, and by the end of the intro they were all clapping along.  More applause and hoots and hollers and then, of course, pictures had to be taken with "the singing librarian."  I had a good time.

So that was my Asia debut.  I've now played guitar and sang for people on five continents -- N. America, Africa, Europe, Australia and Asia.  I'm confident that the other two will come in time.

I was talking with Soyeon later about the importance (to me, at least) of having that outlet -- the work that I do as a library director is very intense, but also very nebulous.   I almost never accomplish anything concrete -- my job is seeding ideas, putting things in motion, creating a positive environment -- the real, measurable accomplishments are all done by others.  But when I pick up the guitar and get ready to sing a song, it's immediate, it's right there, it works or it doesn't.  I'm happy with the performance or not, and then it's over and it's on to the next one.  It's a completely different experience from my daily work and it's tremendously satisfying.  I think it makes me a better librarian.

So tomorrow, Bestwick and I will be at Marty's for happy hour -- the first of three Fridays in a row.Tsscottrick   We've done a series like this a couple of times before and it's great fun.  It's very relaxed and informal.  We trade off songs some, do some duets, occasionally other people show up to sit in.  After an intense week focused on budget and annual planning, I can't think of a better way to kick off the weekend!

Some weeks are more interesting than others...

After a week on the other side of the Pacific, the Crown Room at Hartsfield's B Concourse feels foreign and exotic, despite the number of times I've been here before.  My internal clock reads about 1 in the morning, but I feel fine -- just eager for this last little hop back to Birmingham.  I'll stop at Marian's on the way home so I can give presents to the girls.

I was quite impressed by how seriously the librarians at Songnisan took their workshop assignment.  They were working in their groups until late in the evening planning, and then spent the first part of the morning laying everything out on the flip charts.  The assignment that I'd given them was to identify a particular target group at their institution, analyze their needs, and develop services that would require them to get out of the library and engage with that group in new and creative ways. 

All of the presentations were good, and each one had something special to recommend it.  When the presentations were all finished, Joep and Mr. Choi and I went out into the anteroom to compare notes and select our winners (there were cash prices for 1st, 2nd & 3rd place).  We went back in and I told them that I thought they were all great and I wished that I could bring them all back to America with me, because my colleagues there could learn a thing or two from them.  I meant every word.

I made brief comments on each of the presentations, highlighting the specific areas where I thought they'd particularly excelled and then I announced the awards, in reverse order.  There was much cheering and clapping and many pictures were taken.  Then lunch, and goodbyes, and we caught the bus back to Seoul.

There was one more meal to be had.  After saying goodbye to Julie at the hotel, Joep, Inn Beng and I checked into our rooms, and then we headed out to a Korean barbecue place for dinner.  There, we sat around a small round table with a recessed grill in the middle and ate beef with garlic and spices wrapped in lettuce leaves, along with various pickled and marinated vegetables, while we drank beer and soju and talked and laughed and pretended that we weren't all heading off in different directions the next day.

I said it when I started my presentations each day, and after this week I believe it more than ever -- what a fantastic time this is to be a librarian!


I don't usually spend the hour before I do a presentation strolling around a fifteen hundred year old temple complex, but I highly recommend it.  The Lake Hills Hotel (which has definitely seen better days) is just outside the gate of the Songnisan National Park, a stunning area of thickly forested mountains with dramatic rock outcrops jutting through the trees.  According to my Lonely Planet guide, the name means "Remote from the Ordinary World Mountain" and it is certainly remote from my ordinary world.

The temple complex, which is an easy ten minute walk from the hotel, is called Beopjusa.  At least one story goes that a Buddhist monk was on his way to India on pilgrimage, and at this spot his horse went lame, so he took that as a sign that he should stay and build a temple.  Portions of it have been burned and rebuilt a number of times over the centuries, and it continues to develop -- the very dramatic 30-meter high golden buddha statue on the grounds was just completed in 1990, for example.  But the statue stands next to Palsangjeon, the oldest five-story wooden pagoda in Korea, the original parts of which date back to the founding of the temple.

It was early when we were there, and except for a couple of attendants sweeping the porches of the pavilions, there was no one else around.  The weather was mild and humid, with a light fog at the tops of the mountain peaks.  A stream runs along the path from the town and cuts across the front gate of the temple, and one can look down at the small rock towers that the monks build as a meditative exercise.  On the way back, we passed a group of local women from the town, friends of the temple, who were out early, picking up bits of trash and fallen branches from the path, getting it all ready for the day's legion of tourists.

From there, we walked straight back into the conference room and the work of the day.  In Japan, I did one presentation in the morning, and the other after lunch.  Here, they were back to back.   In Japan, the translation was simultaneous, the team of translators hidden away in a booth, and I just had to be sure to speak slowly enough that they could keep up.  Here, it was alternate -- so I'd talk through the points of the slide while the translator made notes.  Then she'd repeat the substance of my comments to the group.  Fortunately, the translator, Soyeon Lee, is a professor of Library & Information Science at Duksung Women's University in Seoul, so she is very familiar with all of the concepts.  It took me awhile to fall into the right rhythm, but as my confidence in her grew during the course of the morning, I think I got the hang of it.  By the end -- three hours after I'd begun -- I felt that it had gone quite well.

The workshop attendees are eager for discussion, and they ask very long, multi-part questions.  We had time for a few before lunch, and then in the afternoon, after Joep finished up his part we had well over an hour of discussion, with questions for both of us.  It's an impressive group.  And just as in Japan, they face all of the same obstacles and challenges that we do in the states, but also as in Japan, I see the energy and intensity among some of these young librarians that convinces me they will overcome those obstacles.

I gave them a discussion assignment that they spent the evening working on.  Later this morning there'll be six group presentations.  Joep, Mr. Choi and I will be the judges and the winners get a cash award, so they're all taking this very seriously indeed.  I have high expectations for the quality of the presentations.

And then, this afternoon, the drive back to Seoul.  The sun is just now burning through the fog, so I think it'll be a pretty day and a nice afternoon for the drive...

The most exciting time

I start my presentations by saying that I believe that this is the most exciting time in at least 500 years to be a librarian.  Based on the people that I've met here, I'm not concerned about the future of librarianship in Japan.  The challenges are huge, of course, but they're not that different here from what they are in the states.  The opportunities are still great, but just as elsewhere it's going to take energy and creativity and the willingness to experiment to create the kind of future that we want to see.  But librarians like the young reference guy from Kyushu University that I met last night are going to make it happen.

The seminar in Kyoto went well.  A somewhat smaller group, and not as many questions after the presentations as in Tokyo (which, I understand, has been the pattern for these seminars in the past), but great conversations during the breaks and at the reception afterwards.  It's been an honor to be able to spend time with these people.

We went to the Yoshikawa Inn for dinner last night.  There were eight of us, off in a separate room, with an incredible garden just outside.  Once again, the food was amazing and beautifully presented.  Food for the eyes, indeed.  And the conversation was great, and there was much laughter, and wonderful stories told by all assembled.

Hard to believe that it's over so quickly.  But I'll come back -- and with Lynn & Marian & Josie as well.  For now, it's on to Korea....

Tokyo Seminar and on to Kyoto

It's a gray and drizzly morning in Kyoto, but I can see mountains in the distance.  By the time we got to the hotel last night, I was too tired to do anything but send a message to Lynn and tumble into bed.  Now I look out, from the 12th floor of my hotel, and see another vast city spread out below me.  A tree-lined boulevard down to my left, what appears to be a large park in the middle distance to my right; a jumble of office blocks and apartment buildings that could be anywhere, and a scattering of smaller buildings that couldn't be anywhere but Japan.

On the bullet train from Tokyo, Yuki was looking through the evaluations from the seminar.  "Here's one that says you were 'inspiring'." 

Good.  "Inspiring" is good.  I certainly can't tell anybody here how to overcome the obstacles that they face in their organizations -- all I can hope to do is share with them some of my own passion and enthusiasm and excitement about being a librarian in the 21st century, and hope it connects with, and reinforces, their own.

I'd been warned by my hosts that the Japanese librarians would be reserved and hesitant to ask questions, but I thought there were quite a few good ones.  Not much different from what I've seen in US or UK audiences.  And I had a chance to talk with a number of people during the breaks and at the reception in the evening.    I was particularly impressed with Mr. Iizawa, director of the Meiji University Library, who was also one of the presenters and appears to be doing great things with establishing partnerships with faculty to set up information literacy classes for the freshman & sophomores in his university.

As far as I know, the translation went fine.  I met with the translators ahead of time for about twenty minutes.  They had printouts of my slides, along with the detailed notes I'd sent a couple of weeks ago.  They had just a few specific questions about words or phrases, or what I was trying to get across with a particular image.  Afterwards, one of them came up and thanked me and said I'd made it very easy for them.  I was grateful for that.  I was surprised, though, how many people were not wearing the earphone while I was speaking (close to half?).  As far as I could tell from body language and facial expressions, at least some of what I was trying to say was coming through.

I was also quite delighted to meet Tamiko Matsumura, Emeritus Professor at the University of Library and Information Science and Professor at Sugiyama Jogakuen University.  Turns out that she was an indexer at NLM back in the late sixties and early seventies.  Ritsuko had arranged for her to have lunch with the speakers, and so we had a fine time sharing stories about some of the NLM people we knew in common.

The program today is an exact repeat of yesterday.  (I was joking with Joep that by the time we get to Korea, he and I will be able to do each other's presentations).  A somewhat smaller audience (there were just over one hundred in yesterday's session and there are 65 signed up for today).  Different set of translators.  And we don't have to dash for the bullet train at the end of it!