INTRODUCTION
Health system mergers have affected hospital libraries and their services in many ways. A careful review of the literature revealed a paucity of papers addressing these issues [1–3]. Masys, in his 1995 Joseph Leiter NLM/MLA Lecture, recognized that while mergers foster cost cutting and decreases in administrative services, they may create opportunities for new internal information services for combined operations [4]. This brief communication chronicles the positive impact of a merger on three hospital libraries and a school of nursing library that evolved into a system with combined resources, improved buying power, and the ability to provide much more extensive access to current health information.
HISTORY
The Atlantic Health System (AHS) in New Jersey was created in 1996 by the merger of four hospitals serving eight counties of more than five million residents in the north central area of the state. The system has 1,650 beds and 10,000 employees. The largest hospital has 575 licensed beds and the smallest 265. Within the system are a school of nursing and several schools of allied health. The system also supports 250 residents in twenty-three teaching programs. Each of the four libraries employs at least one master's-degreed librarian.
The four library managers began meeting immediately after the merger was announced, two years before it was finalized. Although collaboration was not mandated, the librarians determined that by working together and providing a plan for library cooperation, they could be proactive about how the libraries would operate in a new environment and realize the greatest benefits for their institutions.
The first step was the preparation of a white paper expressing a consensus of the librarians' ideas [5]. This paper proposed the adoption of a common service philosophy, compatible with AHS philosophy, that put customers first and promoted excellent service while containing costs. Many of the ideas put forth in this white paper—namely collective journal selection, a combined book catalog, and back-up staffing—were later adopted. Reciprocal borrowing was instituted using employees' identification badges as library cards. A preliminary journal study was done. This early study evolved into a primary tool used for collective journal selection. Conducted annually, the study has resulted in the ability to share holdings, eliminate duplicate titles, and add additional titles.
PLANNING
Key elements in the transition were planning, developing a team approach, establishing common goals and objectives, and considering which services could be common to all libraries. Planning efforts involved educating and seeking support from a large number of administrators in the campus hospitals and on the corporate level. The team approach begun by the librarians was later determined by administration to be the best route to much-enhanced library services. There was an obvious advantage to having the collective experience and expertise of four professional librarians working together.
Early in 1999, the AHS vice president of medical education became involved in directing the libraries. At this point, the team approach became an administrative mandate. In an additional effort to ensure that the library system would be established according to best practice, a consultant from a large medical library with many branches was hired. Much of her expert advice was implemented, and her report continues to serve as an overall guide.
A common mission, goals, and shared values have been developed. The document is reviewed and revised on an annual basis. The journal renewal process is done collectively and takes into consideration cost issues, accessibility to full text on the Web, and usage statistics. Interlibrary loan procedures have been modified and require all DOCLINE requests to be forwarded to another AHS library before being routed out into the system. Budgets have not increased. However, by eliminating some duplication in book and journal purchasing, additional dollars have become available to purchase titles in specialized areas. Needs assessments and surveys of library patrons determine which titles to add.
CONSOLIDATED RESOURCES
Greatly enhanced electronic access to information is provided by negotiating joint licenses with database vendors. A wider array of databases including full text is provided to all campuses than any of the libraries were able to provide individually. Passwords give system personnel remote access to this broad spectrum of information. Sources for funding are being pursued to acquire online textbooks through MD Consult and StatRef, among others.
A merged online public access catalog (OPAC) is accessible on the AHS libraries' Web page. The online catalog from Professional Software was selected for this project. Prompt delivery of the books between campuses is facilitated by a daily courier service. The AHS libraries' Web page, with more than 500 medical links, was developed by one of the AHS libraries and later converted to a systemwide Website.‡ One of the system librarians is responsible for updating and maintaining the Web page.
Joint public relations efforts have been undertaken to educate all hospital staff and physicians about the services of the joint library system. These initiatives include participation in employee activities, such as job fairs, and in membership on hospital committees. The librarians contribute a column to the monthly intranet-based employee newsletter. These articles keep physicians and employees apprised of new acquisitions and give tips on how to search the various databases. A computer needs assessment of AHS physicians has identified the need for training. A common Users' Guide has been developed as well as a joint curriculum for database searching and Web searching for credible health information in response to identified needs. Hands-on training in database and Internet searching is ongoing at each site with all classes taught by the librarians. These classes are open to all medical staff and employees of the system. The goal is to have a systemwide medical informatics-training program.
No positions were eliminated as a result of the merger. Management viewed the presence of a library in each location as a necessity, because the hospitals are located approximately twenty miles from each other in a heavily populated metropolitan area. The ability to share staff assures coverage for vacations and other absences. General policies and procedures are standardized to make staff training more consistent and increase the ability of staff to easily work in any library in the system. A joint user survey or needs assessment is conducted across all campuses at least once a year. The survey results have noted a very positive response to the increased access to databases and computer training, although, not surprisingly, users have requested even more full-text material. Methods of reaching nonlibrary users for the next survey are being pursued.
At monthly team management meetings, tasks and responsibilities are rotated so as not to overburden any one site or any one person. This team has been able to capitalize on each librarian's different strengths. Each library has retained its local identity, and the librarians are considered leaders in the effort to create systemwide departments.
SUMMARY
Librarians are acknowledged as leaders in providing information and knowledge management. They recognize the importance of maintaining an awareness of the most cutting-edge information and technology to meet the challenges of new business practices and changes that inevitably occur. Working as a team, the AHS librarians have achieved a level of communication and cooperation that is an example to other departments in the system. The success of the merged libraries has created new opportunities for leadership and growth and an optimistic future.
Footnotes
*Dedicated to the memory of Jo-Anne M. Searle, M.B.A., M.L.S., 1945–1998.
†Based on a presentation at the One Hundredth Annual Meeting, Medical Library Association, Vancouver, British Columbia, May 7, 2000.
‡The Atlantic Health System libraries' Website may be viewed at http://www.infolink.org/ahslibraries/.
Contributor Information
Patricia B. Regenberg, Email: pat.regenberg@ahsys.org.
Mary K. Joyce, Email: maryk.joyce@ahsys.org.
Kathleen Moeller, Email: kathy.moeller@ahsys.org.
Juliette Ratner, Email: juliette.ratner@ahsys.org.
REFERENCES
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