Just in time: integrating library services for literature searches in a hospital library setting

Providing timely and comprehensive literature searches is a core service for hospital libraries. These expert searches are mediated across multiple databases and platforms. NSLHD Libraries have pivoted services which were largely site based, to services for staff not just off-site, but when working in isolation across the district. Immediate access to literature searches has been achieved by integrating multiple library services.


Background
Northern Sydney Local Health District (NSLHD) has a community of almost 1 million residents (HealthStats NSW, 2022). Five libraries support a workforce of more than 10,000 staff which includes nurses, allied health staff, medical professionals, community health centers and health service managers. By adopting a strategy of continuous improvement using technology to reduce barriers, NSLHD Libraries supports the NSLHD Strategic Plan vision to be "Leaders in healthcare and partners in wellbeing."

NSLHD Libraries
In 2020 NSLHD Libraries implemented several new resources, Springboard (OVID Discovery) Reftracker (Altarama), and Single Sign-On authentication through OpenAthens. After some months embedding these systems into library workflows, Covid-19 changed the workplace. By early 2021 it became apparent that NSLHD libraries needed to find agile ways to support staff. These new technologies enabled a pivot from services which were largely site based, to services for staff who required access not just off-site, but when working in isolation across the district. As Scott (2021) suggests services need to be re-engineered to meet the needs of staff who struggle to be released from their clinical duties. NSLHD Libraries resolved to implement an improved remote service for clinicians.
Changing environment NSLHD Libraries staff are able to deliver services and adapt to a rapidly changing environment. In doing so this supports the main themes that underpin the NSLHD Strategic Plan (2017-2022) -Evidence Based Decision Making, Responsive & Adaptable Organisation, and an Engaged and Empowered Workforce. All NSLHD Libraries remained open during the pandemic delivering access onsite whilst simultaneously rapidly expanding service delivery offsite and for staff no longer located in their usual place of work. The messaging across the district has been clear and proactive (Haugh, 2021) resulting in a substantial increase of visits to both the NSLHD's 5 Libraries and offsite access via Springboard.

Year
Onsite Removing barriers Time is one of the 8 pain points identified by Laera et al. (2021) when users are accessing clinical information. With staff offsite, furloughed, upskilling, or taking on extra tasks, time is even more compromised. How could some barriers be removed to provide immediate access to search results? NSLHD Libraries set out address these issues.
Literature service review NSLHD Librarians reviewed 5 completed literature searches in a range of topics and databases for patient care for the NSLHD. This amounted to 300 references in total.
The aim of the sample was to address the following issues: Firstly the number of articles available as full text via NSLHD Springboard; secondly articles requiring the document delivery service; and thirdly any technical issues.

Results
Results were encouraging, 70% of the articles were available immediately in full text. The remaining 30% were conference proceedings and results from obscure journals.
These results indicate depth in the NSLHD Libraries collection and reflects the expertise in the selection of relevant journals. Of the 60 citations in an X-Ray search for example, 52 articles were available as full text and only 8 required document delivery (ILLs). No access or authentication issues were identified.
To assist in the design of a study to look at the effect of a chest Xray interpretation tool in the Emergency department.

(ILLs required)
Solutions NSLHD Library staff set out to identify and remove barriers such as the need to fill out an additional form, copying and pasting citations, and the need to contact library staff for assistance. Library staff created a new EndNote output style incorporating Springboard URLs for literature searches. Then by activating the "Auto format" in Microsoft Word the citations could be hyperlinked, ensuring that the user receives direct hyperlinks into Springboard.
Trial of the new service NSLHD Libraries set up a trial of hyperlinking literature searches in July and August 2021. A short survey for users was added to our library forms for feedback. Survey results, though small, were positive, with no issues reported. Additionally no questions or queries were received via the NSLHD's phone and email address. Training sessions for the Library team were set up via video call and work instructions provided. In September 2021 the new hyperlinked search results were implemented across the district.

Conclusion
Hyperlinking citations directly to Springboard gives immediate access to articles. For articles not held at NSLHD, an article request form pops up. Details are prefilled using OpenURL functionality through Reftracker. The implementation of single signon to our library systems, including our Discovery Service, has meant the complex process of remembering additional logins and passwords are no longer required.
Users are familiar with their institutional staff logins and use these to obtain access. This integration represents significant time saving for users and library staff.