IMPACT OF LIBRARY ON HOSPITAL DECISION IN FEDERAL MEDICAL CENTER OWERRI

IMPACT OF LIBRARY ON HOSPITAL DECISION IN FEDERAL MEDICAL CENTER OWERRI

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ABSTRACT

This is a survey of the health information resources availability and pattern of their utilization by doctors in federal medical center, Owerri. A 25 -item structured questionnaire was used to collect data from 1, 995 medical doctors. The data collected were analysedusing Statistical Package for Social Sciences (SPSS 12.0), while Analysis of Variance (ANOVA) was adopted in testing the hypothesis. The results showed that health information resources are moderately available to doctors and that they use them for different purposes. The null hypothesis was rejected as there was significant difference between the mean responses of different categories of doctors on the purpose of use of health information resources. These findings implied that these doctors are being deprived of the privileges of making use of a wide and full variety of health information resources for their different information needs. It was recommended that full range of health information resources be made readily available to doctors in federal medical center, Owerri for optimal performance.

Keywords: Information, health information, health information resources, medical doctors, teaching hospitals, information utilization.

                                                             CHAPTER ONE

                                                            INTRODUCTION

For the purpose of this paper, health information can be defined as that knowledge, facts and news generated from various sources, necessary for good physical and mental condition of human beings. It is in the main sought after and utilized by health professionals including doctors who are the fountainhead of health-givers. Health information resources are the medium of communication between scientists who conduct healthcare and biomedical research and doctors who use their results in medical practice and related purposes. These resources are text or print resources, internet or World Web resources and human resources. Medical text or print resources provide information or knowledge in printed format such as books, journals and grey literature. Books have been in existence and use for centuries now and are regarded as traditional sources of health information. They form the core collection of medical libraries and that of personal collection of the doctors. Medical journals are primary sources of health information as they contain authors own reports of their own studies. The knowledge contained in them represents the most recent in the field (Nworgu.2006). Medical libraries are known for stocking these journals for doctors, who in addition also subscribe to the journals for their personal collection. Grey (or gray) literature is another resource utilized by doctors for extracting health information. Essentially, non-commercial official and administrative documents make up grey literature (Reitz, 2007). Another resource utilized by doctors to acquire health information is the internet. The internet resources also referred to as electronic resources give doctors unlimited opportunity as they may use it for literature searching, accessing online journals and books, searching for patient specific information, professional association updates, consultation with colleagues, e-mails and prescription/patient orders. The internet has made abundance of health information handy for use by doctors just at the click of the mouse within seconds or minutes. Most prominent among the internet resources heavily used by doctors today are the electronic databases. These electronic online databases facilitate doctor’s access to medical literature in books, journals, newspapers, unpublished materials and other relevant sources. Another information resource routinely used by doctors is ‘human’ source. This covers all those doctors contact for health information, and normally includes: specialty consultants, senior colleagues, informed peer and drug information pharmacists. This they do through face-to-face communication, e-mail or telephone contact (Davies: 2007).

All these resources though very vital for teaching and practice are not always available to doctors at the point of need. The extent of availability may also vary from one location to another. However, different factors and circumstances like costs, time, availability and purpose may influence the degree of utilization of the different resources. It is well known that the pace of rapid information generation is higher in health, than any other sector. This has resulted in the availability of vast range of health information resources, that it seems there are almost too many potential information sources for doctors to locate information, efficiently (Davies, 2007). Today, channeling this information to doctors is the major concern of global health bodies and governments. This is more so with Millennium Development Goals (which are mostly health related) in focus. It is certain that this has resulted in the provision of funds and other resources by global agencies like World Health Organization to ensure that health information flows down from their sources of generation to medical doctors for use especially in developing countries. The open access policy is an example of this. What is not certain however are how available these resources are to the doctors in the teaching hospitals in South Eastern Nigeria, and into what use they put the information so extracted. It is in the light of this that this study was carried out.

MEDICAL LIBRARY USAGE PATTERN IN THE ELECTRONIC ENVIRONMENT

 Medical libraries serve both health professionals and students of health sciences. They are involved in the twin purpose of providing learning resources for health professionals and evidence based practice resources to help health professional make good decisions in their clinical practice. Medical libraries of today are operating in the age of electronic and remote access to information. Technology has fundamentally altered library usage pattern. These changes are seen in the notable preference and propensity for electronic resources and remote access to these collections. Franklin and Plum [3] pointed out that the fact that more literature in the medical sciences is available electronically may help to account for why medical library users, and especially faculty, staff, and fellows, choose to use electronic services remotely. Tao, Demiris, Graves, and Sievert [4], noted that desk-top access to online resources is changing library use patterns, which challenges libraries to adjust to this transformed information access environment. As pointed out by Basu and Das [5] other factors are also affecting library use pattern. They include inadequacy of learning materials, non-availability of modern facilities like photocopy, Internet and e-mail services and problem of accessibility might have negative influence on the students in library visit. There is need to help medical students imbibe good library use culture which involve resource use. This is because there are many benefits in the use of medical library resources which has institutionalized access to health information. Libraries have quality collections and also librarians impart the skills needed to access information in the new environment. This can empower students in the ability to identify, locate and use information effectively. In medical education and health care, this is very important because of the emphasis on evidence base practice which requires information skills to harness evidence. The present research is a user study to determine the use of the Medical library in federal medical center, Owerri. This is more so with Millennium Development Goals (which are mostly health related) in focus. It is certain that this has resulted in the provision of funds and other resources by global agencies like World Health Organization to ensure that health information flows down from their sources of generation to medical doctors for use especially in developing countries. The open access policy is an example of this. What is not certain however are how available these resources are to the doctors in the teaching hospitals in South Eastern Nigeria, and into what use they put the information so extracted. It is in the light of this that this study was carried out.

STATEMENT OF RESEARCH  PROBLEM

Hospital programs and services have come under close scrutiny in recent years. The increasingly competitive health care marketplace and concern for the quality of patient care have provided an impetus for careful examination of hospital services. But perhaps a more important motivation for administrative action are recent changes in the federal reimbursement systems for patient care and the expectation that similar models will be used by private insurers. The hospital library has been particularly affected by the following events. A 1983 proposed rule of the Health Care Financing Administration, affirmed in 1984, eliminated the requirement that hospitals maintain a library in order to qualify for Medicare reimbursement . A remarked was made that the need for a hospital library is not self-evident, and that if hospital staff need information, education is a more effective means for disseminating it than libraries. Whatever the validity of Dr. Brandt's opinions (and there is ample evidence that education is not sufficient to meet the clinical information needs of practitioners ), Hardy, Yeoh, and Crawford suggest that it is now up to health sciences libraries to evaluate the impact of their services and assess their worth . Because economic issues and the quality of patient care are closely linked, the contribution of the library to clinical care is an important yet neglected area for investigation. Determining whether and how much libraries contribute to clinical care is difficult. Libraries do not routinely conduct evaluations of their impact, and a system for measuring outputs still needs to be devised. Hospitals have tried evaluating services and quality of care through quality assurance procedures , but the assessment techniques are either inappropriate when applied to the library or provide little insight into the effect of library services on patient care. As a result, evaluations of health sciences libraries are uncommon. When undertaken, they typically address inputs, outputs, and operations (structure and process), with occasional attention to client satisfaction . This information is both necessary and valuable for library decision making, and should be a part of library quality assurance assessments. Yet, the measures offer no direct evidence of either quality of service or impact on clinical care. Assessments of the quality and effects of information services on patient care have, in recent years, commonly focused on specialized services to a limited clinical clientele, such as clinical medical librarian (CML) programs. CML services are admittedly more expensive than the standard information services for health sciences libraries.

OBJECTIVE OF THE STUDY

The study was intended to:

 1.Find out the extent of availability of health information resources to doctors in federal medical center,owerri.

2.Ascertain the purpose of use of health information resources by different categories of doctors in federal medical center owerri.

3.To find out the perceptions and awareness of  health practitioners on Medical library resources in federal medical center, Owerri

4.To determine the extent of use of the Medical library by the health practitioners in federal medical center, Owerri

5.To find the barriers to effective use of the medical library in federal medical center, Owerri.

HYPOTHESIS

H0;There is no significant difference in the mean rating of different categories of doctors with regards to purpose of use of health information resources in federal medical center, owerri.

H1; There is a significant difference in the mean rating of different categories of doctors with regards to purpose of use of health information resources in federal medical center, owerri.

RESEARCH QUESTIONS:

1. What are the perceptions and level of awareness of medical practitioners on Medical library resources in Federal Medical Center, Owerri?

2. What is the extent of use of the Medical library by the medical practitioners in Federal Medical Center, Owerri?

    3.What are the barriers to effective use of the Medical library in Federal Medical Center, Owerri?

SCOPE OF THE STUDY

The study is restricted to finding out the impact of hospital libraries on medical decision. The study limits the collection of data to Federal Medical Center, Owerri. The findings of this study were gotten from observation and interaction with staffs of the agency which was precisely on the availability of library resource and it impact on medical decision.


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