This edition of HILJ club sees the return of author Morag Clarkson, Library Services Manager, Croydon Health Services NHS Trust @moragclarkson

I found Christine Urquhart’s editorial “Assessing return on investment in health libraries requires lateral thinking”  (03 March 2020 HILJ v37 n1 – free access) both timely and insightful.

Urquhart explains the difference between social value and social return on investment, discusses the status and history of trends in value and impact research in health libraries (such as social value analysis) and highlights how it can be used.

The author looks to the Health Education England (HEE) evaluation framework for health library and knowledge services (LKS), as a roadmap for the development of a theory of change .

The co‐creation by health care staff, researchers (and library users) of value and impact, specifically to improve patient care is discussed as a recent and aspirational output.

The author posits that, on the basis of this co-creation, the collection of data to assess social value should be drawn not only from performance data already collected by libraries, but also from data collected by and for the health care organisation. This allows the evaluation of care quality and professional competence and marks a shift towards qualitative measures rather than bald financial metrics.

Urquhart states that identifying the value of health LKS should be an ongoing process.

Value isn’t just a measure of how well the LKS meets organisational goals, and contributes to improving the quality of patient care. It is also about identifying how services must adapt to meet changing needs, and changes in perceived value. In effect a PDSA cycle of quality improvement on the value of the service on many levels.

Urquhart reveals how evidence‐based policymaking, and trials of new services often rely on social return on investment calculations. She discusses whether return’ received for the amount of money invested in a library service can be measured e.g. is a ‘return on investment’ approach valid?

The key stakeholders highlighted in this article for a social value study are the NHS hospital trusts and HEE, with the main stakeholders being patients, carers and the public, although they are mostly indirect recipients of LKS through care provided by health care staff.

The author looks at the six goals of the HEE evaluation framework as theories of change for streamlining of services, education support, evidence and knowledge management, partnerships for patients, LKS staff capabilities and collaborative working.

Urquhart suggests that Library services need to be aware of the data already collected within, and about their organisations such as surveys on staff satisfaction, or patient experience.

In other words, the Library needs to be part of the Trust’s core business, part of the big picture and contribute transparently to the social value metrics of the organisation.

Urquhart wants Library services to call out assumptions and to align with what is important to their employing organisations.

There seems to be a lack of qualitative measures in health library research. In the context of my masters dissertation (DOI 10.5281/zenodo.3635740)   I asserted that research into public libraries suggested that library use supports well-being and social capital. In this context social capital has links to social value.

I found whilst carrying out research in 2015, that there was little literature relating to NHS library use and how it impacted user well-being or user social capital. Generally, research into NHS libraries focused on the services provided e.g. a clinical librarian service or access to online resources.

My research into health libraries concluded that many research methods used quantitative rather than qualitative metrics. I identified published qualitative value measures of public library use and recommended that similar qualitative measures could be used to critically evaluate usage of the NHS workplace library.

This backs up Urquhart’s premise and puts forward the suggestion that more qualitative research into this area needs to be undertaken. This seems especially timely since the COVID-19 pandemic has given us all recourse to reflect on issues around value, impact and the quality of something rather than its quantity.

I haven’t searched the literature recently in any depth on this subject.

Anecdotally or otherwise It would be good to stimulate discussion and hear what others think.

Questions for discussion

  1. What do you think holds back qualitative research in health libraries?
  2. Is qualitative research in health libraries increasing?
  3. As a sector do we publish enough?
  4. What do you think of social value or social capital in relation to health libraries?
  5. Libraries are important third spaces. Has COVID-19 impacted on this?
  6. Is there something else that you would have liked to have seen included in the review?