Murphy, McMahon, Peakin. 6 June 2017. parallel paper, leadership 3. ICML/EAHIL 2017 Introduction Tallaght Hospital is a teaching Hospital of Trinity College, Dublin and within this structure, the Library plays a vital role in maintaining that status. When the Library faced a period of fiscal uncertainty and potential closure due to a loss of clarity with regards to its role within the organisation, the Hospital Executive commissioned a review of the service to be led by the Head Librarian and terms of reference were agreed. Objective The objective was to review the service and make recommendations about its future development, and to utilise a strategic framework to guide this development, highlighting the Library as a service which is essential to the standing of the Hospital. Methods A Library Review Group was established, composed of a broad and representative cross-section of stakeholders. The values underpinning the review were evidence and engagement. Bryson’s Strategic Change Cycle was adopted as the strategic framework to structure the review process. The Group took a multi-faceted approach to gathering the evidence, using benchmarking, stakeholder feedback and a comprehensive literature review. The Group used the opportunity afforded by the review to engage a diverse range of hospital staff who voiced their requirement for the development and expansion of library services. Contemporary best practice was considered as was the strategic context outlined in Tallaght Hospital’s Clinical Service Strategy 2016-2018 and Trinity Health Ireland’s strategic objectives. Results The Library Review Group completed its work in July 2016 with the submission of its report and recommendations to the Executive. The Report and Library Service Strategy outlines how the Hospital can build on the quality of its existing Library service. At the time of writing in October 2016, a meeting with the CEO is scheduled and it is anticipated that the report recommendations will be adopted and resourced by the Hospital. Conclusion The strategic planning involved in leading a review such as this showcases the variety of approaches that can be taken and by analysing this process, a framework can be considered for similar projects. This type of strategic management requires librarians to fully embrace leadership roles as they look to guide their own service and integrate themselves into the healthcare environment. Abstract written 19th October 2016

1. REJOYCE IN OUR BLOOMIN’ LIBRARY
LEADING A LIBRARY REVIEW AND
DEVELOPING A STRATEGIC PLAN
THROUGH EVIDENCE AND ENGAGEMENT
ANNE MURPHY, JEAN MCMAHON & JOE PEAKIN,
TALLAGHT HOSPITAL LIBRARY, DUBLIN
ICML/EAHIL, FRIDAY 16TH JUNE 2017

2. TALLAGHT
HOSPITAL
• One of Ireland’s largest acute teaching hospitals, located in south
west Dublin
• A university teaching hospital for Trinity College Dublin
• Provides child-health, adult, psychiatric and age-related healthcare
/ 20 medical and surgical specialties
• 410,000 patients per year: 562 beds, 12 theatres and 14 critical
care beds

3. TALLAGHT HOSPITAL LIBRARY
• Opened in 1995
• Health sciences library serving 3500 staff and students of 3
organisations: Hospital, Psychiatric Unit and Trinity College Dublin
• Staff use library services principally for direct patient care and
evidence-based practice
• Collections: online and physical evidence databases, journals &
point of care tools, library catalogue / 12,000 print books
• Services: Reference and advisory ; document supply ; expert
search support

4. BACKGROUND TO THE REVIEW
• Loss of understanding in the Hospital about the purpose and need
for the library service resulting in:
• deep cuts in staffing and budget over a period of years
• a move out of the clinical structures
• falling below the requirement of a university teaching hospital and
at certain points, risk of closure
• The librarians brought their concerns to the Executive, which
mandated a review of the service to be led by the Head Librarian

5. NEGOTIATING THE SCOPE OF THE REVIEW
• Executive focus initially was on staffing levels and opening
hours, and strategic opportunities for the library service
• The Librarians had a broader focus
• The terms of reference became the negotiation
instrument by which the scope of the review was defined
and agreed
• Used an iterative process to draft the terms of reference
• Successfully widened the scope of the review to include a
full description of the service and to develop a strategic
plan informed by good quality evidence

6. THE LIBRARY’S OVERALL AIM
To review the service and make
recommendations about its
future development, and to
utilise a strategic framework to
guide this development,
highlighting the Library as a
service which is essential to the
standing of the Hospital

7. PRINCIPLES UNDERPINNING THE REVIEW…
• Work from the beginning with the end in mind:
• Rebuild corporate understanding and knowledge
about the Library service
• Publish a report with recommendations for the
Executive that would have the advocacy and
support of library users
• Establish a Library Review Group that would engage a
broad representative cross-section of stakeholders
• Lean process: the librarians would work to prevent
any additional workload on stakeholders
• Take a thorough approach to gathering the evidence:
stakeholder views and best practice

8. … PRINCIPLES UNDERPINNING THE REVIEW
• Adopt Bryson’s Strategic Change Cycle as the
strategic framework to structure the review
process
• Plan, research, re-plan and plan again
• Developed our thinking in the process of
planning: much discussion, clarifying,
conceptual thinking
• Moved from tacit to articulated concepts
• Market the librarians as highly qualified
professionals and a valuable resource to the
Hospital

9. BRYSON’S STRATEGIC
CHANGE CYCLE
1. Initiate and agree on a strategic planning
process
2. Identify organisational mandates
3. Clarify organisational mission and values
4. Assess the organisation’s external and
internal environments
5. Identify the strategic issues facing an
organisation
6. Formulate strategies & plans to manage
the issues
7. Review and adopt the strategies and plan
8. Establish an effective organisational vision
9. Develop an effective implementation
process
10. Reassess strategies and the strategic
planning process

10. INITIAL PROGRAMME OF WORK
• Description of the current service
• Profile of the Library: User Groups ;
Services ; Access to collections /
resources ; Funding ; Staffing and staff
development ; Communications,
Internal and external ; Physical Library
• Gather the evidence to inform the
outcomes of the review
• SWOT, PESTLE, Stakeholder analysis;
Benchmark: identify Best Practice

11. REVIEW GROUP
REPRESENTATIVES FROM:
• Medicine/Surgery/Psychiatry
• Nursing
• Health and Social Care
Professions
• Laboratory
• Pharmacy
• Clinical Audit
• Finance
• Human Resources
• Library
• External Expert Librarian

12. THE MEETINGS:
MARCH – JULY 2016
Meeting 1 Background to the Review & programme of work agreed
Meeting 2 Review Group SWOT
Meeting 3 In-depth briefing about governance of the library, its internal
organisation and the planning underpinning the library services
Meeting 4 Round Table on the strategic issues - grouped by theme
Meeting 5 Final draft of the Library Report approved
Lunchtime meetings with lunch provided
Little or no work between meetings for group members
Varied format – collaborative and participative
Excellent attendance

13. GATHERING THE EVIDENCE
• External• External
• Internal• Internal
Staff
Survey
Swots
Bench-
marking
Lit
Review

14. ENGAGEMENT:
STAFF SURVEY
• Online survey
• 14 Questions
• 1 month
• Survey Monkey
• Circa 300 responses
• 10% of Hospital Staff
Staff
Survey

15. “To have a library branch /study space with PCs in the main hospital”
“Opening hours need to be extended. The staff there are always very helpful and
knowledgeable, it is frustrating not to be able to use it as an excellent resource because
of the restricted opening hours.”
Flexible opening hours
I wish I could use it after work! The librarians are amazing resource and have always
been so approachable and knowledgeable!
“Endnote service”
“Very happy with the service when available. Always very helpful.”
“Such a wonderful facility in the hospital that is under resourced - more staff required to
make most of such a valuable asset to Tallaght Hospital and the Trinity Centre”
“Improve the heating. (It tends to feel cold in the library)”
“Better anaesthesia/ICU journals.”
“24 hour study space and longer opening hours. I have lost count of the amount of times
that I have gone down to the library and it has been closed.”
“Journal holding”

16. SWOT ANALYSIS
Process Improvement Manager from Quality Safety & Risk
Management conducted SWOTS and compiled results
• Library Review Group
• Pharmacy
• Doctors
• Nurses
• Centre for Learning & Development
• The Library Swots

17. STRENGTHS
databases
Fast journal article supply service
Great print book collection
Development of new services even within tight / reducing budget
Search skills workshops (when they run)
Physical Library: comfortable study space and PCs with internet access
The Library’s broad perspective arising from its unique remit: hospital-
wide focus and serving 3 organisations which informs the service it
provides
Swots

18. WEAKNESSES
Drastic lack of journals
Barriers to accessing journal articles online
Lack of library & information handling programmes
Lack of marketing /service promotion about how to access the services
and what is available
Current place in organisational structures drives confusion and loss of
corporate knowledge of the library purpose and status
Lack of advocacy at senior level
Hospital staff confusion about who the library is for
Cuts in library staffing and funding levels
Swots

19. OPPORTUNITIESMove the Library nearer to the clinical areas:
plan for new build in the medium-term
refit the existing library in the short term
Increase access to librarians’ expertise: information skills; systematic reviews;
search skills; expert searching; librarian-mediated searching; publication
support; academic writing
Market and promote the service
Increase the number of fte librarians in the service
Get the Library to promote the research brand of Tallaght Hospital Swots

20. THREATS
The Library has been so under-resourced that basic services have
broke down
Further reductions in resources and failure to adequately resource the
service
Loss of library staff: revert to 1.6 f.t.e.s in October 2016
Maintaining registration for professionally-qualified staff compromised
by lack of library service
Failure for the Hospital to be accredited for specialist training
NCHDs are key drivers of the library service but are a transient
population and their advocacy for the service is reset to zero at every
changeover
Swots

21. EVIDENCE: KEY FINDINGS OF THE SWOT & SURVEY
• Hospital staff place a high value on the librarians’ expertise
• Opening hours are restricted and unreliable
• Drastic lack of journals
• Lack of availability of information literacy programmes and search
expertise
• Patient care is compromised because the Library’s core purpose to
support patient care not understood or recognised
• Need for research support services
Swots
SwotsStaff
Survey

22. BENCHMARKING
Teaching Hospital Libraries
Ireland & U.K.
Number of
Library Staff
& Staff Mix
Opening Hours
24-Hour
Access/Study
Space
Endnote
SPSS/Survey
Place in
Organisation
Number of
Beds/Staff
Training/
Consult Area
Who Can
Access
Library
Evidence
Databases
Bench-
marking

23. REVIEW OF LITERATURE
• Considered organisational literature
• Tallaght Hospital’s Clinical Service Strategy 2016-2018
• Trinity Health Ireland – Strategic Objectives
• Cross-section of comparative strategic plans
• Public / Private ; Small / Large ; Medical / Non-Medical etc.
• Current academic thinking on the topic
• Important for scope and macro-view
• Helps to see themes emerging from library community
Lit Review

24. AFFINITY DIAGRAM PROCESS
• Beginning of the synthesising process
to move all the opinions and ideas into
coherent goals
• Involved the 3 Librarians, sticky notes
and flip charts
• Much agreement, some differences of
opinions and some plain old arguments
• Collaborative respect for validity of
opinions expressed
• Opportunity for team-building

25. EMERGENT STRATEGIC THEMES
• 7 key themes emerged from the affinity process
A Library Service of Excellence to all User Communities
Library in the Organisational Structure
Opening Hours/Staffing
Library as Place
Visibility and Profile
Collections
Services

26. ADVANCING YOUR OBJECTIVES
• After the themes are defined and developed
• Lay out all the action points from each strategic theme
• Split each milestone into short, medium and long term goals
• Assign responsibility for each action
• Highlight key recommendations
• Also important at this time is insuring buy-in by;
• Building consensus through meetings
• Dissemination of the strategic plan
• Ensuring adoption as a working document

27. STRATEGIC THEMES : SPECIFIC EXAMPLE
6. Collections
Objective 6 Provide a collection of world-class information resources in a variety of
formats and relevant disciplines to support safe effective patient care, to underpin
evidence based practice and supports Hospital staff in their working lives.
Milestone 6.1 Restore the range and provision of journals to clinical areas in line
with the Clinical Service Strategy 2016-2018 as a priority.
Milestone 6.5 Build and manage a collection of research support packages
including Endnote, SPSS, and survey tools.
Milestone 6.9 Continue to build a comprehensive current collection of print
textbooks and monographs.
Milestone 6.10 Expand and promote the Wellbeing and Good Reads sections
of the collection.

28. OUTCOMES (SO FAR)
 Head Librarian presented report to the CEO and Deputy CEO
 Library has been aligned with the Centre for Learning and Development
 Presentation of the conclusions of the report to the Executive Management
Team
 Adoption of the strategic plan as the Hospital’s library strategy by the EMT
 6-month librarian post made permanent: Collections Librarian
 Agreement for a designer to look at refitting the library
 Library acknowledged as a department in its own right with its own cost
centre
 Professional autonomy of the librarians

29. OUR LEARNINGS
• Use mission, vision and values to steer you through the process
and aid external understanding
• Structure your review around a specific strategy development
process but allow for your own ideas
• Ensure stakeholder buy-in throughout the process
• Develop over-arching themes and devise actions from them
• Keep record of outcomes / results and revisit strategy often
• You won’t get everything: but you will hopefully win funds and
influence people

30. ATTRIBUTIONS
• Slide 1: James Joyce Painting by Jacques-Émile Blanche
• Slides 2-6: Tallaght Hospital and TH Library, Dublin
• Slide 6: MPS International. http://www.mpsinternational.in/content/aim
• Slide 7: William Murphy, Boyne Valley Viaduct, Drogheda, County Louth
https://www.flickr.com/photos/infomatique/7022847819
• Slide 8: William Murphy, A walk along the Liffey (the James Joyce Bridge, Dublin)
http://flickr.com/photos/80824546@N00/5042031795
• Slide 10: William Murphy. Dublin canvas [new paint a box programme] Ref-107942
https://www.flickr.com/photos/infomatique/21281478025