The value of librarians for clinical and health governance

10 January, 2019

Dear colleagues,

As a follow-up of a discussion last year on the EAHIL (European Association of Health Information and Libraries) mailing list we conducted a survey and wrote a paper about the roles of librarians in the governance of healthcare organisations and health systems.

Irina Ibragimova, Maria Helena Korjonen, (2019) "The value of librarians for clinical and health governance (a view from Europe)", International Journal of Health Governance,


Governance of healthcare organisations and health systems requires many different competencies, with a great emphasis on evidence and information governance, which are traditional fields of librarians' expertise. However, stakeholders are unaware of how health and hospital libraries are contributing with specific activities and what are the trends in library support for health/clinical governance in Europe, mainly because traditional methods of measuring impact are restricted to specific library activities or are not showing direct impact long term. The paper aims to discuss these issues.


A model combining components of clinical and health governance (C/HG), related library activity types, and the possible impact was developed based on a literature review and tested by a European expert panel. A web-based survey was offered to the members of the European Association for Health Information and Libraries (EAHIL) to offer further insight into activities and examples of contribution to C/HG.


Librarians from 25 European countries participated in the survey. The model proves that librarians in Europe are involved in supporting most identified components of C/HG, with examples of clinical effectiveness and research, education and training, patient and public involvement, partnership engagement, formulating strategic direction, etc.

Research limitations/implications

The authors were unable to cover the roles of libraries in all European countries in this paper, but dialogue and research will continue within the EAHIL group.


No such comparative research has been undertaken before, looking at what activities and tasks libraries undertake to support C/HG. This research has highlighted valuable services and tools that can be replicated in libraries across health care organisations and at the same time promote libraries and librarians as significant actors in organisational governance.

Some excerpts from the article:

“It is not always known or clear to stakeholders (including decision makers) what libraries and librarians can provide and where their services fit. Authors from the USA showed that though medical librarians “possess expertise to navigate various search resources and can investigate inquiries during health information system project lifecycles” they were not included in implementation and research teams (Saimbert et al., 2010). Research from Italy about hospital-based HTA stated that “the librarian is almost never represented within the HTA evaluation group” (Balduini et al., 2013). “Information professionals carry out many

activities involved in mobilising research into practice but this is often not recognised” concluded recent research on public health decision making in the UK and Scotland (van der Graaf et al., 2018).”

“Libraries are developing other ways of reporting impact, e.g., through case studies (prepared and published both by librarians and health services staff ): knowledge management stories (; impact case studies (; library impact � case studies (”

“In total, 83 participants from 25 European countries completed the survey. About one-third of them provided examples of their activities in support of specific components. The largest groups were from hospitals (31.1 per cent) and from medical libraries (14.3 per cent), others represented research institutes (10.7 per cent), university public health or medical library (10.7 per cent), university teaching hospitals (9.5 per cent), national ministry or health agency (8.3 per cent), freelance librarians (3.6 per cent), 10.7 per cent were from other types of organisations (mostly a combination of a research institute and a hospital).

By target audiences: the most frequently named groups were researchers (89 per cent) and physicians (83 per cent), then nurses (77 per cent), other hospital healthcare practitioners (77 per cent), and public health professionals (54 per cent), less participants stated providing services to non-hospital healthcare practitioners (40 per cent), patients and public (38 per cent), other health and non-health professional staff locally or internationally (36 per cent) and decision makers on all levels (30 per cent).

When asked about clinical governance , practically all the participants stated that they supported clinical effectiveness and research (98 per cent) and education and training (96 per cent); the majority supported patient and public involvement (84 per cent), staffing and staff management (72 per cent), using IT and information (77 per cent); less than a half were involved in risk management (38 per cent), and audit (32 per cent). Nearly half supported other aspects of clinical governance (48 per cent).

When asked about health governance: the majority stated support for partnerships (71 per cent) and for participation and consensus (60 per cent); half - for

formulating policy/strategic direction (50 per cent) and for generating information/intelligence (52 per cent). Less than half provide support for transparency (47 per cent), organisational adequacy/system design (44 per cent), accountability (38 per cent) and regulation (21 per cent).”

The article is not in open access, but we are planning to submit a pre-print version to one of the relevant open access repositories.

Irina Ibraghimova, PhD

Library and Information Management Consultant.

Regional Editor (Europe) for the International Journal of Health Governance.

HIFA profile: Irina Ibraghimova is a medical librarian, based in Croatia, and works with health care professionals in the countries of the Former Soviet Union, Central and Eastern Europe, and Africa. Her interests include evidence-based practice (both in health care and in library/informatics field).

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