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Wow!  Thank you, everyone, for your great advice.  The biggest flag that
was brought up and I THANK YOU is the confidentiality issue.  After
going to my director - the human resources director - I found out that
he wanted to know WHO was using the library not WHAT they were asking
about.  So that made me feel a lot better.  Below I have roughly
summarized people's ideas.  I again thank you all for your expertise.
What a great listserv!
Emily

Emily H Erickson
Medical Librarian
Mary Greeley Medical Center
Ames, Iowa
515-239-2154
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Organized by department
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in the newest issue of  National Network (Oct 05, p 22-23), dollar value
to what you do in the library.
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Log book
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Cc boss once in a while to show him what kind of service I provide
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Increasing online resouces 
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Keeping statistics by user speciality
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As a member of MLA, find benchmarking ideas from other hospitals of
similar size
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Keep track of reference questions from managers and employess of
hospital
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New JMLA has article by Theresa Cuddy that includes Abel's taxonomy of
value measurement for hospital libraries
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Ebsco,Ovid, Stat!Ref and others allow you to go in and get monthly usage
stats. 
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Use check out cards for books
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Calculate turnaround time for ILL and it searches
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During after hours, get a checker or camera
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Keep a tally of how many journals you find lying around
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