Thanks again to everyone who shared their ideas and advice on this topic.

I posted a message last week with a few questions asking for comments about consolidating several libraries.  I am gathering information for a friend of a friend and I've compiled all the responses below.  I had several responses requesting a summary - it looks like this is a question that others are grappling with as well.

I'll quickly add just a comment about the reorganization here (academic library).  The libraries at UCSD will soon become just 2 buildings (elimination of 4 library buildings) and the subject libraries will be eliminated in favor of a single "all subjects" library housed in 2 buildings.  Our positions will be changing from subject based to functional based.  For example, public services will be made up of several departments - Liaisons, Instruction, Reference, Digital Services, & Learning Spaces.  We don't know yet who will be where or what those jobs will look like.  We are just at the stage where the heads of those departments have been selected and those details will be worked out.  So far, layoffs were not needed, but we sure have lost quite a few to retirements and new positions elsewhere.  The novelty of functional over subject organization seemed worth mentioning even though we still have lots of questions to answer.

The replies - I've taken the messages apart and combined those sections into categories.  Since this is a long message, I'm hoping the sections will make it easier to read.  The sections are:
Thoughts in brief,
Standards & Accreditations,
A central library?,
For Further Reading

Again, thanks to everyone who responded.


Thoughts in Brief

DISTANCES and geographical concentrations from the eventual facility

TRANSPORTATION from the viewpoints of users (primary, official & unofficial), staff, visitors, suppliers, servicers (including maintenance) students etc

SAFETY: personal, equipment, print collection, and of the space itself -location, access what's nearby (and what is not)

ACCESS, CONVENIENCE (in realistic terms) - availability of food, water, lavatory, quiet study area, etc Immediate environment: lighting, power outlets, layout as adaptable to your collection's equipment, furniture & personnel needs & uses;

EQUIPMENT spaces that are appropriate and adaptable for anticipated timeframe, accommodation for users' various devices

COPY EQUIPMENT - this stage is ideal for being sure you have what you NEED, and for de-emphasising machinery etc that has already (or may soon) become burdensome (I think of Bowling Leagues and hospital library copy machines, inadvertent public availability of institutional property such as reams of paper, missing issues of journals at binding time, --- you have your own lists!

THINK AHEAD in terms of possible needs or opportunities for new equipment (some not yet invented), predictable replacements (which can sometimes include consolidations both instututional cooperationwise and technologic overlap)


Go electronic - the docs like it - space needs are minimal but be prepared to do a lot of teaching.

There were 9 libraries in 3 New England states.  Print was consolidated in a central location, after removing duplicates, outdated information, etc.  The thought was just in time, not just in case.

Pull and discard all the old stuff - over 5 years

We went electronic a few years ago.   One problem it solved is that all sites now have exactly the same access to materials  whereas before site A had some stuff that site B did not  --etc etc. --and it caused problems.

As much as I hate to say it medical books are dead.

In a shared setting, each maintains a few journals and books on site in the Medical Staff office.

Print journals I think are pretty much gone.  Books still have a future, especially until they get the licensing/access issues resolved, and until a greater percentage of books are available electronically at a cost-effective price. Currently , the print version is still the most cost-effective.    Perhaps the different locations could each specialize, with various foci: Nursing, peds, orthopedics, surgery, internal med, etc.  This would eliminate some duplication and allow a deeper and broader total collection.
When The Commonwealth Medical College here in Pennsylvania started up a few years ago the library director started from scratch with a goal of having a 95% virtual library. Not all resources are available online even today, so depending on your needs, going totally virtual might force you to do without certain things.  I think this is more likely the case with non-medical resources, however.
Yes and no. If cost is no issue, than yes, I suppose a modern medical library's resources could be completely virtual, though you would still need a librarian at the helm (to negotiate contracts, provide instruction, perform lit searches, facilitate ILL's, etc.). However, if there is a tight budget having a completely virtual library would be difficult. Many online journals offer a discounted rate to print subscribers, and in many cases subscribing to print alone is more cost effective. There's also often an additional charge to subscribe to the back files, which may be important to have for core journals.
We are slowly building a virtual collection but this is difficult as the cost is so much higher.  Additionally, books on the reading lists for our undergraduate and postgraduate students are not available electronically.  If they are, you get access to the online content using a code on the front cover of the print book, so you still need physical shelving.  This is an important consideration when deciding if you can go completely virtual, especially if you have contracts, service level agreements or other quality standards that mandate certain stock provision.
Words of wisdom about Collections

Funding:  Last fall about 25% of my library space was removed to create a new patient registration area.  As part of the agreement, I requested and received about $23,000 to support the purchase of more online resources, given the reduction in space.  Unfortunately, it was only one-time funding so I couldn't use it towards any subscriptions, but the new ebooks have been greatly appreciated by the patrons.  By the way, the finance person involved referred to that kind of money as "construction dust," so small in their overall budget for the project!!!

Funding:  Ask for what you would really like (with justification, anticipated statistics, business case) in terms of additional funding to support more electronic content in a smaller physical space -- try hard for a commitment to annual funding so you can get subscription items or new items each year... pursue a commitment in writing from someone with authority to make it happen year-to-year.

There seems to be a lot of push from higher-ups to go completely virtual without an understanding that many of the nursing books people use are not available online at a price they are willing to pay.  And some things are not available online at all (BLS Books for instance).

We don't ILL books...just too complicated to receive and mail across the state, then hope we get them back.  Most people can live without that service.

Not all resources are available online even today,

The final thing I have learned is please ask the users what they want from the library.


Perhaps the some of the spaces should be kept for core collections, collaborative space, and technology, such as computers, a scanner, a laminator, fax (yes, a fax machine is still needed at times), a printer,

a photocopier, etc, software , headphones, projection screens, etc.

It could be reframed as a "Colllaboratorium" space, or " Collaboration Center."

The library space is space that is used by a variety of departments and people, so defend it that way.  The key is to keep it flexible.  Moveable partitions, moveable multifunctional furniture, good lighting (track lights of some sort including those that can be raised and lowered might add to flexibility of space), many electrical outlets, wireless internet access.

Don't be so quick to give up all the space.

Keep a few public access computers and a few reading chairs.

There seems to be a lot of push from higher-ups to go completely virtual without an understanding that many of the nursing books people use are not available online at a price they are willing to pay.  And some things are not available online at all (BLS Books for instance).

I do believe we can still make a case for Library as Place.  Maybe we won't need the journal stacks forever, but we do need the computer lab and the study carrels and tables and reading rooms with space for people to work when they are away from their home offices.

I just want to put in a word for Library as Place.  The space the library provides is multifunctional.  A place for collaborative work, small groups, contemplative thought and study, work on projects, etc.  A community space.  A personal space.

We had good document delivery between centralized location and other businesses.  And most of us were within a quick drive and would pick up materials from centralized location for our customers.  At some point the centralized location wanted the space.  But the engineers still wanted their print, so one of the businesses took the materials.  And this was just as pdf was starting factor.  I don't believe this would have worked without the librarians in offices, sort of embedded in departments.


Try to keep at least minimal library staff presence around.  Out of site ( sight ) out of mind is really true.

All the librarians moved from libraries into offices, with a bookshelf.  The priority was to become more involved in business teams and be more a part of the organization.

I don't believe this would have worked without the librarians in offices, sort of embedded in departments.

The staff and physicians of all 4 hospitals have Library website access to books, journals, & databases.  They can call, email or fax us for literature searches and articles M-F, 8:00-4:30.

Questions about Staffing:

If there is not a library or a librarian within a facility would there be a liaison to collect library questions?  Would that person serve as a gatekeeper?

Who would provide instruction on how to use these resources?

Would it fall to the librarian who is working in the main library to do it all (organize & maintain the collection, perform searches, order articles and materials, teach and train staff on how to use the resources and more)?  When would he or she travel to the other facilities or would they have time to do so?

Concerns about Staffing:

It's nice to have a person on site to train staff and physicians to use online resources, and with only 2 of us, librarian and tech, that's not possible in the remote locations.

Standards & Accreditation requirements

Years ago the Joint Commission had standards that required (or at least suggested) a library within the facility.

These days the Magnet designation is our champion and those hospitals that have Magnet status can see the utility of having not only libraries but an actual librarian to assist nurses with their evidence based practice and EB projects.  Our hospital has a nursing model that actually puts the library in the model.  (Oncol Nurs Forum. 38(5):509-11, 2011 Sep.)

What should be considered is the needs of your user base, the hospital medical and other staffs. JCAHO requires access to information resources but not to a physical library, I believe.  If your system is going for magnet the library should be a big consideration.

Can a central library serve several facilities?

We think so and we think we do a pretty good job of it.  At present we have only three facilities, the most distant about 20 miles away.  (We are soon to add a more distant facility, which will test the proposition more completely.  But in this electronic era I think a central library is quite feasible and definitely practical.

I am a one person, one facility library supporting four hospitals and 100+ clinics distributed throughout our county/region.  Yes, you can definitely provide library services from a single location with a geographically dispersed audience.  There are other MLA and SLA members with similar geographic service areas -- many global corporates have single or a few sites for their library staff, but patrons/employees distributed around the region, country, or world.  It's definitely an option.

Yes (though I don't think it's ideal). Our library serves two smaller, affiliate hospitals as well as our own. We're able to provide literature searches and document delivery via e-mail and fax, and can often send books through our courier service (though books are rarely requested). The hospitals are close enough that the librarian is able to occasionally go to them to teach classes.

Communicating suggestions:

[Changes that included an unstaffed smaller library space]. ...  It has worked, though much more promotion is needed than ever before as so many people have said to me the unmanned site is closed. "um, no it is just unmanned, did you read your emails, or those umpteen signs around the hospital?".

List for further reading:

Book --  Medical Library Downsizing by Mike Schott
JMLA Review
Peak at the TOC

Journal articles about trends & changing library collections:


Maintaining parallel systems.<>

Starr S.

J Med Libr Assoc. 2010 Oct;98(4):269. No abstract available.

PMID: 20936063 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


International trends in health science librarianship: part 1 - the English speaking world.<>

Browne R, Lasserre K, McTaggart J, Bayley L, McKibbon A, Clark M, Perry GJ, Murphy J.

Health Info Libr J. 2012 Mar;29(1):75-80. doi: 10.1111/j.1471-1842.2011.00973.x.

PMID: 22335292 [PubMed - indexed for MEDLINE]

Related citations<>


Got value? Journal collection analysis is worth the effort.<>

Daniels K.

Med Ref Serv Q. 2010 Jul;29(3):275-85.

PMID: 20677068 [PubMed - indexed for MEDLINE]

Related citations<>


Defrosting the digital library: bibliographic tools for the next generation web.<>

Hull D, Pettifer SR, Kell DB.

PLoS Comput Biol. 2008 Oct;4(10):e1000204. Epub 2008 Oct 31. Review.

PMID: 18974831 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


The art and science of making choices.<>

Plutchak TS.

J Med Libr Assoc. 2003 Jan;91(1):1-3. No abstract available.

PMID: 12568150 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


Breaking the barriers of time and space: the dawning of the great age of librarians.<>

Plutchak TS.

J Med Libr Assoc. 2012 Jan;100(1):10-9.

PMID: 22272154 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


Special report: symposium on transformational change in health sciences libraries: space, collections, and roles.<>

Lynn VA, FitzSimmons M, Robinson CK.

J Med Libr Assoc. 2011 Jan;99(1):82-7. No abstract available.

PMID: 21243060 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


Searching for common ground: public access policy and the Scholarly Publishing Roundtable.<>

Plutchak TS.

J Med Libr Assoc. 2010 Oct;98(4):270-2. No abstract available.

PMID: 20936064 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


An analysis of reference services usage at a regional academic health sciences library.<>

Barrett F.

J Med Libr Assoc. 2010 Oct;98(4):308-11. No abstract available.

PMID: 20936071 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>


Eyes on the prize: reflections on the impact of the evolving digital ecology on the librarian as expert intermediary and knowledge coach, 1969-2009.<>

Homan JM.

J Med Libr Assoc. 2010 Jan;98(1):49-56.

PMID: 20098655 [PubMed - indexed for MEDLINE] Free PMC Article

Related citations<>

Karen Heskett
Instruction Coordinator & Cancer Center Liaison
UCSD Biomedical Library
9500 Gilman Dr.  0699
La Jolla, CA   92093
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