The Changing Face of Healthcare Authorities in Nova Scotia:

perspectives and strategies for the health sciences libraries

Gayle Graham BSc (Hons), MLIS

Peggy McEachreon BA, MA, MLIS

Outline

Nova Scotia Dual Health Authorities

Why the change? What is the vision?

NS Hospital Libraries

How do the changes affect all of the hospital libraries?Overview, challenges and future outlook on our individual projects

Why merge?

Throne speech pledge by Premier Stephen McNeil on behalf of the Liberal government to reduce “the number of health Authorities from ten to two” in September of 2014 (The Canadian Press, 2014).

Health merger legislation passed in October of 2014 (Doucette, 2014).

Oct. 2013 - McNeil government assumes office

Sept. 2014 - Throne speech

Oct. 2014 – legislation is passed

Apr. 2015 - merge

Jan. 2015 – Gayle and Peggy start new jobs!

June 2015 – present at APLA

Apr. 2014 – Consolidated Library Services Proposal

May 2014 – service agreement signed

Birth of the Nova Scotia Health Authority (NSHA)

Officially on April 1, 2015, nine of Nova Scotia’s District Health Authorities were consolidated into one. The IWK is the second provincial health authority. (“Nova Scotia,” 2015)

The NSHA Mission and Vision

“Working together to achieve excellence in health, healing and learning.” (NSHA, 2015, slide 3).

“plan provincially, implement locally” (NSHA, 2015, slide 2).

“Healthy people, healthy communities – for generations.” (NSHA, 2015, slide 4).

The “visual identity inspired by the powerful waves of the Atlantic Ocean” (NSHA , 2015, slide 7).

“Signifies the momentum and strength we have to shift the conversation about health”

(NSHA, 2015, slide 7).

“Just as each ocean wave impacts the shape of our coast, the collective effort of individuals and communities will impact the health of our province and our people” (NSHA, 2015, slide 7).

The NSHA Logo

NSHA Leadership Model

LEADS in a Caring Environment

• Lead Self – self-motivating leaders

• Engage Others – engaging leaders

• Achieve Results – goal-oriented leaders

• Develop Coalitions – collaborative leaders

• Systems Transformation – successful leaders

(NSHA , 2015, slide 8) .

NS Health Care Delivery Sector: Consolidated Library Services Proposal (Stark, Logan, & Chapman, 2014)

- An evidence-based proposal:

- Study funded by The Academic Health Council to examine the business case and develop a plan for a Nova Scotia Virtual Health Library (NS VHL) (p3)

- “Providing self-service access to electronic information resources is the most efficient approach to meeting the demand for health information.” (p8)

- To address inequities “in the availability of information resources and services” for health professionals (p4)

- “acquisition and licensing, reference, training and literature searching, document location and delivery, [and] library services for patients” including patient education pamphlets, “are currently available only for IWK, Capital Health and the Tri-DHA employees” (p4)

- “Remote access – only Capital Health [now Central Zone] provides this service” (p6)

- “the remaining three DHAs have no service at all.” (p4)

Benefits of the Consolidated Library Services Proposal

- cost-savings on e-journal subscriptions: “content is bundled so that individual journal subscriptions cannot be cancelled, forcing the buyer to pay for unwanted content” (p6)

- centralized management of information resources will reduce “unnecessary duplication or too-restrictive access to rights” (p6)

- a “single library website” (p9)

- “one catalogue” (p7)

- “standard offsite/remote access to core resources for all [NSHA & IWK] health professionals” (p9)

- virtual services “via online chat, email and telephone.” (p9)

Service Agreement HighlightsThe agreement specifies province-wide collaboration on:

• Shared subscriptions of e-resources

• Remote access

• Funding salaries of 2 additional employees whose activities will support all DHAs

Service Agreement Highlights (continued)

• No change to existing library facilities, staff, or current subscriptions.

• Collections will remain in their current locations.

• Library services will be coordinated by a Steering Committee, who

will:

o Regularly consult with library staff across all DHAs

o Report to the CEOs of the DHAs

• Capital Health will pay the costs of provincial library services and invoice each DHA for their share at the end of the fiscal year.

Our Library Clients at a Glance

Employees: (unionized and non-unionized): 23,400+

Physicians: (1,292 specialists 1,194 family physicians) 2,486

Medical Residents: 500+

Learners: 5,500+

Volunteers: 7,000+

Community Health Boards: 37(NSHA, 2015, slide 9)

And patients and families…

NSHA Current Facts and Statistics

  • 45 health services facilities

  • A budget of more than $1.9 billion

  • More than 1,200 active research projects underway

(NSHA, n.d.).

• Specialty multi-site hospital complex (QEII Health Sciences Centre): 1

• Regional Hospitals: 9

• Community and other locations: 35

(NSHA, 2015, slide 10).

 

Shared Catalogue Project

Strategy

• Consult with all districts

• Reach initial agreements where possible and/or urgent

• Start discussions across the province about ongoing/long-term considerations for a province-wide service

• Collect catalogue records from all areas, begin database-building

• Consult with local staff and vendors to conceptualize possibilities and best practices for a user-friendly provincial catalogue

• Consult with hospital library staff outside the province who have completed similar projects

Collections:

(Horizon Health Network, n.d.)

Challenges

• Coordinating schedules

• Making contact with appropriate staff in regions without library service

• Obtaining catalogue records

• Communicating with vendor Andornot in Vancouver

Achievements to date

• One face-to-face meeting with representatives from most areas.

o Decisions made; discussions started

• Received catalogue records from most locations

• Brainstormed provincially and locally re: ideal look and functioning of catalogue

• Consulted with vendor about possibilities and pricing

Electronic Access

(P. Logan, personal comunication, March 10, 2015).

Remote Access Project

Goal: equity

- Every location will have the same level of service as the former

Capital Health District Authority (CDHA)

- Easy access to library e-resources when not on a networked device

- Former CDHA uses EZproxy and Active Directory log-ins

Strategy

1. Research/self-education

- What is EZproxy? Is it our only choice? Is it our best choice?

- Consult with colleagues, IT personnel, vendor (sales and Sr. Product Manager), supervisor, do a literature search, etc.

2. Organization

- Identify allies

- Make decisions based on available evidence and circumstances

Strategy (continued)

3. Implementation

- S.M.A.R.T. goals (Szeto & Dobson, 2015)

- e.g., upgrading EZproxy functionality at former CDHA

4. Reflect, debrief, and celebrate!

- What was learned?

5. Lather, rinse, repeat process(es), always moving closer to end goal

Challenges Opportunities?

- State of flux during transition period

- Communicating via email (misunderstandings, lack of response, ‘nagging’, etc.)

- Identifying contacts and team members

- Relationship building

- Learning curve as a ‘newbie’

Achievements to date

- Identifying resources/allies (EZproxy list-serve, IT contacts, OCLC contacts, etc.)

- Growth of personal knowledge base re: EZproxy (e.g., config.txt file)

- Failed first attempt to upgrade Central Zone EZproxy to leverage full capabilities

- Successful second attempt to upgrade = improved our catalogue

Old

New!

Future Outlook

“Nobody’s gonna slow me down, oh no, I’ve got to keep on movin’…”

Shared catalogue:

• Ongoing developments and record cleanup in consultation with all districts.

• Establish protocol for centralized cataloguing/services, keeping track of record deletions

• Potential partnership with Novanet and amalgamation of hospital library catalogues across the Maritimes

EZproxy:

• Proposal for provincial implementation project awaiting approval

• Purchase licenses, oversee installation, troubleshoot

• Develop and deliver staff training throughout the province

References

The Canadian Press (2014, Sept. 25). Premier Stephen McNeil takes aim at public sector costs. CBC News. Retrieved from: http://www.cbc.ca/news/canada/nova-scotia/premier-stephen-mcneil-takes-aim-at-public-sector-costs-1.2777778

Doucette, K (2014, Oct. 3). Nova Scotia legislature passes contentious health merger legislation. The Canadian Press. Retrieved from: http://atlantic.ctvnews.ca/nova-scotia-legislature-passes-contentious-health-merger-legislation-1.2037235

Horizon Health Network (n.d.). Diagnostic and statistical manual of mental disorders : DSM-5 (DSM V) [catalogue record]. Retrieved from: http://hhn.andornot.com/permalink/catalog14141

LEADS Framework & Tools (2015). CHLNet. Retrieved from:http://chlnet.ca/tools-resources/leads-framework

Nova Scotia Health Authority (2015). Retrieved from: http://novascotia.ca/dhw/about/nova-scotia-health-authority.asp

NSHA (2015). NSHA overview presentation [PowerPoint slides].

NSHA (n.d.). Current facts and statistics. Retrieved from: http://intra.nshealth.ca/Pages/About-Us.aspx

Oldie Lyrics. (n.d.). Matthew Wilder “Break My Stride”. Retrieved from: http://www.oldielyrics.com/lyrics/matthew_wilder/break_my_stride.html

Stark, W., Logan, P., & Chapman, D. (2014). Nova Scotia health care delivery sector: Consolidated library services proposal. Halifax, NS.

Szeto, A., & Dobson, K. (2015). The Working Mind: Workplace Mental Health & Wellness: Facilitator Manual. Mental Health Commission of Canada. 96-97.

http://www.youtube.com/watch?v=z5yiBQkOL0k&sns=em

Image ReferencesCanadian College of Health Leaders (n.d.). LEADS Collaborative [logo]. Retrieved from: http://www.cchl-ccls.ca/site/pd_leads

CloudPro (2014). Collaboration [photo]. Retrieved from: http://www.cloudpro.co.uk/saas/collaboration/4638/cisco-box-team-up-for-project-squared-ios-android-collaboration-app

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Peggy McEachreon, BA, MA, MLIS peggy.mceachreon@nshealth.ca

Gayle Graham, BSc (Hons), MLISgayle.graham@nshealth.ca