"Iron rusts from disuse; water loses its purity from stagnation...even so does inaction sap the vigor of the mind."
Leonardo da Vinci

Mount Carmel Health System Library Services (MCHSLS) employs a uniquely developed business model in the continuous expansion of its staff engagements to support the Mount Carmel Health System (MCHS), a Ministry Organization of Trinity Health, on six regional operating sites, diverse academic entities including the Mount Carmel College of Nursing (MCCN), and five additional corporate sites in three different states. Upon his appointment a decade ago, the director introduced the use of an adaptive leadership framework, which has led to a series of transitions for MCHSLS resulting in a focus on synergizing staff and centralizing and consolidating MCHSLS services and resources.

Matching the organizational acumen in operational efficiency and excellence has allowed MCHSLS to thrive in such a challenging environment that demands the continuous evolution of library operations and services. A decade ago, what was then known as the College of Nursing Library primarily supported the academic needs of MCCN; today, MCHSLS is positioned as a central hub to support the growing regional hospital system including MCCN. Moreover, by engaging in service agreements with several other Trinity Health Ministry Organizations in different states and aligning its transformation to the organizational strategic initiatives, the MCHSLS continuum of services is constantly evolving. Earlier this year, MCHSLS joined the American Library Association (ALA) initiative, embarking on a long-term planned course of changes focusing on client demands and organizational opportunities.

The early completion of an internal and external environmental scan and SWOT analysis was integral to the successful navigation of this decade-long journey. This initial exploration phase assessed the need for change and redefined strategies for continuous revitalization of library services focusing on operational efficiency and creating a culture of Service excellence.

These assessments revealed MCCN’s vision for growth in enrollment through the establishment of new educational programs including diverse master of nursing tracks, accelerated programs, and a doctor of nursing practice (DNP) program, all of which MCHSLS would support. Moreover, the opening of a new MCCN regional campus and the rapid growth of available online education significantly impacted the direction of needed change to the organizational and reporting structure. As a result, MCHSLS established liaison support to its primary clients in all academic departments, and moved within the reporting structure from the MCHS information resources department to MCCN. Additionally, the continuous growth of MCCN and the establishment of solid liaison relations with both graduate medical education (residency program support), and professional clinical staff (rounding with physicians, educational sessions, specially designed portals for information access and education) demanded an increase in library staffing. At that time, the establishment of consumer health library services and MCHSLS participation in student work-study programs resulted in a substantial 69 percent increase in the number of staff full time equivalents (FTE).

During this period of growth and restructuring, with a view to raising the bar for service excellence, the library focused on the conversion of client-library staff relations through updates to terminology, access, and services to streamline clients’ informational navigation on the MCHSLS website. A long-term investment in required continuing education for MCHSLS staff led to a qualitative improvement in conducting literature searches and the dissemination of EBM resources. The delivery of these optimized services to clients was quickly followed by a recorded increase of 25 percent in the number of literature searches requested and conducted in academic year 2015-2016. Furthermore, to meet the needs of our MCHSLS clients, library staff have committed to making personalized services available 24/7/365, accommodating all clients’ schedules and preferred meeting locations. In addition, library orientations were established as an integral part of all academic entities, and transformed the old model of “brown-bag” educational sessions into specially designed and targeted self-guided learning sessions accessible virtually at the point of client need.

Over the last decade, the ratio of print to electronic materials in the MCHSLS collections has completely reversed from 70:30 to 10:90, increasing the demand for technology. In addition to 12 existing desktop computer stations, MCHSLS has added 22 laptops and six iPads to its circulating collection. The library’s operating hours have also increased, from 44 hours per week total to 56 staffed hours per week, with access to library space 24/7/365 for all clients using their organizational badges. The relocation of reference services to librarian workstations located in an open quiet study space, virtual support through online chat and texting services, and the use of diverse video applications have totally redefined the concept of innovative MCHSLS on-demand services. The functional and effective use of mobile technology, diverse library software (i.e. LibGuides, LibCal, LibAnalytics, discovery tools, etc.), iTunes University, and other multimedia learning guides have helped to establish and continue building the library’s online presence.

One of the most noticeable revitalizations has occurred in the physical space of the library. When the library moved into a newly constructed building in 2004, the original gray wall paint with botanical art prints, classic cubicle setting for staff, and the general appearance of the warehouse look was not well received by library staff or users. The classic study carrels and four plain study rooms were far from innovative in optimizing the use of library space. Moreover, the maintenance of a large print collection as a primary access point for information had already been superseded by electronic access, especially with the existence of a substantial repository of print resources on the state consortia level. Therefore, by organizing, leading, and completing the first substantial weeding of print collections and subsequently changing the shelving arrangement, the library was able to give half of one floor to MCCN to meet its needs. Transforming this space into a large state-of-the-art classroom further integrated the library into the MCCN educational environment. To support the use of newly introduced educational technology at MCCN, MCHSLS directed the transformation of library study rooms with the addition of audio-visual equipment. The growing MCCN student population created a demand for additional study rooms. Therefore, the warehouse-like space was transformed through the addition of new study rooms and by adding the MCHS-branded burgundy color to the walls. The conversion of library staff cubicles into open personalized work stations increased staff visibility and accessibility for client support and interaction. One floor of the library was redesigned to include a display of MCCN historic documents, artifacts, and a timeline celebrating 110 years of nursing education at MCHS. In addition, one wall was devoted to the library, with a picture of the library founder and organizational faith-based foundations. The transformation of the library’s physical space will continue to take on new forms in the coming months and years through the execution of MCHSLS plans as part of the ALA “Libraries Transform” initiative.

Library finances have also undergone an important restructuring, which started with the consolidation of multisite operating collections and staffing. Furthermore, financial analyses have provided justification for financial expenditures for the purpose of library revitalization. Newly implemented return-on-investment reports and justifications for client-driven purchases and acquisitions have become standard financial practice for MCHSLS. Additional financial growth has stemmed from the establishment of service agreements to support the library needs of multiple Trinity Health Ministry Organizations and the reevaluation and improved control of revenue streams through interlibrary loan services. In addition, receiving grants and securing funding sources for library needs has had a great impact on current and future library revitalization projects.

By positioning itself as an information resources and services hub within MCHS and establishing a significant corporate presence, MCHSLS has become an essential element in the support of the educational and informational needs of the growing MCHS medical and academic community. The revitalization of MCHSLS was also enhanced through a decade of continuous transformation of diverse marketing and outreach initiatives.

The evolving nature of the MCHSLS, implementation of innovative personalized and virtual practices and services, redesign of physical spaces, and a focus on the establishment and development of collaborative partnerships with academic, clinical, and consumer communities are the essence of our service continuum. MCHSLS has fostered a transformational environment of engaged colleagues who strongly believe that our leadership philosophy, “It’s not about ME, it’s about WE!” is a strong foundation on which to build and direct our future actions and achievements.

We are excited about our plans for future development and strongly believe that the services and support we provide to our communities will empower them with the needed professional information and knowledge. Driven by visionary leadership and intrinsic motivation, our synergized team is committed to innovation, excellence, and continuing growth and change in health sciences librarianship.

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Acknowledgements: I am grateful to my colleague Allison Erlinger, BSN, RN, MA, MLIS, for editing and assisting in the completion of this article.