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For Librarians | LibraryZone July 2011, Springer’s College Marketing Project

LibraryZone speaks with Ms. Fujimi Kawai, Chief Librarian in the Medical Library, St. Luke’s International Hospital

1. St. Luke’s International Hospital is run on the philosophy of Rudolf Teusler. Are the activities of the Medical Library based on these principles as well? 


Every member of staff takes great care to follow the hospital’s philosophy. The words of the philosophy are displayed on the wall of the Medical Library and we remind ourselves of them as we work. Above all, the hospital is meant to function as “a living organism” so we try not to be a merely passive service but to be active always in providing support in the treatment of patients as circumstances demand.

2. We believe the Medical Library engages in educational activities also. Could you elaborate? 

K: The Library is part of our Center for Education and Research. The Department of Clinical Education and the Department of Research Development also belong to the Center. We give an orientation session to each staff category and deliver very meticulous training, mindful of firmly rooting the hospital’s philosophy into our newly recruited members. As for EBM training, we have the Center for Clinical Epidemiology, where workshops on clinical epidemiology are held and support for clinical research is provided.
In addition, we have something called St. Luke’s Academia. This is the brainchild of our President who wanted to nurture the ground for clinical research within the hospital. Started five years ago, it is an academic meeting that meets once a year. An organizing committee comprising members appointed from the Center for Education and Research and other sections plans and runs the Academia.
The Medical Library’s role in this is mainly to edit and publish the program and proceedings of the Academia. We do not intend this to be simply an in-house presentation; we promote the submission of papers to external conferences and to get them published in journals. Therefore, we investigate opportunities for presentation of papers to other academic meetings and for publication of papers. We also edit the list of the academic achievements.
St. Luke’s policy is not just to tackle the work that is in front of us but always to try to question things and to make an effort to achieve higher quality, and ultimately to communicate the results we achieve to the wider world in the form of clinical research. Our goal first and foremost is to provide high quality healthcare.

3. What strategies do you employ in determining which information resource to select? 


At St. Luke’s, our approach is not only to serve the doctors but also to assist all members of staff in their work, including other healthcare professionals as well as administrators. One illustration of this would be our active drive to introduce EBM tools that are easy to use clinically. The tools are not simply for doctors’ use. We believe they can be used by nurses and allied healthcare professionals.
We have an environment where there is free access to digital resources across the hospital. A great deal of use is made of these resources. Also, thanks to package contracts, we have more resources that we can access, enhancing our coverage ratio of reference documents.
For example, Springer’s package is used a lot. Until now, users were only able to read certain titles but we were quite surprised to find that there was such a demand. We are keenly aware that users chiefly look for references that contain evidence rather than browse through journal by journal.

4. What are you doing in order to promote the use of information resources? 


Although we have not made it publicly available, we have created a library homepage and an environment where you can do OPAC and catalog search. Another venture is collaboration with the librarian at St. Luke’s College of Nursing that is located adjacent to us. We hold “Information Retrieval Guidance” five times a year. This is a practical learning session in which doctors, nurses and student nurses can take part. Also, at the request of departments and individuals belonging to St. Luke’s, we hold search skills classes. We are supporting users by offering training that enables our members to use resources effectively.

5. What is your view on the acquisition of information resources that can be accessed using mobile devices? 


An increasing number of interns and other staff are requesting use via mobile devices such as iPhone or smartphone. We are introducing several different EBM tools to our users but I expect young users who are very familiar with such devices would lead the way in spreading the use of these tools, trailing the older generations with them. I am paying attention to this development very much. I think the use of e-books will spread, too.
Not only library resources but projects are also ongoing in Japan to develop electronic medical record access and diagnostic systems. I am sure it won’t be too far in the future when the first choice for information search in the hospital would shift from PC to mobile device.

6. How do you monitor library usage by users and how do you reflect the data in your resource acquisition? 


St. Luke’s has always considered use to be the priority. Living in this digital age, it is now easier to obtain user statistics. For printed materials, we get the used copies to be put back onto our wagon. We make a record of these the following day and then return them to the shelves. This is the method that has been used over many past decades. We can gage user trends this way and we use this information for budgeting the following year.
We are always trying to eliminate waste while paying attention to what is really needed and what can be done somehow to make ends meet when we find that something is absolutely necessary. We only have limited space, so we resort to disposal after determining whether or not certain books or back issues of periodicals are really needed.

7. Our final question is, do you personally have any special challenges you’d like to take up? 


My predecessor qualified as librarian in the USA in the 1980s. She was a pioneer who brought home and put into practice the work of a clinical librarian, a career that was attracting attention at the time. Because of EBM, the “informationist” has now appeared as an occupation in Europe and America and is thriving; however, this is not going to become a reality in Japan anytime soon. Still, as our hospital aims to provide high quality healthcare, I would like to continue working with high aspirations, selecting and providing high quality information.
In addition, I would like to create networks between hospital libraries. We have two librarians at St. Luke’s but in many other hospitals around the world, a one-person library is common. In the medical world, the resources that are wanted are fairly similar and we share the same problems such as employment, budget and training. As we live in the internet age, I think it would be good if we can network hospital libraries of the world and liaise with each other.
Two years ago, I had the opportunity to talk to a hospital librarian in South Korea. I really felt that we work in a similar environment. Meanwhile, within the hospital itself, I cannot easily find anyone I can turn to for advice on library operations. In Japan itself, we are engaging in coordinated activities through the Japan Medical Library Association Hospital Libraries Section. What I would like to do is to create a global network, because it seems to me that we have much in common with other hospital libraries in the world.
The Great East Japan Earthquake of March 11 this year inflicted catastrophic damage and a huge death toll. The desperate effort at the frontline of medical care in the region still continues. As part of disaster relief, the Japan Medical Library Association is providing reference documents free of charge to healthcare professionals in the affected area. My library has registered as a supporting library offering this free document service. We are hoping to be of assistance in any way we can through the network of librarians and libraries.
The ultimate goal of medical care is to help patients. I believe that differences in needs and resources should not affect the quality of medical care that is delivered at the endpoint. It would be a good thing if we can offer support to needy areas and contribute to providing fairer medical care.

The founding philosophy of Rudolf Teusler: 

“This hospital is a living organism designed to demonstrate in convincing terms the transmuting power of Christian love when applied in relief of human suffering.”

St. Luke’s International Hospital  

St. Luke’s logo
Dr. Rudolf Teusler was sent to Japan as a missionary by the Episcopal Church in the United States of America. He founded St. Luke’s International Hospital in Tsukiji, Tokyo in 1902. The hospital is a facility that provides holistic care guided by Christian principles. It is also a model training facility for healthcare professionals including doctors and nurses.
A new hospital building was built in 1992. All in-patients are in single care units except for ICU and Pediatrics. Facilities include the Emergency Medical Care Center and the Center for Preventive Medicine. In conjunction with St. Luke’s Life Science Institute’s Center for Clinical Epidemiology, research and education in clinical medicine and nursing are conducted.
St. Luke’s has 520 beds. It is notable in having a higher staffing ratio than is the average in Japan. General hospitals in Japan have a total of 118.8 personnel per 100 beds (of which, 13.3 are doctors). St. Luke’s has a total of 315.2 per 100 beds (of which, 56.6 are doctors). This is 3 to 4 times the average Japanese ratio. Team healthcare and clinical research are promoted. Not only doctors but nurses, allied health professionals and administrative staff also are highly motivated in pursuing learning and research.
To realize the goal of providing “high quality healthcare”, St. Luke’s has compiled and published its Quality Indicator since 2004. President Tsuguya Fukui is a leading light in EBM research in Japan. He currently serves as the President of the Japan Medical Library Association.

Fujimi KAWAI: Profile 

Joined St. Luke’s International Hospital in 1986, currently works as Chief Librarian in the Medical Library, which forms part of the Center for Education and Research, engaging in library management as well as selection/management of periodicals (mainly e-journals) and databases
As a Director of the Japan Medical Library Association, Ms. Kawai is responsible for Executive Committee and Contract Research Services Committee. Also chairs the Expert Searching Working Group for Clinical Practice Guidelines. Since 2011, has been a committee member for the Minds (Medical Information Network Distribution Service) Project of the Japan Council for Quality Health Care
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