The role and functions of the skilled librarian are often overlooked as a team member when it comes to evidence-based practice. For those who have access to a librarian, the value of their contribution is evident. For those who may not use or underuse the expert practice of the librarian as an active individual and team resource, this is a call to action for reasons described.
Evidence-based practice is complex, but the goal is simple: to bring the prevailing science to bedside practices. As science grows within nursing and health care, the number and types of resources available that are trustworthy curators of evidence require discernment on the part of the user—from the point of care onward. If we believe that evidence-based clinical practice informs patient outcomes, then the argument stands that we should also be using evidence-based leadership or management practices. Everyone who plays a role in the organization influences human and material resource use, influences and tries to improve the organizational culture, and ensures that work design optimizes the talent, skills, and abilities of workers to attract and retain them. Health care workers are in short supply and are often highly specialized, providing added impetus for evidence-based leadership practices.
The Role of the Librarian
Organizational leaders and professional development educators should locate a reference library that is both accessible and adequately sourced. Sources of research and evidence have been elevated by electronic access to journals and other materials, but the cost is a consideration in choosing a library that assumes the cost of fees for subscription databases. Those who affiliate with an organization that makes library services free and funds access to collections should see this as an employee benefit. Beyond employment or academic settings, accessing collections through public libraries is a benefit of tax dollars paid. For those without access to a network, scientific manuscripts are available through the Internet but often at a charge per manuscript, which can become cost prohibitive, especially without the professional guidance offered by a librarian.
Once a library is selected, the next important relationship to develop is with a librarian. Librarians today range from the rare generalist to specialists in metadata, reference, research, scholarly publishing, and more, as well as within disciplines of health care, entrepreneurship, general business and finance, patents and trademarks, and beyond (Crosby, 2000). Given a choice, users should request a librarian most aligned with their needs, knowing that someone with an area of expertise will possess knowledge of database vocabularies, which can produce more precise search results. Approaches that librarians use when developing a professional partnership vary. It is common for the librarian to help the user achieve independence from the onset, so users should appreciate the effort to become emancipated from the librarian. Frequently, librarians will approach the user as a partner and colleague, where there is a mutual dependence on the user teaming with the librarian, especially in subjects that require sleuthing for targeted information that may be rare or indexed in a particular manner.
Users can expect a range of services from working with a librarian. Some of these are the following:
- Research consultations and support. The librarian helps the user gain a greater understanding of how to use the library databases, manage citations, and find answers to research questions or specialized queries. Some librarians have expertise in performing systematic reviews, which will improve the quality of the work.
- Instruction sessions. Librarians hold routine educational sessions where users can benefit from group-based learning. For the novice user, these sessions build confidence with the vocabulary and structure of databases, creating a comfort level and curiosity about the range of possibilities that exist in the contemporary library. For experienced users, these sessions can also lead to new insights about various databases and help them to further build their searching skills to more efficiently find the best evidence.
- Scholarly communications. For the user with publishing aspirations, the librarian is poised to guide the user about where to publish works of different types (e.g., research oriented, case study). Journals have impact factors that rank their influence, and the librarian can interpret the impact factor if relevant. Copyright, open access, and other legal aspects of publishing are all within the librarian's expertise.
- Subject and journal alerts. Many users want to track a topic, author, or even the table of contents of a journal. When the topic is covered in the social or print media, the librarian can help to set up alerts so the user is abreast of late-breaking publications on topics of interest and the latest issues of key journals.
- Citation searches and alerts. For users who are authors, there may be interest in identifying who is accessing the publications of the user. Another service librarians offer is assisting users to set up alerts that enable the user-author to stay aware of how their work is being used and cited, locally and globally.
The Case for Evidence to Drive Leadership Practice
We contend that leadership practices are undersourced and bear an overreliance on instinct and intuition. Habits acquired through life experience, social norms, and technologic expertise occur through experiences in organizations, beginning with the family unit. Organizational theorists have configured organizations based on the predominant models shaped through the industrial revolution, and many advanced degree programs support training in these tactics. Topics studied included work design, human factor analysis, motivation and incentives, individual and group behavior, productivity and economics, and topics studied by social scientists—psychologists, anthropologists, sociologists, among others—outside the mainstream of health care.
Databases most familiar to health care leaders and clinicians are PubMed® (for medical topics) and CINAHL® (with a nursing and allied health professions orientation). Both index leadership and management topics published in health care publications, usually through the lens of researchers who have health care backgrounds and possess an interest in health policy, job satisfaction, workforce supply, demand trends, and work cultures. As helpful as this research is, it is limited in terms of drawing from best practices in other businesses and industries, and by the range of professions that examine organizational behavior and industry trends.
To better draw on the best leadership practices of industries outside of health care, educators should guide uses to business-related databases. These databases will cover the field of accounting, business theory and practice, communications, decision-science, economics, finance, information system, management and strategy, marketing research, and organizational behavior. Business databases include analyses of research, company information, and content from newspapers and trade magazines.
In a convenience sample of libraries with a business orientation, we offer (without endorsement and with the knowledge that databases are ever-expanding) that two databases stand out for leadership and organizational publications. ABI Inform (Pro-Quest®) is a database indexing 6,800 business and management publications, 5,510 of these with full text. Business Source Complete (EBSCO) indexes more than 2,200 active full-text journals and magazines and 600 active full-text peer-reviewed journals dating back to 1965.
Everyone wants a productive search, and this begins with being clear about the question the user wants to be investigated. Next, users should break the question into key concepts using the PICO format (Problem, Intervention, Comparison, Outcome). Based on the subject matter being pursued, the user selects the database most likely to yield comprehensive results, which have been previously identified. If the goal is a comprehensive search, using more than one database is advised to include the use of words with similar or alternative common terms to the concept under review. A librarian can help uncover the vocabulary and keywords by combining them with what are called Boolean operators (fueling the database with the words AND, OR, and NOT). Recall that searches generally begin broad and are narrowed. The user will gain ideas for how to refine a search when they see the results of the broad search. Again, the librarian can help refine the search until the user gains confidence in using the databases that best suit their personal preferences.
In this article, we addressed the need for evidence-based leadership and organizational practice. Like clinical evidence, there are best ways to improve organizational functioning, and if evidence exists, it should replace intuition as a support for decision making. Health care providers are familiar with clinical searches but less comfortable with searches that extend outside the clinical realm. By using librarians and introducing other databases that cover leadership and organizational topics, we see that new best practices are possible if extrapolated into the health care environment.