Showing papers in "Health Information and Libraries Journal in 2005"

Effective e-learning for health professionals and students--barriers and their solutions. A systematic review of the literature--findings from the HeXL project.

Abstract: Introduction: In 2003/4 the Information Management Research Institute, Northumbria University, conducted a research project to identify the barriers to e-learning for health professionals and students. The project also established possible ways to overcome these barriers. The North of England Workforce Development Confederation funded the project. Methodology: The project comprised a systematic review of the literature on barriers to and solutions/critical success factors for e-learning in the health field. Fifty-seven references were suitable for analysis. This review was supplemented by a questionnaire survey of learners and an interview study of learning providers to ensure that data identified from the literature were grounded in reality. Results: The main barriers are: requirement for change; costs; poorly designed packages; inadequate technology; lack of skills; need for a component of face-to-face teaching; time intensive nature of e-learning; computer anxiety. A range of solutions can solve these barriers. The main solutions are: standardization; strategies; funding; integration of e-learning into the curriculum; blended teaching; user friendly packages; access to technology; skills training; support; employers paying e-learning costs; dedicated work time for e-learning. Conclusions: The authors argue that librarians can play an important role in e-learning: providing support and support materials; teaching information skills; managing and providing access to online information resources; producing their own e-learning packages; assisting in the development of other packages.

The value and impact of information provided through library services for patient care: a systematic review

Abstract: Objective: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. Methods: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, Medline, PreMedline, Embase, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. 28 research studies of professionally led libraries for healthcare staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format since the studies were heterogeneous and precluded a statistical analysis. Results: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. Conclusions: Research studies suggest that professionally-led library services have an impact on health outcomes for patients and may lead to time savings for health care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.

Using mobile technologies to give health students access to learning resources in the UK community setting

Abstract: Objectives: This article describes a project which explored the potential for mobile technologies to give health students in the community access to learning resources. The purpose included the need to identify possible barriers students could face in using mobile technologies. Another focus was to assess the students perceptions of the importance of being able to access learning resources in the community. Methods: This 1-year project used two main approaches for data collection. A review of the literature on mobile technologies in the health context was conducted. This was used in a systematic way to identify key issues and trends. The literature review was used to inform the design and production of a questionnaire. This was distributed to and completed by a group of community health students at Northumbria University, UK. The questionnaire was piloted and there was a 100% completion rate with 49 returned forms. Results: The literature review indicated that most mobile technology applications were occurring in the US. At the time of the review the most prevalent mobile technologies were PDAs, laptops, WAP phones and portable radios with use being concentrated around doctors in the acute sector. A range of advantages and disadvantages to the technology were discovered. Mobile technologies were mainly being used for clinical rather than learning applications. The students showed a low level of awareness of the technology but placed great importance to accessing learning resources from the community. Conclusions: Significant development and changes are taking place in mobile technologies. Since the data collection for this work was completed in 2004 podcasting and videocasting have become significant in mobile learning for health professionals. Librarians will need to address the relevance and implications of m-learning for their practice. Care and consideration needs to be given on the time and resources librarians allocate for the necessary development work around mobile technologies. Collaboration and partnership working will be most effective approach for librarians wishing to integrate their services with m-learning technologies.

A strategic approach to developing e-learning capability for healthcare.

Abstract: Objectives: This article examines a strategic approach to developing e-learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e-learning developments are considered. Methods: The 2-year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e-learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented. Results: The MLE has been piloted and on-line learning packages have been acquired. There has been a phased take-up of e-learning opportunities and e-tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning. Conclusions: The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e-learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints—the MLE's benefits are widely recognized.

Undertaking an information-needs analysis of the emergency-care physician to inform the role of the clinical librarian: a Greek perspective.

Abstract: Aim of study: The primary focus of this pilot study was to gain a better understanding of the information needs of emergency-care clinicians. The secondary focus was to compare the traditional current practice of information provision within other emergency departments in Greek hospitals, with the new model of clinical librarianship (CL). Rationale: Clinical staff in the emergency department deal with a variety of cases, they have no time to visit the library, but need information instantly in their place of work. Clinical decision making in the emergency department setting frequently requires the clinician to obtain additional sources of information and clinical librarians may facilitate this. Study design: The present study focused on two professional groups: medical librarians (group A) and clinicians (consultants, senior registrars, registrars, nurses (group B), working in the emergency departments of two Greek hospitals. The study was organized through a questionnaire survey and some in-depth interviews. Results: This study showed that, for 100% of the clinicians in daily practice, the main information needs arise while treating patients, and that information would help in making patient-care decisions. Clinicians made little use of hospital libraries because they are usually under tremendous time pressure. The main outcome of the study was the use of a clinical librarian as an information provider. Clinical librarians supply information to assist decisions, based on this model. This extends the librarian's role in evidence-based medicine, giving much stronger attention to the relevant evidence in clinical practice. Conclusions: Nowadays, health services are facing organizational change. The introduction of new technology, and rapid growth of medical knowledge creates a demand for new ways of providing information. Clinical librarian programmes may deliver patients specific information in a timely manner. The mission of the clinical librarian is to facilitate access to quality information which is necessary for improving health, and to act as an informationist in the emergency department.

The information needs of perioperative staff: a preparatory study for a proposed specialist library for theatres (NeLH).

Abstract: Aims/objectives: To undertake an information-needs analysis of operating theatre staff in order to inform the development of a specialist library of the National Electronic Library of Health (NeLH). Setting: Three hospitals in an NHS Trust in a rural county in the north of England. Methods: In-depth interviews, during which staff were questioned in regard to their job roles and information needs, information-seeking behaviour, access to computers, use and perceptions of the NeLH, and what they would like from a specialist library. Results: Information needs were found to concern direct care, professional and academic development, medical devices knowledge and administration. Currency and speed of delivery were the key information requirements. Poor communication appeared to be a major problem for many staff and inhibited efficient information exchange. When using the Web, both clinical and non-clinical staff searched in a similar fashion to health consumers generally, despite their need for highly specialist information. Most respondents reacted warmly to the idea of the proposed National Electronic Library for Theatre Staff (NeLTS) and made several practical suggestions for suitable material. However, access was problematic for nurses and might prove to be an obstacle to take-up of the Specialist Library. Conclusions: Communication difficulties, the fragmentation of data in the field and the consequent difficulties of finding information point to the need for an NeLTS. However, for this library to embrace and succeed with all the various groups that constitute the operating theatre staff, issues of access and digital literacy need to be addressed.

Use of libraries and electronic information resources by primary care staff: outcomes from a survey.

Abstract: Objectives: To assess the use of existing libraries; usage of the Internet and biomedical databases; and need for training on use of the Internet and biomedical databases for primary care staff. Methods: A postal survey of general practitioners (GPs), practice nurses (PNs) and practice managers (PMs) in Nottingham and Rotherham, UK. Results: Overall, 243 questionnaires were used. The response rate in Nottingham was 24%, in Rotherham it was 34%. Reported use of libraries was low (30%), with PNs reporting significantly higher usage (65%) than others (P < 0.01). Most respondents reported using the Internet (81%), but fewer (44%) reported using databases. GPs and PNs were significantly more likely to report using databases than PMs (P < 0.01). Lack of training was the most reported barrier to using the Internet (67%) and databases (52%). Overall, 52% of respondents reported wanting Internet training, 64% wanted database training. The percentages requesting training on databases were high among GPs and PNs, but significantly lower for PMs (P = 0.02). Conclusions: There are differences in the usage of libraries and electronic resources among the primary care team, and in reported training needs. While the reported levels of usage of the Internet and biomedical databases are encouraging, our study identified a training need. If met, this could increase usage further.

Information-seeking behaviour and use of the Internet by French general practitioners: a qualitative study.

Abstract: Background: Numerous studies deal with the use of computers and the Internet in the health sector. Most of these studies show an increase in the use of the new technologies in searching for medical information—particularly by patients—but these uses remain very heterogeneous and depend on the studies. Aims: The aim of this work was to consider the use of computers by French general practitioners (GPs) and to analyse the impact that computerization could have on their information-seeking behaviour. Methods: The nature of the approach used is qualitative using interviews. Results: Most of the GPs interviewed are equipped with a computer. The policies of the government were supposed to give financial incentives for GPs to start using computers for the management of administrative procedures, but many physicians do not know how to use the new tools properly. Their computers are, in most cases, underused for searching for medical information. Most of the time, the Internet sources are thought to be unreliable. Conclusion: This study sheds light on the use of computers and the preferences of GPs in searching for medical information.

Impact of librarians in first‐year medical and dental student problem‐based learning (PBL) groups: a controlled study

Abstract: Background : Librarians at the University of Alberta have been involved with teaching undergraduate medical and dental education for several years. After 1 year of increased librarian involvement at the problem-based learning (PBL), small-group level, informal feedback from faculty and students suggested that librarians’ participation in PBL groups was beneficial. There was, however, no real evidence to support this claim or justify the high demand on librarians’ time. Objectives : The study aimed to determine whether having a librarian present in the small-group, problem-based learning modules for first-year medical and dental students results in an improved understanding of evidence-based medicine concepts, the nature of medical literature, and information access skills. Methods : One hundred and sixty-four first-year medical and dental students participated in the study. There were a total of 18 PBL groups, each with approximately nine students and one faculty tutor. Six librarians participated and were assigned randomly to the six intervention groups. Students were given pre- and post-tests at the outset and upon completion of the 6-week course. Results :P ost-test scores showed that there was a small positive librarian impact, but final exam scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not. Conclusions : Impact was not sufficient to warrant continued participation of librarians in PBL. In future instruction, librarians at the John W. Scott Health Sciences Library will continue to teach at the larger group level.

Australian occupational therapists' use of an online evidence-based practice database (OTseeker).

Abstract: Introduction: Online databases can support the implementation of evidence-based practice by providing easy access to research. OTseeker (www.otseeker.com), an electronic evidence database, was introduced in 2003 to assist occupational therapists to locate and interpret research. Objectives: This study explored Australian occupational therapists' use and perceptions of OTseeker and its impact on their knowledge and practice. Methods: A postal survey questionnaire was distributed to two samples: (i) a proportionate random sample of 400 occupational therapists from all states and territories of Australia, and (ii) a random sample of occupational therapists working in 95 facilities in two Australian states (Queensland and New South Wales). Results: The questionnaire was completed by 213 participants. While most participants (85.9%) had heard of OTseeker, only 103 (56.6%) had accessed it, with lack of time being the main reason for non-use. Of the 103 participants who had accessed OTseeker, 68.9% had done so infrequently, 63.1% agreed that it had increased their knowledge and 13.6% had changed their practice after accessing information on OTseeker. Conclusion: Despite OTseeker being developed to provide occupational therapists with easy access to research, lack of time was the main reason why over half of the participants in this study had not accessed it. This exploratory research suggests, however, that there is potential for the database to influence occupational therapists' knowledge and practice about treatment efficacy through access to the research literature.

The information needs and information-seeking behaviours of home-care workers and clients receiving home care.

Abstract: Cooper, J. & Urquhart, C. (2005). The information needs and information-seeking behaviours of home-care workers and clients receiving home care. Health Information and Libraries Journal, 22(2), 107-116. Sponsorship: AHRC

A survey of UK clinical librarianship: February 2004.

Abstract: Aim: This article will describe a survey carried out in February 2004, the aim of which was to summarize the form and content of clinical librarian (CL) and other similar outreach information services to UK health professionals in the acute (secondary or tertiary) sector. Objectives: (i) To survey the activities and views of UK information professionals offering information services involving the librarians’ presence in the clinical setting, (ii) to develop a tool to explore critical aspects of this form of information work, (iii) to create a contacts database for UK CLs, to be made available on the Internet. Methodology: All known information specialists/librarians offering CL or similar services were surveyed. The semi-structured questionnaire was piloted. Respondents were asked to consider their activity over a period of 4 weeks. Results: Twenty-six people responded to the invitation to take part and met the inclusion criteria. Conclusions: A summary of a ‘typical’ clinical librarian revealed by this survey is given, with a major conclusion that there is a very mixed picture of activity. Opinion on how far CLs should go in fully appraising search results is uncertain. The survey suggests reasons for this and the developments that may influence change are discussed. Recommendations for future research and development are offered.

Healthcare librarians and learner support: a review of competences and methods.

Abstract: London Health Libraries (LHL) are undertaking a project, in order to develop the role of their library and knowledge services staff in supporting learners within the NHS in the London area [LHL Learner Support Project]. This paper reports on the first phase of the project, a literature analysis to provide guidance on the skills and competences needed for library and knowledge staff to perform this function. A variety of competences are identified, and structured in a model incorporating both training skills and general professional competencies. Library and knowledge staff will need themselves to have a high-level of information literacy and to be active lifelong learners. A ‘blended learning’ approach, involving e-learning together with other methods, is identified as the most appropriate way for skills to be acquired.

Examination of the impact of information-skills training on the academic work of health-studies students: a single case study.

Abstract: Aim: To examine the impact of information-skills training on the academic studies of student midwives. Objectives include ascertaining whether student confidence increases, learning experiences are enhanced and academic standards are improved. Methods: A student midwives’ discussion group at a higher education institution, plus an in-depth interview with the students’ course leader. Results: Students reported increased confidence in using library and information resources. Appropriate and timely information-skills training embedded into health-studies curricula can lead to students becoming independent and lifelong learners, as well as improving the standard of their academic work. Conclusion: Information skills for health-studies curricula in higher education can be developed and delivered collaboratively by both library and academic staff. This can have very positive effects on both student perceptions and experiences and standards of teaching and learning.

Health information in Italian public health websites: moving from inaccessibility to accessibility

Abstract: Aims: In January 2004, the Italian government passed new legislation designed to give people with disabilities access to online services. Starting from the new legislation requirements, the purpose of this study is to investigate whether Italian Local Health Authorities websites are accessible to users with different abilities. Methods: One hundred and seventy websites were analysed evaluating their compliance to the World Wide Web Consortium (W3C) Priority 1 guidelines via a combination of appropriate accessibility testing methods. This review was carried out twice: the first time it took place between the end of 2003 and May–June 2004. The same survey was repeated again in December 2004, after the issuing of the draft of the Implementation Regulations for The Stanca Law in July 2004. In this second survey, all the websites analysed before were checked again to establish if some measures to make those sites accessible were taken. Results: Seventy-six per cent of the analysed websites fail to satisfy the most basic W3C requirements, but Italian Local Health Authorities websites are likely to present significant improvements to access for some disabled user groups: the number of accessible websites increased consistently between the first and the second review. Conclusions: It seems that awareness of web accessibility issues is increasing among developers of health information websites because of law enforcement. Recommendations for future research and development are offered.

Information needs of United Kingdom primary care clinicians.

Abstract: Background. The scope of primary care makes knowledge management in this context very challenging, especially as access to information increases and the role of primary care within the NHS expands.Objectives: This paper reviews the literature on the information needs of primary care clinicians to enable evidence-based decision making. Drawing on the literature, and using a specific example of a clinical informaticist service, some lessons are drawn on the role of information professionals in facilitating evidence-based health care.Methods: Literature review. Case study of clinical informaticist service.Conclusions: There are numerous barriers to clinicians engaging with evidence-based practice. However, providing evidence-based information to clinicians' questions in a user-friendly format has the potential to facilitate changes in practice. The successful implementation of information services requires attention to both academic and service dimensions, fostering closer working relationships between clinicians and information professionals.

Information needs of specialist healthcare professionals: a preliminary study based on the West of Scotland Colorectal Cancer Managed Clinical Network.

Abstract: Objectives: Funded by Research in the Workplace Award (RIWA) 2001, the study investigated the information needs and use of NHS library services by members of the West of Scotland Colorectal Cancer Managed Clinical Network (MCN), a single subject, cross boundary, multi-professional organization. Method: A postal questionnaire sent out in October 2002 was returned by 100 members and follow-up interviews were held in March 2003 with 11 of the respondents. The questions related to access to resources, library services such as literature searches, current awareness and training. They also explored the use of electronic resources and the Internet. Results: Respondents were mainly hospital doctors and a few nurses from across five health boards. Most had access to a library, although not all made use of it, possibly an indication of the need for improved communications between librarians and health-care staff. Generally, research and professional development were reported as reasons for needing cancer information, but on further investigation the motivation to conduct literature searches was more related to patient care. Examples included treatment of unusual cases, locating information for patients and identifying guidelines. There are indications of unmet needs for local contact information and evaluated patient information. Conclusion: Development of a cancer portal within the NHS Scotland e-Library available from May 2004 based on the Managed Knowledge Network (MKN) concept is attempting to address many of the issues raised in the survey, including inequities of access to services and signposting to a variety of types of information.

Exploring the benefits of user education: a review of three case studies

Abstract: This paper builds on Leslie Morton's vision of enabling users through education and training. It describes three different approaches to mediated training for medical students and clinicians provided by peers, juniors (i.e. medical students) and information specialists (i.e. clinical librarians) and considers the benefits to the participants. The training was provided either on a one-to-one basis or within teams in their work environments (e.g. offices, wards, team meetings). The first two projects (peer tutoring and reverse mentoring) suggest that contextualized training, using intermediaries, provides the direct benefit of cost-effective IT skill development and the indirect benefits deriving from the interactions between the trainers and the target groups. The third project, the outreach librarian study, provides evidence of both direct benefits (i.e. time saved, quality of service, skills acquired, financial savings and improved evidence-based medicine implementation) and indirect, long-term benefits relating to more social issues (e.g. perceptions of the library, clinical teams, job satisfaction and patient interactions). The general conclusion to emerge from this review of case studies is that the concept of educational benefits is very broad and that empirical studies need to look at both obvious and less obvious benefits.

The increasing globalization of health librarianship: a brief survey of international trends and activities

Abstract: Background and purpose: Throughout his career, Leslie Morton was interested in international developments in health librarianship. In memory of the work he did in this field, the authors examine current developments in international health librarianship and describe some current themes. Procedures: The authors draw from their combined experience in international activities and the published information available from selected library associations and related organizations. Findings: Although many of the major health library associations around the world are tackling agendas specific to their own country, issues of international concern are emerging in common. These are grouped around globalization, partnerships and co-operation, electronic access, especially open access, and working with the developing world in a number of different ways. Of course, the basis of all of these initiatives is to improve the health of the population by providing the best possible access to materials. Conclusions: Professional associations can provide a useful institutional infrastructure for addressing issues of international interest. Librarians should encourage their associations to develop these international initiatives and to seek out new and innovative ways to work together across international boundaries.

MEDLINE in the UK: pioneering the past, present and future.

Abstract: This article provides a brief history of the development of the medline database and its huge impact within the UK, from its inception to the present time. The origins of medline can be traced back to a collection of books in the US Surgeon General's Office during the American Civil War and John Shaw Billings’ decision, during 1867, to make this Library as complete as possible. From these beginnings, Index Medicus was developed in the early years of the 20th century, and electronic versions of the database began with the computerized on-demand search service MEDLARS in 1964 and then via CD-ROM and Internet Grateful Med to the web-based and free-to-all service, PubMed, in 1997. The response to PubMed was immediate and startling with usage increasing from 7 million searches per annum in 1996 to 400 million searches per annum in 2001 and the service continues to improve. medline providers are now offering mapping of natural language queries to the sophisticated indexing vocabulary (Medical Subject Headings, MeSH) and the provision of specific filters for different types of publication to improve searching efficiency, as well as links to full-text versions of the papers where available. The next steps are likely to involve an increased blurring of database and full-text boundaries, incorporating seamless access to the best available evidence within medline and a wide range of other information resources within a single search and to an increasing amount of full-text via various open-archive initiatives. As ever, the US National Library of Medicine is in the vanguard of research and further applications of its medline database for users within the UK will be awaited with great interest.

The information needs and behaviour of clinical researchers: a user-needs analysis.

Abstract: Aims: As part of the strategy to set up a new information service, including a physical Resource Centre, the analysis of information needs of clinical research professionals involved with clinical research and development in the UK and Europe was required It also aimed to identify differences in requirements between the various roles of professionals and establish what information resources are currently used Methods: A user-needs survey online of the members of The Institute Group discussions with specialist subcommittees of members Results: Two hundred and ninety members responded to the online survey of 20 questions This makes it a response rate of 79% Members expressed a lack of information in their particular professional area, and lack the skills to retrieve and appraise information Discussion: The results of the survey are discussed in more detail, giving indications of what the information service should collect, what types of materials should be provided to members and what services should be on offer Recommendation: These were developed from the results of the needs analysis and submitted to management for approval Issues of concern, such as financial constraint and staff constraints are also discussed Conclusions: There is an opportunity to build a unique collection of clinical research material, which will promote The Institute not only to members, but also to the wider health sector Members stated that the most physical medical libraries don't provide what they need, but the main finding through the survey and discussions is that it's pointless to set up ‘yet another medical library’

Managing knowledge to support the patient journey in NHS Scotland: strategic vision and practical reality

Abstract: Background: The strategy for NHS Scotland Knowledge Services is set in the context of a global transition to a networked model of management within health services. Objectives: Development planning for NHS Scotland aims to establish strategic vision and operational delivery systems which meet the needs of this changing health environment. Methods: Analysis of knowledge needs at strategic organizational level and through consultation with healthcare staff form the basis of a vision of seamless knowledge support throughout all stages of the patient journey, based on a hybrid model of complementary human- and technology-based knowledge networks. Results: The central role of the NHS Scotland e-library as a system-wide technology infrastructure facilitating management of both explicit and tacit knowledge is described. The implementation pathway and approaches to evaluation are outlined, based on practical steps to translate the concept of knowledge networks into a working reality. Conclusions: The model emerging is that of a knowledge matrix, with the primary delivery system comprising inter-dependent human, organizational and technology-based networks focused on the overriding common purpose of improving patient care.

A survey of users and non-users of a UK teaching hospital library and information service

Abstract: Background: The Lancashire Teaching Hospitals NHS Trust was formed in 2002 with the merger of two existing trusts. The library services unified to create a new expanded service with 11 staff. Objectives: The librarians wanted to test out users’ opinions of the service, as a basis for a developmental strategy. They also wanted to find out to what extent they were offering a multi-disciplinary service, available to all staff. Therefore it was decided to include both users and non-users in the survey. Methods: A twenty-question questionnaire was sent out to a 10% sample of registered users in all staff categories. The same questionnaire was sent out to a 10% sample of non-users, with the help of the Human Resources Department. Results: The library staff and facilities were generally well regarded. The stock needed expansion in various areas, especially allied health and biomedical science. Non-users were in fact often occasional or remote users. Other non-users needed informing that they were entitled to use the service. Conclusions: Further research is required, especially concerning the information needs of allied health and scientific staff. There is a need for stock expansion. A marketing strategy is required to capture the interest of potential users.

Availability of accessible publications: designing a methodology to provide reliable estimates for the Right to Read Alliance.

Abstract: Objectives: To establish reliable estimates of the proportion of books available in formats accessible to visually impaired people; to recommend a practical method of updating the estimates. Methods: The project had two stages. Stage one estimated the overall availability of all categories of books. The British National Bibliography (BNB) for 1999–2003 was chosen as the sampling frame. A sample of 2069 titles over the 5 years was selected using a systematic sample design. These titles were then checked for availability against the catalogues of four major producer/suppliers of materials in accessible formats. The second stage involved checking the availability of books in six genres; about 400 titles for each genre were examined. Results: Of the titles selected for the overall estimate, 92 (4.4%) were found to be available in one or more accessible formats. Availability of titles in accessible formats varied greatly between categories. Adult fiction had the highest number of available publications (26.3%), least represented were cookery (1.9%) and gardening (1.8%). Conclusions: This study provided baseline figures and a methodology for the Right to Read Alliance to monitor their progress in campaigning for more books to be accessible to visually impaired people.