BENCHMARKING DATA WORKSHEET 2004
Print this worksheet to organize your responses before entering them on the live Web questionnaires. (DO NOT submit this form to MLA; it is for your use only.) The JavaScript pop-up data definitions feature is not available on this worksheet. Read or print definitions from the definitions page.
Depending on your institution type and the availability of data in your institution, this worksheet will require several hours of work to complete. Once you have the data available, however, you should be able to enter the information into the live data questionnaires very quickly. Availability of the live questionnaires will be announced to members on MLANET and in MLA-FOCUS.
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Location
| GD01. Enter your MLA ID# (or may be carried over from login screen): new | ______________________ |
| GD02. Indicate the state/province in which your institution is located: new | state: _________________ |
| GD03. Indicate the MLA chapter area in which your institution is located: new | chapter: ______________________ |
Time Period
| GD04-08. Indicate time period for
which you are reporting ALL the data for this benchmarking survey (should
be 2002 or 2003 data): Formerly PA01a-e. |
___ calendar year (include year below) ___ fiscal year (include months and years below) From month: _________ year: ___________ to month: _________ year: ___________ |
Institution Type
FOR SYSTEM HOSPITAL LIBRARIES ONLY;
all others go to SINGLE INSTITUTIONAL PROFILE QUESTIONNAIRE for your institution
type.
Should you submit data as a health system? READ THIS FIRST!
General Institution Information
| Enter numbers below. DO NOT use commas. Use decimal points as needed. | |
| SY00. Enter your MLA ID# (or may be carried over from login screen): | |
| SY01. What is the corporate name of your health system? new - 60 character limit. | _____________ |
| SY02. What is your system type? new | ___ Model A ___ Model B ___ Model C |
| SY03a. How many hospitals are in the health system? formerly PB02 | _____________ |
| SY03b. How many non-hospital, preacute and/or postacute health-related facilities (e.g., wellness services, mental health services, outpatient services, employer health services, long-term care), owned and operated by the health system BUT SEPARATE FROM ANY HOSPITAL, does the health system have? new | _____________ |
| SY03c-i. If you provided a number greater than zero in SY03b, select the type(s) of services your health system provides: (check ALL that apply) new | ___ wellness services, ___ mental health services, ___ outpatient services, ___ employer health services, ___ long-term care ___ other (please list): _____________ |
| SY04. Indicate your health
system's OWNERSHIP status (choose ONLY one): Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR01. formerly PB05 |
___ government institutionfederal ___ government institutionDept. of Defense ___ government institutionDept. of Veterans Affairs ___ government institutionstate ___ government institutioncity or county ___ government institutionother ___ investor-owned ___ nongovernment nonprofit 501 (c) 3 ___ nongovernment nonprofit 501 (c) 6 ___ other type (please list): _______________ |
| SY05. Indicate whether
the institution(s) your library serves are: formerly
PB04 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR02. For PR02, use the type for the specific institution in which your library has a physical presence. |
___ teaching hospital ___ non-teaching hospital ___ both types |
| SY06a-b. Indicate the
care categories of the institution(s) your library serves(choose ONLY
one): new Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR03. For PR03, use the type for the specific institution in which your library has a physical presence. |
___ cancer ___ general medical and surgical ___ osteopathic ___ pediatric ___ psychiatric or mental health ___ tertiary care ___ rehabilitation or chronic disease ___ multiple categories ___ other (please list): _______________ |
| SY07. Total number of physicians in the health system (please include both full-time physicians employed or appointed by the system and any affiliated community physicians): formerly PB06 | _____________ |
| SY08. Total number of
physicians in the institution(s) your library serves (please include
both full-time physicians employed or appointed by the system and any affiliated
community physicians for your specific institution): formerly
PB07 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR04. |
_____________ |
| SY09. Total
number of health system (not library) full time equivalents (FTEs) (exact
as known, OR according to the most recent AHA Guide): formerly PB08 |
_____________ |
| SY10. Total
number of full time equivalents (FTEs) in the institution(s) your library
serves (exact as known, OR according to the most recent AHA Guide):
formerly PB09
Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR05. |
_____________ |
| SY11. Total
number of health system outpatient visits annually? formerly PB12 |
_____________ |
| SY12. Total
number of outpatient visits annually in the institution(s) you serve?
formerly PB13 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR06. |
_____________ |
| SY13. Total bed count throughout the full health system (exact as known, OR as defined by the most recent AHA Guide): formerly PB14 | _____________ |
| SY14. Total
bed count in the institution(s) you serve (exact as known, OR as defined
by the most recent AHA Guide): formerly
PB15 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR07. |
_____________ |
| SY15. Total
number of admissions throughout the full health system annually (exact as
known, OR according to the most recent AHA Guide): formerly PB16 |
_____________ |
| SY16. Total
number of admissions in the institution(s) you serve (exact as known, OR
according to the most recent AHA Guide): formerly
PB17 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR08. |
_____________ |
| SY17. Within the system, how many institutions maintain separate listings in the AHA Guide? formerly PB28 | _____________ |
FOR SYSTEM TEACHING HOSPITAL LIBRARIES ONLY
Non-teaching system hospitals continue to Question SY25.
| SY18. How many postgraduate training position concurrent slots are available in the health system annually (e.g., the system may have 20 slots with 80 residents rotating through within a year)? formerly PB18 | _____________ |
| SY19.
How many postgraduate training position concurrent slots
are available annually in the institution(s) your library serves (e.g.,
you may have 5 slots with 20 residents rotating through within a year)?
formerly PB19 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR11. |
_____________ |
| SY20. How many medical school clerkship slots are available throughout the health system annually (e.g., there may be 75 slots, but 300 students that rotate through within a year)? formerly PB20 | _____________ |
| SY21.
How many medical school clerkship concurrent slots are available in the institution(s)
your library serves (e.g., there may be 25 slots, but 100 students that
rotate through them within a year)? formerly
PB21 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR12. |
_____________ |
| SY22.
Do the institution(s) your library serves provide services to any School
of Nursing students or faculty? formerly
PB22 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR13. |
___ yes ___ no (if no, answer 0 in SY23) |
| SY23.
If "yes," how many School of Nursing student slots are
available annually in the institution(s) your library serves? formerly
PB23 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR14. |
_____________ |
| SY24.
Do the institution(s) your library serves provide services
to any School of Allied Health students or faculty? formerly
PB24 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR15. |
___ yes ___ no (if no, answer 0 in SY25) |
| SY25.
If "yes," how many Allied Health student slots are available
annually in the institution(s) your library serves? formerly
PB25 Model B and Model C libraries who choose to enter individual library profiles, also include this data in Question PR16. |
_____________ |
General System Library Information
FOR HOSPITAL LIBRARIES ONLY
(OTHER LIBRARY TYPES, SEE BELOW)
| PR00. Enter your MLA ID# (or may be carried over from login screen): | |
| PR01a-b.
Indicate your institution's OWNERSHIP status: formerly PA02 |
___ government institutionfederal ___ government institutionDept. of Defense ___ government institutionDept. of Veterans Affairs ___ government institutionstate ___ government institutioncity or county ___ government institutionother ___ investor-owned ___ nongovernment nonprofit 501 (c) 3 ___ nongovernment nonprofit 501 (c) 6 ___ other type (please list): _______________ |
| PR02. Indicate whether your institution is: formerly PA03 | ___ teaching hospital ___ non-teaching hospital |
| PR03a-b. Indicate
your institution's care category (choose ONLY one): formerly PA04, revised |
___ cancer |
| PR04c. Total number of physicians in the hospital (please include both full-time physicians employed or appointed by the hospital and any affiliated community physicians): formerly PA05 |
_____________ |
| PR05. Total number of institution (not library) full time equivalents (FTEs) (exact as known, OR according to the most recent AHA Guide): formerly PA06 | _____________ |
| PR06. Total number of hospital outpatient visits annually (exact as known, OR according to the most recent AHA Guide): formerly PA08 | _____________ |
| PR07. Total bed count in the hospital (exact as known, OR as defined by the most recent AHA Guide): formerly PA09 | _____________ |
| PR08. Total number of admissions in your institution annually (exact as known, OR according to the most recent AHA Guide): formerly PA10 | _____________ |
| PR09. What are the total annual operating EXPENSES of your institution (as reported in your annual report or in the AHA Guide)? new | _____________ |
| PR10. What is the total annual INCOME of your institution (as reported in your annual report or in the AHA Guide)? new | _____________ |
Add-on For Teaching Hospitals Only
FOR HEALTH ASSOCIATION LIBRARIES ONLY
(OTHER LIBRARY TYPES, SEE BELOW)
FOR LIBRARIES SERVING RESEARCH FACILITIES ONLY
(OTHER LIBRARY TYPES, SEE BELOW)
FOR ALL OTHER LIBRARIES
General Library Information
| AD00. Enter your MLA ID# (or may be carried over from login screen): | |
| AD01. Does your library have a branch location? formerly PA17; moved | ___ yes ___ no |
| AD02. If yes, will your data for this benchmarking survey (all questionnaires) INCLUDE branch location data? formerly PA18, moved | ___ yes ___ no ___ not applicable |
| AD03. What is the total AREA of your library, in square feet? formerly PA19, moved | _____________ |
| AD04. Of the figure in AD03, how many square feet are used for a consumer health information service (estimates permitted; if not applicable, enter 0)? new | _____________ |
| AD05. How many hours per 7-day week is the library open for service? formerly PA20, moved | _____________ |
| AD06. Does your library provide 24-hour physical or electronic access to any user population? formerly PA21, moved, revised. | ___ yes ___ no |
Library Personnel
| Enter numbers below. DO NOT use commas. Use decimal points as needed. | |
| AD07. A full-time employee in my institution works: formerly A02 | _______ hours per week |
| AD08. Indicate the total number of FTE PROFESSIONAL STAFF in your library (includes librarians, archivists, network staff, etc.): formerly A03 | _____________ |
| AD09. Indicate the total number of FTE SUPPORT STAFF in your library (DO NOT include student assistants to be counted in question AD17): formerly A04 | _____________ |
| AD10. The full-time equivalents (FTEs) of all employees in your library: new | Automatically calculated as AD08 plus AD09. Number not correct? Change a figure in AD08 or AD09. |
| AD11. Total hours worked by FTE PROFESSIONAL STAFF: new | Automatically calculated as AD07 multiplied by AD08 |
| AD12. Total hours worked by FTE SUPPORT STAFF: new | Automatically calculated as AD07 multiplied by AD09 |
| AD13. Total hours worked by ALL STAFF: new | Automatically calculated as AD10 multiplied by AD07. NUMBER SHOULD MATCH AD11 + AD12 |
| AD14. Percentage of library FTE PROFESSIONAL STAFF (of all staff): new | Automatically calculated as AD08 divided by AD10 |
| AD15. Percentage of library FTE SUPPORT STAFF (of all staff): new | Automatically calculated as AD09 divided by AD10 |
| AD16. Indicate the total volunteer hours of all volunteers who work in your library; report as hours per month: formerly A05 | _____________ |
| AD17. Indicate the total student assistant hours of all student assistants who work in your library; report as hours per month: formerly A06 | _____________ |
| AD18. In the institution's organization chart, is the library considered a separate department with a distinct budget? formerly A07 | ___ yes ___ no |
| AD19a-b. In the institution's organization chart, to which area or department does the library report? formerly A08, revised. | ___ administration
(main) ___ institutional/corporate education ___ finance and accounting ___ human resources ___ information systems (IS/IT) ___ marketing or public relations ___ medical education ___ medical records ___ medical staff/medical director/medical affairs ___ nursing services / clinical support services / clinical affairs / patient care services ___ performance improvement/quality management ___ other (please list): _______________ |
| AD20. What is the title of the person to whom the director of the library reports? formerly A09 | _____________ |
| AD21. Does the library director/manager have department head status? new | ___ yes ___ no |
| AD22. Does the library director/manager report to "senior management" (see definitions page for this term)? new | ___ yes ___ no |
| AD23. Does your institution maintain a library committee? formerly A10 | ___ yes ___ no |
| AD24-25. Which specialty subject does your library cover, such that 60% OF TOTAL LIBRARY ACTIVITY is devoted to that subject? Choose ONE from list, or specify: new | ___ cancer ___ chiropractic ___ dental ___ health care administration ___ mental health ___ nursing and allied health resources ___ pediatric ___ pharmacology/drugs ___ primary care (formerly family practice) ___ public health ___ rehabilitation or chronic disease ___ veterinary medicine ___ vision science ___ women's health ___ NONE at 60% ___ other (please list): __________________ |
Library Operating Expenditures
| AD26. Please indicate how you would like MLA to handle your financial data (choose ONLY one): formerly A11 | ___ I can enter data, and MLA can report
it in aggregate or individually. OR ___ I can enter data, but MLA should only report it in aggregate or within preselected ranges (with other members' data). OR ___ I can't report any financial data. (please answer questions AD37, AD39, and AD41) |
| NOTE: DO NOT include one-time or capital purchases, such as security systems, in your operating expense figures. | Enter financial data below. DO NOT include commas, dollar signs, or decimals. Round amounts to the nearest whole US$. |
| AD27. Total expenditures for salaries and wages (exclude fringe benefits): formerly A12 | $ _____________ |
| AD28. Total expenditures for staff development and professional travel: formerly A13 | $ _____________ |
| AD29. Total expenditures for monographs: formerly A14 | $ _____________ |
| AD30. Total expenditures for print serials: formerly A15 | $ _____________ |
| AD31. Total expenditures for audiovisual/media resources: formerly A16 | $ _____________ |
| AD32a. Total expenditures for electronic information resourcesdatabases: new | $ _____________ |
| AD32b. Total expenditures for electronic information resourcesserials: new | $ _____________ |
| AD32c. Total expenditures for electronic information resourcesbooks: new | $ _____________ |
| AD32d. Total expenditures for ALL electronic information resources: formerly A17 | Automatically calculated as AD32a + AD32b + AD32c |
| AD33. Total expenditures for delivery services: formerly A18 | $ _____________ |
| AD34. Total expenditures for computer/network equipment (approximate, if institution centralizes): formerly A19 | $ _____________ |
| AD35. Report any other operating expenses not listed above: formerly A20 | $ _____________ |
| AD36. Total operating expenses: formerly A21 | Automatically calculated as AD27 + AD28 + AD29 + AD30 + AD31 + AD32d + AD33 + AD34 + AD35 |
Library Annual Income
Information Services
| Enter numbers below. DO NOT use commas or decimals. Use whole numbers only. | |
| PS00. For programming use only; hidden carry-over from login: MLA ID# | n/a |
| PS01. Indicate the total NUMBER of reference questions received annually: formerly PS01 | _____________ (if not applicable, enter 0) |
| PS02. Of the number given in PS01, how many were consumer health reference questions (for professional staff, patients/families, or the general public)? formerly SP09, moved to this location | _____________ (if not applicable, enter 0) |
| PS03. Indicate the total NUMBER of mediated searches performed in your library annually: formerly PS02 | _____________ (if not applicable, enter 0) |
| PS04. Of the number given in PS03, how many mediated searches were for use in a consumer health information service (estimates permitted)? new | _____________ (if not applicable, enter 0) |
| PS05. Of the number given in PS03, how many mediated searches were directly related to patient care (estimates permitted)? formerly PS03 | _____________ (if not applicable, enter 0) |
| PS06. Indicate the total NUMBER of educational program sessions offered by your library annually: formerly PS04 | _____________ (if not applicable, enter 0) |
| PS07. Of the number given in PS06, how many educational program sessions were provided to consumers as part of a consumer health information service (estimates permitted)? new | _____________ (if not applicable, enter 0) |
Resource Use
| CQ00. For programming use only; hidden carry-over from login: MLA ID# | n/a |
| CQ01. If you are in a specialty library and would be interested in developing specific measures for your library/institution type, please check here: new | _____________ |
| CQ02. Considering the effort you have made to collect data for this benchmarking survey, how often would you be willing to collect this (or similar) data for future benchmarking surveys? new | ___ every year ___ every two years ___ every three years ___ every five years ___ I never want to do this again |
| CQ03. Use this space to provide comments, to ask non-urgent questions, or to suggest additional questions for future benchmark data collection. If you have an urgent query about any question or definition in this survey, contact Kate Corcoran, corcoran@mlahq.org, 312.419.9094 x12. Formerly just a comments box | _____________ |