Objectives:  Assessment of the usage of medical library services before and after the implementation of several new services, as well as assessment of the clinical impact of the information provided by the medical library.

Methods:  A sample of employees, residents and physicians were surveyed using a stratified, random selection process in two surveys 4 years apart. The response rate for the first survey was 52% and the response rate for the second survey was 35.2%.

Results:  Differences in usage included increased overall use of the librarians and library services, decreased use of the Internet as a source of information, and direct and indirect impacts upon patient care. Information needs of respondents also increased to where 65% of employees and 94% of physicians require information at least once a week. Patient management was the main reason for needing information. The top two specific uses were to find out about a condition and determine a treatment plan.

Conclusions:  These findings parallel some of the findings of other researchers, and contradict the findings of others. Possible explanations for these findings and implications for future research are discussed.