PROGRAM DESCRIPTION / DESCRIPTION DU PROGRAMME From Partnership to Program: The Evolution of SHIRP

: Created to license a subset of the University of Saskatchewan Library’s electronic resources for access by health care practitioners in the province, the Saskatchewan Health Information Resources Program (SHIRP) has undergone substantive organizational and administrative changes in its first decade of existence. Although its mandate remains the same, the transition of SHIRP from a partnership to a program and its subsequent integration into the University Library’s operations, has streamlined processes, increased the visibility and understanding of SHIRP across the province, and enhanced SHIRP’s ability to provide electronic resources and library services to practitioners working alongside Saskatchewan health sciences students.


Introduction
The Saskatchewan Health Information Resources Program (SHIRP) licenses a subset of the University of Saskatchewan University Library's subscribed eresources for use by health care practitioners employed in the province of Saskatchewan. This program is among the first of its kind in Canada, tracing its origins back to the early 2000s. SHIRP has received two national awards in recognition of its achievements: the 2008 CLC/OCLC Award for Resource Sharing Achievement [1] and the 2009 CHLA/ABSC Flower Award for Innovation [2]. Other libraries, in accordance with developments in their provinces, have also created innovative solutions and programs to address the information needs of their health care practitioners [3,4]. While most of these other solutions and programs provide e-resources on a cost-recovery, consortial purchase, or membership fee basis, funding for SHIRP e-resources is included as part of the operating budget the University of Saskatchewan receives from the provincial Ministry of Advanced Education. This article touches briefly on the history of SHIRP, describes its current state following its transition from a partnership to a program, and highlights its future plans.
SHIRP was created as the Saskatchewan Health Information Resources Partnership in a 2003 funding proposal to the Saskatchewan Academic Health Sciences Network (SAHSN) [5] written by representatives from the University of Saskatchewan (UofS) Health Sciences Library and the Saskatchewan Health Libraries Association (SHLA). This proposal responded to access to health information issues identified by the Liaison Committee on Medical Education (LCME) during their 1995 and 2002 undergraduate program accreditation visits to the UofS. LCME identified two main library issues: inadequacies in the UofS Health Sciences Library's collections, staffing, and space, as well as discrepancies in access to electronic health information resources for the province's health care practitioners who work alongside UofS medicine (and other health sciences) students [6]. The proposal was included in a larger submission to what at the time was the provincial government's Ministry of Advanced Education, Employment and Labour (the Ministry) as part of the plan by the UofS to address all of the College of Medicine undergraduate program accreditation issues.
At the time of these LCME accreditation visits, health care practitioner access to electronic health resources depended on their affiliation(s) throughout the province. Health care practitioners who are active UofS preceptors play an important role in the formal training and evaluation of students. Upon appointment as preceptors they are provided with full access to all UofS Library resources. However, other practitioners in the province who frequently work alongside UofS students and provide guidance and support in an informal capacity were not able to access any of the University Library's resources. The College of Medicine's distributed learning environment heightened the need for these practitioners to access key electronic resources from the University Library's collections. SHIRP was created to support this group of practitioners, by providing them with greater access to e-resources, training to optimize their use of these resources, and a free document delivery service.
The funding proposal identified: three distinct, yet interlinked, challenges … each requiring separate, ongoing funding. The first is to address the LCME accreditation and by extension the curricular needs of the College of Medicine as it applies to the University of Saskatchewan Health Sciences Library. The second challenge is to extend an initial suite of the U of S library's electronic resources to cover the Saskatoon, Regina Qu'Appelle and Prince Albert Parkland Health Regions….. The third is to extend access to this initial suite of health information resources to all health care practitioners in the province. [6] SHIRP was created in response to the second and third challenges. The funding proposal also notes that access to SHIRP "will strengthen the student learning experience by ensuring that the health care providers they are working with have access to the most current information resources" and that SHIRP …. does not replace any of the existing regional health libraries, academic libraries or other entities within the province. Rather, it serves to gather and present the most valuable electronic information and knowledge resources and services to a shared clientele in a more systematic and cost effective manner. Some of the resources will be provided from member libraries, while the 'gaps' will be identified and filled by the partnership. [6] By licensing a core suite of e-resources for use by health care practitioners across the province, and in later years for use by post-secondary health students and government health employees, SHIRP would be instrumental in providing equitable access to electronic resources to support health education and, by extension, health research and practice in Saskatchewan.

Description
The funding received by the UofS from the Ministry was divided into three budgets: College of Medicine, Health Sciences Library, and SHIRP, and was provided as separate envelope funding directed for accreditation expenditures only. For the first several years this funding had to be annually justified and rerequested from the Ministry. Over time, the way this funding was received from the Ministry evolved into targeted funding, then to being included as part of the University's annual operating grant in 2014-2015. This latest change in the way that the funding was provided impacted the financial accountability and overall reporting structure of SHIRP. When SHIRP was funded through envelope and targeted funding it was accountable to the Ministry via SAHSN. With the funding now part of the University's operating grant, financial and operational accountability for SHIRP rests with the University Library Dean. Under these circumstances, SHIRP was transitioned from a Partnership to a Program of the University Library in July 2014.
To address the second challenge of extending access, a portion of SHIRP funding was allocated to support the services offered by hospital libraries in the Regina, Saskatoon, and Prince Albert regional health authorities; these three health regions are the primary hubs where distributed medical education takes place. The SHIRP budget reimburses the salaries and benefits for 3.5 FTE librarians, 1 FTE library technician, interlibrary borrowing costs, and some funding for technology in those libraries. SHIRP electronic resources became accessible through the library catalogues and (or) websites of those regional health authority libraries between 2004 and 2005.
Starting in 2006, SHIRP resources were made available to the University of Regina and Saskatchewan Polytechnic employees and students through their library websites as a means of enhancing their health sciences collections. That same year, access to SHIRP was extended to the Saskatchewan Ministry of Health, eHealth Saskatchewan, Health Quality Council, and Saskatchewan Cancer Agency employees through their respective institutions' websites and (or) intranets. All other licensed health care practitioners in the province were eligible to sign up for a free account that would give them access to the SHIRP collections and services via the SHIRP website ( Figure 1). The initial staffing structure of SHIRP consisted of co-chairs (the Head of the Health Sciences Library and a representative from one of the health region libraries) and two SHIRP librarians responsible for licensing and outreach. Under the partnership model, a SHIRP Advisory Committee was created in 2007 to act in an advisory capacity to the SHIRP executive, providing advice and input on significant issues, such as collection development, fund allocation in a broad capacity, evaluation of services, long-term planning, and policy items and issues. Membership on the Advisory Committee included representatives from health regions, post-secondary institutions, professional associations, and health related government agencies. The members were to also act as advocates for SHIRP and as liaisons between SHIRP and the groups which they represented. This committee was never populated. In June 2011 the proposed Advisory Committee was reconstructed as an advisory board with a slightly revised terms of reference and membership and met regularly until early 2014. This advisory board was replaced by the Collections Consultative Group (CCG) in mid-2014 following SHIRP's transition to a program of the University Library.

Outcomes
The current organizational structure of SHIRP places operational oversight with the Head, Health Sciences Libraries and includes one SHIRP librarian and one 0.5 FTE library assistant. Much of the administrative activity associated with SHIRP's budget (i.e., projections, expenditure tracking, and contracts) is now managed out of the University Library Dean's office. The SHIRP operations and acquisitions budgets have been merged with those of the University Library, but continue to be tracked separately. Strategic planning for SHIRP has become part of the annual unit plan for the University Library's Health Sciences branch rather than a separate planning process with an external facilitator. Internal and external assessment for SHIRP is coordinated by the University Library's Assessment Analyst, which ensures a consistent approach that aligns with University Library practices. This also provides additional resources for collecting, analyzing, and acting on assessment data.
The CCG is advisory to the Dean, University Library and (or) Head of the Health Science Libraries and provides feedback on existing resources under consideration for renewal or deselection from the SHIRP collection, new resources under consideration for inclusion in the SHIRP collection, and usage data gathered during assessment of the SHIRP collection. CCG members are invited by the University Library Dean and include librarians from various health libraries across the province as well as one licensed health care practitioner. Where appropriate, CCG members also assist in the promotion of SHIRP resources to Saskatchewan's licensed health care practitioners [7]. Selection and de-selection of SHIRP resources has always been a consultative exercise, but is ultimately tied to what the University Library subscribes to in keeping with SHIRP's mandate to support the education of health sciences students.
The University Library's Collections Services Unit conducts e-resource license negotiations for SHIRP as part of overall University Library eresource license negotiations. The SHIRP librarian and library assistant continue to provide first-line eresource troubleshooting assistance to health region libraries as well as directly to SHIRP clients. In keeping with practices in the University Library branches, higher level e-resource troubleshooting for SHIRP is conducted by employees in the University Library's Collection Services Unit.
These changes in e-resources licensing and management have leveraged University Library expertise and knowledge to SHIRP's advantage. The SHIRP Librarian is now able to focus on promotion of SHIRP collections and services to clients, building relationships with health care licensing bodies and continuing education groups, and acting as the central point of communication for the SHIRP CCG.
A refresh of the SHIRP website coincided with the integration of SHIRP into the University Library. This website is used by healthcare practitioners in independent practice, those in facilities without a health region library, as well as by eHealth Saskatchewan, Health Quality Council, and the Saskatchewan Cancer Agency employees. The new SHIRP website (http://shirp.usask.ca) was launched in July 2016 and uses the some of the same software as the University Library (LibGuides, SFX, and Drupal). It looks and functions like a University Library subject guide, which visually reinforces SHIRP as a program of the University Library. Where SHIRP requires its own instance of software solutions, e.g. due to technical aspects of providing access across the province by IP range, SHIRP has adopted business practices that align with the University Library. The creation of the website was an opportunity for both SHIRP and various units within the University Library to work together and discover where technological integration would be most beneficial.
SHIRP's new visual identity has provided a powerful message to SHIRP clients, many of whom are graduates of the UofS; SHIRP's connection with the University is understood more clearly now. Informal and unsolicited feedback from SHIRP clients indicate they are finding the new website easier to use and are more successful in finding and accessing SHIRP resources.
Reflecting back on the initial impetus for the creation of SHIRP, the UofS Undergraduate Medical Education program is fully accredited for an extended period through March 2018. None of the UofS health sciences library resource issues raised in the 1995 and 2002 accreditation reports were noted in recent LCME visits as ongoing concerns; and, Saskatchewan's 26 000+ licensed health care practitioners have had free access to a subset of the University Library's eresources for about 10 years.

Discussion
SHIRP continues to serve its initial and core purpose of providing access to a subset of University Library licensed resources for the benefit of those working alongside health sciences students across Saskatchewan. Integration into the University Library is now complete and it has resulted in an efficient and effective management structure and a strong operational foundation. As a direct result of the integration, University Library employees now have a clearer understanding of how SHIRP's collections and clients intersect with, but differ from, the University Library's. Effort has also been made to inform SHIRP clients of the operational and administrative changes and explain their benefits to them.
Going forward, brief "spot check" assessments of SHIRP services, collections, etc., will be presented through the new website 2 to 3 times per year. Future larger scale, comprehensive assessment activity will occur in collaboration with the University Library's Assessment Analyst and University Library Dean and will become part of the University's scheduled reviews of units and departments.
SHIRP has developed closer ties with the health sciences Continuing Education units at the UofS and provincial health care licensing bodies that offer their own continuing education. By making this subset of eresources available to health care practitioners across the province, SHIRP is also helping to support the competency Role of Scholar within the CANMEDS framework [8] and the Standards and Foundation Competencies for the Practice of Registered Nurses in Education and Research [9].
SHIRP currently subscribes to 6 databases offering access to 2400+ journals in full text, 8 point of care tools, and over 150 e-books. With integration now in place, a major focus for SHIRP in the coming years will be to continue to ensure sustainable access to the most relevant subset of University Library e-resources through engagement with its CCG and with SHIRP clients. Continuing to build new relationships, especially groups serving aboriginal populations, optimizing available technologies to measure use of the website and collections, and expanding online instruction are also primary goals for SHIRP as it moves into its second decade of existence.
In early January 2017 the province announced plans to consolidate existing health regions into one provincial health authority by fall 2017. The impact of this consolidation on SHIRP service and e-resource provision is unknown at this time.