, Heritage writer
Librarians use the expression “marking and parking” to describe the essence of their craft: tagging content and storing it for future access. It sounds simple, but the devil’s in the details. There are an enormous number of steps – including accession, organization, and cataloging – that happen behind the scenes to make for a smooth and user-friendly library experience. It’s called “library science” for a reason.
During World War II, Avram Yedidia was hired at the Kaiser Richmond shipyards to manage the enormous volume of material required to build these vessels. Having earlier processed collections at San Francisco’s Sutro Library, he realized that he could apply those same methods of marking and parking to tracking railroad cars and storing steel.
Yedidia’s tools for managing that industrial workflow served after the war when he become the economist for the Kaiser Foundation Health Plan, which had accumulated an enormous volume of research while providing affordable, high-quality care to the public. Just as Yedidia’s system kept track of shipbuilding materials and got them to the right location, librarians took charge of organizing medical books and journals and getting research results into the hands of physicians and nurses.
Now celebrating a 70-year anniversary, Kaiser Permanente librarians continue to help clinicians and administrators find the information they need to provide great care.
Like many things, it started small. When the first Permanente Foundation hospital in Oakland opened in 1942 to provide medical care for the Kaiser Richmond shipyard workers, the medical library collection was a single shelf of books in the office of founding physician Dr. Sidney R. Garfield. The first librarian at Oakland was hired May 1947 to assist and support libraries at the expansion facilities.
Libraries are much more than just books, though. In 1969, the pioneering Health Education Research Center opened next to the Oakland hospital, featuring a health library equipped with 24 individual projection booths for viewing films, slide-sound programs, and videotaped TV programs.
Kaiser Permanente library systems began to be linked by computer networks in the mid-1980s, and in the mid-1990s began conversion of manual card catalogs to digital records. Today, electronic resources are essential; the joint catalog includes more than 1,700 eBooks and 8,500 eJournals. The “kpLibraries” systemwide online access catalog was launched in 2005.
Physicians are still the heaviest users of library resources and services; last year, librarians handled more than 8,000 requests for articles and literature searches from physicians nationwide. Nurses comprise the second largest group of library users, making more than 2,000 informational requests.
But it takes librarians to make a library work. As Baldwin Park Medical Center Library Services Manager Kristyn Gonnerman recently described it,
The value we provide lies partly in just being there to work alongside our clinicians and employees and providing answers and support to them as they work on day-to-day clinical questions… the relationships we build with them over the years [means] they know they can come to us with their questions and get answers.
Avram Yedidia would have been proud.
The author has a Masters of Information Management from U.C. Berkeley
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By Lincoln Cushing
Imagine the chaos of a thousand boxcars of steel destined for ship production sitting in and around Richmond, Calif., in 1942. How could managers
unravel the mess and get the far-flung steel to the right place at the right time and avoid production delays?
The solution was obvious to Avram Yedidia, a native of Israel who later made his mark as a Kaiser Permanente consultant and economist: Handle steel like books in a library.
Yedidia earned a bachelor’s degree in education at Hebrew University in Jerusalem and did graduate work in economics and philosophy at Columbia University and the University of California, Berkeley. In 1937 he learned library science by the seat of his pants so he could lead efforts to archive the huge Adolph Sutro special collection in San Francisco.
The Sutro Collection, part of the California State Library system, is made up of documents chronicling the Mexican Revolution and the British “poor laws” of the 16th and 17th centuries.
Yedidia applied the principles of library science to create an effective process for unloading, storing and delivering steel to the job sites. He was a shipyard expediter, charged with ensuring timely deliveries of equipment and materials to meet the “just in time” production pace of the yards, a task made especially challenging by wartime shortages.
In 1945 he was hired by Dr. Sidney Garfield as a representative for the Kaiser Foundation Health Plan, responsible for signing up groups of workers and their dependents. Between 1957 and 1982 Yedidia was a consultant for the Kaiser health plans in northern California, Hawaii, and Ohio, as well as other health maintenance organizations (HMOs) nationwide. He was a champion of the “dual choice” concept, asserting that wherever the Kaiser plan was offered another medical plan must be available to employees.
For Yedidia, this was a carryover from shipyard days when he let his 400 employees know they were not required to sign up for the Kaiser Health Plan.
“Tell them it is voluntary,” Yedidia told the supervisors who presented the plan to workers. The plan cost 50 cents a week ($2.60 a month). They all signed up within 24 hours, except one Danish woman. “She didn’t understand what it was. Once she understood, she signed up too,” Yedidia recounted in his oral history.
Yedidia was a graduate of Hebrew University in Jerusalem and studied economics and philosophy as a postgraduate at Columbia University and the University of California, Berkeley.
In 1959, he established his own consulting service in the organization of health care services and advised Kaiser Permanente for the next 31 years. Yedidia and his son Peter consulted with the program on the organization of geriatric services in the late 1980s.
Yedidia’s influence on health care financing and delivery extended beyond Kaiser Permanente. He earned an international reputation as a medical economist and a consultant on employee health benefits.
He was instrumental in the establishment of the Community Health Foundation in Cleveland, which later became Kaiser Permanente’s Ohio Region. He was also involved with the reorganization of the Health Insurance Plan of Greater New York.
Yedidia passed away in 1990.
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