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Medical libraries have had to swiftly change the way they connected their clients to instruction services starting Spring of 2020. The focus of this article is on the instructional services of [hospital library] pre and post 2020 and it will also provide insights into what hospital libraries in Canada have been doing, what they are succeeded at and working on. This paper will describe the design, implementation, and outcomes of a Quality Improvement (QI) project and concludes by exploring the changes recommended to enhance online instructional services in an urban research and teaching hospital library environment. The QI project led the team to prioritize three areas for improvement: a peer feedback system that has been designed to support instructors in building their confidence and skills; monthly the Instruction Team will debrief any workshops using the peer feedback data, attendance information, instructor feedback, and attendee evaluations. The workshops offered will expand beyond the typical hour-long, one-off workshop sessions to other formats. The results of the QI process have produced many ideas that could be used to improve the design and delivery of online instruction and confirmed that libraries in hospitals across Canada are encountering similar barriers around time, staffing capacity, technology, and training.
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