Objective: The purpose of this review is to evaluate the tools used to measure the financial value of libraries in a clinical setting. Methods: Searches were carried out on ten databases for the years 2003-2013, with a final search before completion to identify any recent papers. Results: Eleven papers met the final inclusion criteria. There was no evidence of a single 'best practice', and many metrics used to measure financial impact of clinical libraries were developed on an ad hoc basis locally. The most common measures of financial impact were value of time saved, value of resource collection against cost of alternative sources, cost avoidance and revenue generated through assistance on grant submissions. Few papers provided an insight into the longer term impact on the library service resulting from submitting return on investment (ROI) or other financial impact statements. • It is worth pursuing the concept of value of information studies in the context of clinical libraries.• Health library associations should collaborate on the development of common measurement standards, which reflect accounting practices in the wider clinical setting.• Health librarians should commit to adopting and implementing these standards in their own organisation.• It is important that health librarians identify and include feedback and outcomes in studies analysing the financial impact of their clinical library service.

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Hospital librarians must ensure they are contributing positively to the organization's goals and are proactive in meeting user needs while making the best use of scarce resources. Therefore, effective communication with library clients is essential. Client audits are useful tools, but response rates are often poor as the audit can get lost in the overwhelming amount of unsolicited mail received by clinical practitioners, who quickly become expert at selecting and culling. This column shares lessons learned through conducting the audit, highlights key findings from the audit itself, and examines ways to use the audit process to promote and develop a library's services.

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