I think Vital Pathways was mentioned just in passing during class, but I decided to look a little further into it. Vital Pathways: The Hospital Libraries Project was created by the MLA in 2005 to study trends in hospital libraries and see how the organization could best support hospital librarians. After an extensive amount of study, the task force recommended several strategies to help hospital librarians continue in the face of cutbacks. These included self promotion, doing research and sharing results, getting rid of irrelevant or outdated services, and networking with colleagues to share ideas. You can read a more extensive report at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759155/