The library as a publishing partner: bridging a gap in cancer care research

In September 2024, The University of Texas MD Anderson Cancer Center, the nation’s top-ranked hospital for cancer care, announced the launch of a new journal, Advances in Cancer Education & Quality Improvement (ACE-QI). ACE-QI is an open access, peer-reviewed journal that presents research in the education and professional practice aspects of cancer care. 

The launch came about through a leadership collaboration between Clara Fowler, Director of MD Anderson’s Research Medical Library, and Joshua Kuban, MD, Associate Vice President of the Department of Education & Alumni Relations. Both saw the opportunity to leverage the library’s publishing resources and expertise to support a new publication featuring under-served scholarship. 

Noticing a publishing gap 

In his years running MD Anderson’s medical residency and fellowship programs, Josh noticed a lot of initiatives that improved education effectiveness or patient care outcomes. But there were few options for sharing the success of these projects where other institutions could learn from it.  

Josh, also Editor-in-Chief of the new journal, explains, “Many times education and other projects that are done in the hospital are not as prominent as cell or therapy-based research or clinical trials.” 

An example is a quality improvement study to improve communication during patient transfers from outpatient clinics to acute care facilities. Josh explains, “Handoffs are a really common pinch point of medical error. Our Division of Education and Training implemented a system to improve handoffs,” reducing the chance that important patient information is missed.  

As colleagues within MD Anderson’s Division of Education, Josh often rubbed elbows with Clara, who is also Editorial Director for ACE-QI. With a team that includes both scientific editors and information specialists who contribute regularly to MD Anderson’s scholarly output, Clara has an eye for uncovering opportunities to showcase the institution’s world-class expertise.  

Through OpenWorks, MD Anderson’s institutional repository built with Elsevier’s Digital Commons platform, they were already publishing oral histories, digital archives, and other forms of grey literature. Clara notes, “We knew that the opportunity for publishing a journal was part of the Digital Commons package. Leadership in our division were very excited about the idea.”  

Both Josh and Clara recognized their journal could also elevate the status of underrecognized contributors to the hospital’s care and educational mission. Josh explains, “We wanted to showcase not only the work of our Graduate Medical Education program directors and coordinators, but also the important quality improvement work of our techs, nurses, physician assistants and healthcare engineers.” 

Josh also notes, “Cancer is a huge part of what every medical center does now. If we created an avenue for people to showcase their work, we could improve processes everywhere.”  

Building support and structure

Organizing library resources 

While Josh was building support across institutions, Clara was recruiting team members across the library. “We have tremendous expertise for scientific publishing - some were previously managing editors for journals. Because they edit manuscripts for our faculty, they are well-positioned to decide on quality.”  

Clara could also draw on the experience of Kate Krause, a Library Information Analyst at MD Anderson and now Production Manager on the journal’s editorial team, who had previously launched journals on the bepress platform (now part of Digital Commons) while at a different institution.  

This was especially helpful for some hands-on work building out the journal publishing capabilities on OpenWorks. Clara notes, “We're able to be more nimble because Digital Commons has some plug and play aspects to it and is well designed. We're able to produce something that looks good and has quality content. And we've had the necessary support from the Digital Commons team to be able to do this.” 

Clara also emphasized how libraries are primed for connecting our authors to the ability to produce scholarship: “The often-hidden work of librarians and editors is embedded in a long tradition and methodological expertise that takes years to develop. This expertise has enabled us to pull off an outstanding first issue and I expect it to be outstanding from here on out.” 

Working with challenges 

Supporting editorial vision and peer review 

Although the initial concept for the journal was an education focus, they soon realized a broader scope would serve related needs and improve the journal’s reach. Josh explains, “We ended up coming up with 3 bins that we thought were underrepresented: a quality improvement/patient safety bin, a healthcare engineering bin and an education bin - three different areas but all tied together by cancer.”  

However, this three-bin scope created complexity for their editorial and review processes. Josh explains, “We came up with Associate Editor roles to provide expertise for each area; they have their own networks for finding peer reviewers.“ Clara’s team provides management for the peer review process that makes it easier for reviewers to contribute. 

Support for new authors 

The library also created a program to support new authors. Josh notes, “A lot of our authors have done these quality projects, but never written for publication. They submit stuff that's cool, but nowhere near the standard that a journal would need.” The library allocated a part of their long-established coaching service in academic writing to support journal authors. A writing coach works with authors one-on-one over multiple sessions to turn their projects into academic literature. 

Raising value for authors 

As a new journal without an impact factor, “It takes a lot of persistence to get people to submit and assure them that we're the real deal – it’s peer-reviewed, a good process and a place that people are going to want to read your articles,” Josh explains. 

To help attract authors, Josh secured support from the Promotion & Tenure Committee at MD Anderson, which agreed to look favorably on candidates who have published in the journal. He explains, “It’s seen as a service to the institution,” because it helps build a reputation for the journal and supports the institution’s commitment to open science principles.  

Measuring early success 

After publishing the first issue in the spring of 2025, the ACE-QI team look at both quantitative and qualitative parameters to understand the journal’s success – such as consistent publication frequency, views, downloads, and geographic distribution. Josh notes, “We had a bunch of articles downloaded thousands of times in 100 countries and people started to comment on social media, saying, ‘Hey, this is really great. Thank you for doing this.’” He added that the attention fostered enough organic growth that they did not have to do a roadshow for the second issue – “People are excited about it and submitting.” 

They’re also keen to understand something much harder to measure, but perhaps more important: how the journal’s information influences patient care and processes at other institutions. One reflection is anecdotal feedback Josh received about the handoff system, published in the first issue. “Some people from outside MD Anderson said ‘This is a great system. We're going to look into doing this as well, because everyone has trouble with that.’”

From roadshow to roadmap – goals for growth 

Indexed in Scopus and PubMed 

Clara identifies getting indexed in Scopus and PubMed, targeted within the next four years as her top goal. Besides helping the journal gain an impact factor, her strategy to achieve this is “cultivating balance in submissions across topics and from authors both in and outside of MD Anderson.” She adds, “When that happens, things will grow a lot easier on their own.” 

Reach and recognition 

Josh’s top goal is extending beyond MD Anderson, noting, “We want this to be a national or international journal that has broad appeal. While we have an increasing number of people submitting from outside of MD Anderson, the next jump is going beyond personal networking to the journal standing on its own and people just knocking down the door to get in.” 

To approach that goal, they assembled an editorial board from across the country, including peers from other cancer centers like Memorial Sloan Kettering, UCLA, Dana Farber Cancer Institute, and UCSF. Josh adds, “In the future I’d like to see more integration of leadership from outside MD Anderson.” He also sees potential in formalized partnerships with some societies, and presence at ASCO (American Society of Clinical Oncology), AACR (American Association or Cancer Research) and other conferences where they can showcase more work. 

Embracing a start-up mindset 

The team launched the journal without any funding, putting in extra hours for the roadshow and preparing the first issue.   

The evolution of ACE-QI also shows how academic libraries can iterate on their strengths to empower new initiatives. Clara remarks, “It's been an exciting opportunity for the library because it has allowed us to work in new spaces and connect core ideas we have for the library: working with research from inception to production and the communication of science.” 

Clara noted how their approach extends to another way they are breaking the mold of traditional journal publishing. “In our first issue we had somebody submit a poem, a reflection on one of our beloved doctors and mentors who passed, which is one of our most read items. From that we've realized there is a strong interest in narrative medicine.”  She formed an editorial team to support a creative bin for the journal and they've received three submissions for the fall issue. Josh notes, “This also points to our mentality, which is akin to a start-up.  If we see opportunities, we work to make them fit. Our mindset is ‘Let's do it. Let's look for cool new things to do.’”