Abstract: Introduction – The hospital librarian requires an understanding of the information needs, information-seeking process, and use of information resources by a hospitals chief executive officer (CEO) so that the librarian may support, promote, and foster evidence-based decision making (EBDM) at the executive level. This research aimed to identify various reasons hospital CEOs seek information and uncover their feelings and thoughts about the process. Method – In this study, funded by the Canadian Health Libraries Association / Association des bibliothèques de la santé du Canada (CHLA / ABSC), Ontario hospital CEOs were interviewed by telephone in the summer of 2006. Findings – Barriers to EBDM as described by the CEOs included a lack of on-demand information and limited time for the information-seeking process. The CEOs preferences regarding the content and delivery method of needed information and the CEOs specific information needs and wants are described in this paper. Ontario CEOs do not perceive the hospital library as a first source that they turn to for EBDM. Of the 27 CEOs interviewed who directly use a library (on- or off-site), 37% did not know the librarians name. CEOs were asked whether they believed a hospital library would exist 5–10 years from now and to forecast the future for library services. The CEOs envision library services as shared or joint services, or virtual, or both. Conclusion – We have concluded from the findings that the hospital librarian who has not already communicated their expertise and demonstrated their ability to link the strategic goals of the hospital to available evidence-based resources will not be around in 10–15 years.