Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
•Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
•Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
•Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
•Trialability: The adopter should have the opportunity to ‘play around’ with the new technology and explore its capabilities.
•Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare:
•Review the Learning Resources this week about successful implementations of EHRs.
•Consider how you would present the new EHR system to the nurses to win their approval.
•Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?
To complete:
Write a 3- to 5-page paper which includes the following:
•Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.
•Analyze the role of nurses as change agents in facilitating the adoption of new technology.
This Assignment is due by Day 7 of Week 6.
Reference:
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
Readings
•McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning. ◦Chapter 17, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
•Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
Retrieved from the Walden Library databases.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
•Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
Retrieved from the Walden Library databases.
This article defines the United Kingdom‘s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
•Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
Retrieved from the Walden Library databases.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provides insights on change management, the reasons people resist change, and the ways to establish a culture that is more open to change initiatives.
•Gruber, N., Darragh, J., Puccia, P. H., Kadric, D. S., & Bruce, S. (2010). Embracing change to improve performance. Long-Term Living: For the Continuing Care Professional, 59(1), 28–31.
Retrieved from the Walden Library databases.
This text describes the implementation of a new electronic health record system at a 105-bed hospital related-facility. The authors highlight five key elements that were deemed necessary for a successful EHR implementation.
•Hyrkäs, K., & Harvey, K. (2010). Leading innovation and change. Journal of Nursing Management, 18(1), 1–3.
Retrieved from the Walden Library databases.
According to the authors, the health care field is in need of more effective leaders who understand innovation, who appreciate diversity and change, and who can foster and implement innovation and creativity. The authors describe how nurse leaders can be instrumental in embracing and disseminating innovation throughout the health care system and provide scaffolding for subsequent articles in this issue of the journal.
•Mooney, B. L., & Boyle, A. M. (2011). 10 steps to successful EHR implementation. Medical Economics, 88(9), S4–6, S8–S11.
Retrieved from the Walden Library databases.
The authors of this article describe the incentives and requirements for electronic health records (EHRs) outlined in the Health Information Technology for Economic and Clinical Health (HITECH) Act. The authors then provide 10 steps for health care leaders and organizations to follow when implementing EHRs.
•Murphy, J. (2011). Leading from the future: Leadership makes a difference during electronic health record implementation. Frontiers of Health Services Management, 28(1), 25–30.
Retrieved from the Walden Library databases.
In this article, the author examines the causes behind the increasing complication of EHR implementations. In addition, the author explores the role of leadership in guiding successful EHR implementations.
Media
•Laureate Education, Inc. (Executive Producer). (2012b). Electronic health records. Baltimore, MD: Author.
Note: The approximate length of this media piece is 19 minutes.
In this video, Katie Skelton, Richard Rodriguez, Carina Perez, Shannon Mori, and Carmen Ferrell describe how their hospital implemented an electronic health record. They also outline the general considerations, benefits, and support measures related to electronic health records.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript
Readings
•McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (2nd ed.). Burlington, MA: Jones and Bartlett Learning. ◦Chapter 12, “Systems Development Life Cycle: NI and Organizational Decision Making”
This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.
◦Chapter 13, “Administrative Information Systems”
This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.
•Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change. Consulting Psychology Journal: Practice and Research, 63(2), 138–148.
Retrieved from the Walden Library databases.
The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.
•Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective. Journal of Nursing Research, 19(2), 150–160.
Retrieved from the Walden Library databases.
The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated that self-efficacy, top management support, and the quality of information retrieved are the most important determinants of the willingness of nurses to adopt and use a new technology.
•Kelley, T. F., Brandon, D. H., & Docherty, S. L. (2011). Electronic nursing documentation as a strategy to improve quality of patient care. Journal of Nursing Scholarship, 43(2), 154–162.
Retrieved from the Walden Library databases.
This article summarizes a literature review of the relationship between electronic health records (EHRs) and quality of patient care. The article identifies deficiencies in existing research regarding the daily interactions of nurses, patients, and electronic documentation, and it provides a comparison between electronic and paper-based documentation and its effect on quality of care.
•Nurse leaders discuss the nurse’s role in driving technology decisions. (2010). Virginia Nurses Today, 18(1), 8–9.
Retrieved from the Walden Library databases.
This article summarizes a roundtable held with a number of nursing executives to discuss the role nurses should take in the selection and adoption of new technologies for health care. The executives concluded that the nurses’ goals should be to select technology that will further their ability to provide safe, quality care to their patients.
•Page, D. (2011). Turning nurses into health IT superusers. Hospitals & Health Networks, 85(4), 27–28.
Retrieved from the Walden Library databases.
This article highlights the importance of involving nurses with all phases of the decision and implementation process surrounding new health information technology. The author stresses the importance of communication in the process as well as defining success.
•Swab, J., & Ciotti, V. (2010). What to consider when purchasing an EHR system. hfm(Healthcare Financial Management), 64(5), 38–41.
Retrieved from the Walden Library databases.
In this article, recommendations are given for purchasing health information technology. These include selecting the appropriate vendor, carefully considering the cost of both new equipment and personnel, and involving clinicians in decisions.
Media
•Laureate Education, Inc. (Executive Producer). (2012g). Systems development life cycle. Baltimore, MD: Author.
The systems development life cycle (SLDC) provides a framework for all of the steps necessary to implementing a new technology or process within an organization. This video explains the SDLC and how it is used in the health care field.
Optional Resources
•Agency for Healthcare Research and Quality. (2005). A toolkit for redesign in health care. Retrieved from https://www.ahrq.gov/legacy/qual/toolkit/index.html
This website supplies strategies for reconfiguring and transforming a hospital’s care processes. The text breaks down the redesign process into a series of steps.
Please proceed to the Discussion.
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