Assessing IT Readiness
Because many hospital staff are already overworked, the very idea of having to adapt to a new technology adds a new level of stress. Those who feel particularly overburdened may resist or even sabotage the rollout of an electronic medical record (EMR) because the changes it will bring seem overwhelming.
Knowing the magnitude of the task ahead—implementing an EMR in 16 hospitals, ranging from a two-bed, rural critical access facility to a 443-bed tertiary care referral hospital—the leaders at Mountain States Health Alliance in Johnson City, Tenn., mapped out a change management process.
Kathryn Wilhoit, MSN, RN, vice president and chief nurse executive, commissioned a readiness-for-change survey for physicians and other clinicians to help them prepare for technology changes—and to help the leadership team understand how to implement the EMR system most successfully.
Wilhoit believes that an individual’s readiness for change indicates whether a person will resist a planned change or support it. “I wanted very much for us to raise the awareness of physicians and all clinicians that technology was coming and to recognize the changes with which we were going to get hit,” she says. “I thought that if we stimulated their thinking about their readiness, that would make them stop and think, ‘Maybe I need to be ready for this.’”
Survey Influences Communication Plan
Wilhoit worked with a nursing professor at a local university to develop a survey designed to meet three objectives:
To increase awareness of the IT initiative.
To learn the difference between physicians and other clinicians in their readiness to adopt the new technology.
To collect baseline measures so that, as different types of technology are introduced, the Mountain States Health Alliance can compare measures and understand staff readiness levels.
The survey was first administered in 2005 to assess physicians’ and staff members’ acceptance or resistance to an EMR system in four areas: personal adaptation, level of commitment, interpersonal communication, and institutional support.
Since then, a random sample of 20 percent of the health system’s clinical staff members and physicians have received the survey each year so that Wilhoit and other leaders can understand their needs and modify the EMR implementation to meet those needs.
For example, the survey results revealed that the frontline manager (called a clinical leader) is the primary source of communication for nurses and other direct caregivers. Originally, the system’s change management coordinator had been expected to develop formal written communication and presentations about the EMR implementation that would be presented broadly throughout the organization. When it became clear that clinicians wanted to hear from their frontline manager, the coordinator began working directly with those individuals to develop unit-specific communications regarding the EMR implementation.
Change Requires Rest
The survey results also help identify the appropriate pace for introducing new IT functions. “People do hit points when they say, ‘You know, I’ve got to have a rest—I can’t take any more right now,’” says Wilhoit. “It doesn’t mean they can’t handle more change; they just need a rest.”
Planning—and gathering information through a survey—can avoid pushing too much change too quickly. “We must be mindful of the speed with which change is hitting all of the clinical disciplines in health care,” she says. “We have so many deadlines and we have so many things that we must accomplish, we sometimes forget the staff’s ability to take just so much change at any one time.”
Through good planning, nurse leaders can create an atmosphere in which nurses and other clinicians are eager to be involved in the EMR project, says Wilhoit. “There are ups and downs, highs and lows in any project,” she says. Creating a vision for where we are trying to take the organization is an ongoing process, and having these individuals see that vision, catch it, and try to help make it a reality is a large part of my job.”
This case study
originally appeared in the April 2009 issue of The Business
of Caring newsletter.
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