Implementation of a New Electronic Health Record System
The Role of a Nurse Facilitator in Addressing Resistance to Implementation of a new Electronic Health Record System
Implementation of change within an organization is a great challenge. The reason behind this is that most people do not like to come out of their comfort zone. This is what drives resistance to change. Change agents must be ready to deal with the resistance. They must ensure that the change being implemented is embraced by everyone in the organization. The focus of this paper is the implementation of a new electronic health record system in a small hospital (EHR system) in line with the five qualities outlined by Rogers (2003). The nurses’ approval of the new EHR system can only be achieved if the system is presented to them in the best way possible. In a planned meeting between the nurses and a nurse facilitator, there are several actions that should be taken by the nurse facilitator during the meeting to ensure that the new EHR system is approved by the nurses.
A nurse facilitator should ensure that nurses assume ownership of the project. They should be made to understand that the changes made are for their good. The facilitator should assure them that their jobs are still secure regardless of the changes made. Additionally, the nurses should be psychologically prepared by being given all the details of the new project. They should be made aware of how the change will affect them as well as the company.
Effective communication should be used when presenting the project to the nurses during the meeting. The presentation should be done enthusiastically with the aim of reducing resistance. It should also be done in stages to ensure that all the project’s details are well presented. The facilitator should give room for questions, particularly during the first meeting. All the questions should be answered regardless of their weight. The attitude of the nurses towards the new project will depend on the facilitator’s ability to handle the presentation process effectively. Rogers (2003) outlined five main qualities that can determine the role of nurses as well as their attitude towards the adoption and implantation of new technology. The qualities include complexity, compatibility, relative advantage, observability, and trialability.
The degree to which a new idea is perceived as better than an idea it supersedes is what is referred to as relative advantage (Rogers, 2003 p 229). A new idea has high chances of being adopted if the relative advantage is high. In this paper, relative advantage measures the extent to which the HER is better than the existing standards. Nurses are the adopters of the new system. In this regard, they must measure its benefits against the potential risks associated with its adoption. The benefits must outweigh the risks for the system to be adopted.
It is beneficial to use the new technology than using the manual health record systems. A health facility with a high-technology reputation attracts a lot of patients. Patients judge hospitals by their staff, equipment, and facilities (Bramble et al., 2010). It is from this perspective that a hospital with a magnetic imaging facility (MRI) is preferred over the one without. Using the same logic, it is evident that a hospital with an electronic health record system will be the most preferred by patients. In 2012, Emani et al. found that EHR plays a significant role in the improvement and efficiency of healthcare (Emani et al., 2012). Interoperability is the best advantage of this system.
In 2003 Rogers defined compatibility as “the degree to which an innovation is perceived as consistent with the existing values, past experiences, and needs of potential adopters” (p. 15). Compatibility refers to the degree of similarity between an old system and a new system. The higher the similarity, the higher the chances of adoption. For the case of the EHR, compatibility describes its degree of consistency with the existing needs, past experiences, and healthcare values of health care providers. An easily compatible idea provides few uncertainties to its potential adopters. In this case, the potential adopters are the nurses of the EHR. The EHR should be compatible with the need for innovation by patients as well as their beliefs and sociocultural values.
The use of the EHR system is among the major global reforms in the health industry. It contributes greatly towards the betterment of the healthcare services. There is evidence of cases where the implementation of this system has failed. In this regard, some nurses might be worried that the process of implementing this system may not be successful. It is the role of the facilitator to ensure that they are encouraged to adopt the new system. Jha et al., (2009) found that the EHR is compatible with the need of both patients and healthcare providers. According to Jha et al., the EHR is time-saving, easy to use, and less costly.
Complexity refers to the degree of ease or difficulty in understanding a new idea (Rogers, 2003 p15). The EHR system has never been used by many nurses. They need to be educated on how to use it as well as its benefits. The more they understand the system, the higher the chances of adopting it. Additionally, the adoption of this system requires nurses to be equipped with certain new skills. The extent to which the nurses adopt the new skills will determine the rate of its adoption. For instance, given that the EHR is a complex multifunctional system, its users must learn how to use the software mouse clicks as well as the keystrokes. They must also learn how to ensure that the system supports the newly designed workflows.
Observability is the noticeable results after adopting a new idea. Individuals tend to adopt an idea with visible results faster than the one without (Castillo, Martínez-García, & Pulido, 2010; Rogers, 2003 p 16). The implementation of the EHR project can be done through a phased approach to ensure that the results of the system are visible to its potential adopters. In this approach, the project is implanted in different stages which allows an opportunity for the adopters to visualize and internalize its benefits.
In 2003, Rogers defined trialability as “the degree to which an innovation may be experimented with on a limited basis” (p. 16). That is, the how effortless it is for the adopters to use the new product. According to Rogers (2003), ideas that can be easily out in practice have high chances of being adopted. In this regard, the degree to which the nurses will be able to use the new EHR system will determine their willingness to adopt it. In an aim of ensuring that the nurses can effectively use the system, the facilitator should ensure that the system is implemented through a phased approach. This will give the nurses enough time to learn how to use the system. The approach will also ensure that the complexity of the system is minimized given that the nurses will not be required to learn about the whole system in one phase. Additionally, the nurses will gain experience in using the system which is an added advantage since they will easily adapt to it.
Conclusively, the implementation of change within an organization is a great challenge which is often accompanied by resistance. Change agents must be ready to deal with the resistance. In this regard, a nurse facilitator should ensure that nurses assume ownership of the project. Effective communication must be used when presenting the new idea to the nurses. Additionally, a nurse facilitator should consider the five qualities outlined by Rogers (2003) during the implementation of a new electronic health record system. The qualities include complexity, compatibility, relative advantage, observability, and trialability. The degree to which a new idea is perceived as better than the existing idea is what is referred to as relative advantage. Trialability refers to the degree of effort required for the adopters of a new product to interact with it. Observability is the noticeable results after adopting a new idea. Complexity refers to the degree of ease or difficulty in understanding a new idea. Lastly, compatibility refers to the degree of similarity between an old system and a new system.
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