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Social Challenges when implementing Information Systems in everyday work in a nursing context
Blekinge Institute of Technology.
Blekinge Institute of Technology.
Blekinge Institute of Technology.
2014 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 32, no 9, p. 442-450Article in journal (Refereed) Published
Abstract [en]

Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses’ solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.

Place, publisher, year, edition, pages
Wolters Kluwer, 2014. Vol. 32, no 9, p. 442-450
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-44600DOI: 10.1097/CIN.0000000000000075OAI: oai:DiVA.org:lnu-44600DiVA, id: diva2:822353
Available from: 2015-06-16 Created: 2015-06-16 Last updated: 2018-04-23Bibliographically approved
In thesis
1. Social challenges when implementing Information Systems in a Swedish healthcare organization
Open this publication in new window or tab >>Social challenges when implementing Information Systems in a Swedish healthcare organization
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

When the Swedish National IT Strategy for Health and Social Care was introduced in 2006, intensive work started in implementing Information Systems (IS) in Swedish healthcare organizations. To follow up on the requests for more research with a combined socio-technical focus on challenges, the overall aim of this thesis was to identify social challenges when implementing IS in a Swedish healthcare organization. Furthermore, the aim was to understand the impact of identified social challenges when implementing IS in this context by putting them in an interdisciplinary Applied Health Technology theoretical framework. Institutional ethnography and phenomenological hermeneutics influenced the study design. Study 1 aimed to investigate different meanings of accessibility when implementing Health Information Technology in everyday work practice. The results indicate that accessibility depends on working routines, social structures and patient relationship. When an IT strategy and interaction in everyday work use the same word in different ways there will be consequences. Study 2 sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. It was found that there is a need for improvement in communication and understanding between nursing staff at the hospital and in primary healthcare. The aim of study 3 was to explore social challenges when implementing IS in everyday work in a nursing context. Power (changing the existing hierarchy, alienation), Professional identity (calling on hold, expert becomes novice, changed routines), and Encounter (ignorant introductions, preconceived notions) were categories presented in the findings. The aim of study 4 was to explore and obtain a deeper understanding of how identified social challenges have an influence on the implementation process of IS, based on healthcare staff’s experiences on micro, meso and macro levels of Swedish Healthcare organizations. It was found that the challenges were related to the steps of putting into practice, making IS a part of everyday work routine and establishing an identity in the implementation process. In the thesis’s discussion, social challenges when implementing IS in Swedish healthcare organizations and how they might be met and dealt with constructively are further reflected upon in relation to the interdisciplinary theoretical framework and as possible consequences of the modernity-era. This thesis contributes to the starting up of a discussion of how ingrained professional characteristics are important to feel secure of being part of an established profession. If the characteristics are questioned, the whole professional performance is threatened. One consequence of this insight is the reinforcement of the realization that a basic understanding of IS and IS implementation processes in healthcare organizations needs to be integrated in to the construction of professional identity of nurses already from the start in nursing education.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2014. p. 96
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 14
National Category
Other Engineering and Technologies not elsewhere specified
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-73281 (URN)978-91-7295-293-5 (ISBN)
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-04-23Bibliographically approved

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Nilsson, LinaBorg, Christel

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