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The influence of social challenges when implementing information systems in a Swedish health-care organisation
Blekinge Institute of Technology.ORCID iD: 0000-0003-2074-3584
Blekinge Institute of Technology.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
2016 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 6, p. 789-797Article in journal (Refereed) Published
Abstract [en]

Aim

To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation.

Background

Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation.

Methods

An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis.

Results

Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities.

Conclusion and implication for nurse management

Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016. Vol. 24, no 6, p. 789-797
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Caring Science; Health and Caring Sciences, Health Informatics
Identifiers
URN: urn:nbn:se:lnu:diva-52140DOI: 10.1111/jonm.12383ISI: 000387215400011PubMedID: 27121147Scopus ID: 2-s2.0-84991387208OAI: oai:DiVA.org:lnu-52140DiVA, id: diva2:920895
Available from: 2016-04-19 Created: 2016-04-19 Last updated: 2019-02-27Bibliographically 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: 2019-02-27Bibliographically approved

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Nilsson, LinaBorg, Christel

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