Health Information System Implementation in a Complex Acute Care Environment: A Sociotechnical Analysis

........................................................................................................................ i CO-AUTHORSHIP STATEMENT................................................................................... iii ACKNOWLEDGEMENTS ............................................................................................... iv LIST OF APPENDICES ................................................................................................... vii PART ONE – INTRODUCTION ........................................................................................ 1 HIS Implementation in Acute Care Hospitals ......................................................... 1 HIS Implementation and Nursing ............................................................................ 3 Theoretical Background ........................................................................................... 4 The Sociotechnical Approach ...................................................................... 4 Sittig and Singh’s Eight-Dimensional Sociotechnical Model ..................... 5 Sociotechnical Theory in Nursing and Leadership ...................................... 7 Conclusion ............................................................................................................... 8 References .............................................................................................................. 10 PART TWO – MANUSCRIPT ......................................................................................... 18 Introduction ............................................................................................................ 18 Review of Literature .............................................................................................. 21 Literature Review Findings ........................................................................ 22 Nursing and Health Information Systems ...................................... 22 Nursing and Health Information System Implementation ............. 25 Nursing and Sociotechnical Research ............................................ 27 Summary of Literature Review .................................................................. 29 Research Questions ................................................................................................ 30 Methodology .......................................................................................................... 30 Secondary Analysis .................................................................................... 30 Qualitative Content Analysis ..................................................................... 30 Data ............................................................................................................ 32 Data Analysis ............................................................................................. 33 Approached for Creating Quality Research ............................................... 34 Findings and Interpretation .................................................................................... 35 Hardware and Software Computing Infrastructure .................................... 36 Workflow and Communication .................................................................. 37 Human-Computer Interface ....................................................................... 39 People ......................................................................................................... 40 Clinical Content ......................................................................................... 42 Internal Organizational Policies, Procedures, and Culture ........................ 43 External Rules, Regulations, and Pressures ............................................... 44 System Measurement and Monitoring ....................................................... 45