Abstract
Objective: To describe the general functionalities of a next generation emergency department (ED) management information system and the impacts of its recent implementation as perceived by doctors and nurses in one hospital.
Background: Information and communication technology (ICT) holds the potential for improving the efficiency, cost-effectiveness, quality, and safety of health care delivery. Investigations of the implementation of such systems in the ED have been limited. The acceptance, impact and eventual success of information systems rely heavily on the views and attitudes of its users.
Methods: A case study was conducted in the ED of a 650-bed Australian metropolitan public teaching hospital. Qualitative data relating to clinicians’ perceptions of a recently implemented ED patient management system (Cerner FirstNet) were collected through interviews with thirteen physicians and seven nurses, combined with two observation sessions. Interview transcripts and observation field notes were analysed by two researchers using a thematic grounded theory approach.
Results: The ED management information system assists clinicians in the general management of the department as well as providing the necessary administrative functions from patient admission to discharge. Interaction with the system was perceived to considerably increase the administrative workload of clinicians which decreased efficiency of work practices. This was due largely to the perceived complexity of the system.
Discussion and conclusions: The system failed to fully adapt to the context and work practices at the study site, reinforcing the need for clinician participation in systems customisation to ensure that functionalities and features support provider practice and patient care. However, whilst preliminary perceptions were largely negative, ICT evolves with each phase of implementation; research is needed to monitor the changing user perceptions that accompany such evolution. Broadening the scope of our study to encompass hospital administrative departments may also assist in creating a more complete profile of the impact of FirstNet both on the hospital and for the community.
Background: Information and communication technology (ICT) holds the potential for improving the efficiency, cost-effectiveness, quality, and safety of health care delivery. Investigations of the implementation of such systems in the ED have been limited. The acceptance, impact and eventual success of information systems rely heavily on the views and attitudes of its users.
Methods: A case study was conducted in the ED of a 650-bed Australian metropolitan public teaching hospital. Qualitative data relating to clinicians’ perceptions of a recently implemented ED patient management system (Cerner FirstNet) were collected through interviews with thirteen physicians and seven nurses, combined with two observation sessions. Interview transcripts and observation field notes were analysed by two researchers using a thematic grounded theory approach.
Results: The ED management information system assists clinicians in the general management of the department as well as providing the necessary administrative functions from patient admission to discharge. Interaction with the system was perceived to considerably increase the administrative workload of clinicians which decreased efficiency of work practices. This was due largely to the perceived complexity of the system.
Discussion and conclusions: The system failed to fully adapt to the context and work practices at the study site, reinforcing the need for clinician participation in systems customisation to ensure that functionalities and features support provider practice and patient care. However, whilst preliminary perceptions were largely negative, ICT evolves with each phase of implementation; research is needed to monitor the changing user perceptions that accompany such evolution. Broadening the scope of our study to encompass hospital administrative departments may also assist in creating a more complete profile of the impact of FirstNet both on the hospital and for the community.
| Original language | English |
|---|---|
| Title of host publication | HIC 2009 |
| Subtitle of host publication | Proceedings; Frontiers of Health Informatics - Redefining Healthcare |
| Place of Publication | Brunswick East, VIC |
| Publisher | Health Informatics Society of Australia (HISA) |
| Pages | 121-125 |
| Number of pages | 5 |
| ISBN (Print) | 9780980552010 |
| Publication status | Published - Aug 2009 |
| Externally published | Yes |
| Event | Health Informatics Conference 2009 - National Convention Centre, Canberra, Australia Duration: 19 Aug 2009 → 21 Aug 2009 Conference number: 17th |
Conference
| Conference | Health Informatics Conference 2009 |
|---|---|
| Abbreviated title | HIC 2009 |
| Country/Territory | Australia |
| City | Canberra |
| Period | 19/08/09 → 21/08/09 |