Making Sense of Health Information Technology in an Academic Medical Center

理解学术医疗中心的健康信息技术

• 批准号: 8069106
• 负责人: Rebecca R Kitzmiller
• 金额: $ 3.59万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8069106
• 关键词: Making; Sense; Health; Information; Technology

DESCRIPTION (provided by applicant): Hospital adoption of health information technology systems (HIT) is promoted as essential to decreasing medical error and reducing the estimated 44,000 annual deaths and $17 billion in healthcare costs associated with that error. Yet, adoption of HIT in hospitals continues to occur slowly and inconsistently, due in large part to complexity of the hospital care environment. Implementing new practices, such as an electronic nursing documentation system therefore, is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g. information exchange, communication, relationships) of providing care on in hospitals. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning and effective problem solving; strategies which studies have linked to successful change. Project team work, a change strategy increasingly used by hospitals, facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. My long term goal is to engage in a career of nursing research, contributing to knowledge that facilitates practice change improvements at the bedside and in hospitals. My proposed study will explore the role of project teams' sensemaking during the implementation of new information technology in a tertiary care hospital. Aims include: describe and compare sensemaking across multidisciplinary project teams that differ in terms of hierarchical role and disciple of members; describe how sensemaking of multidisciplinary project teams changes over time; describe how multidisciplinary project teams' sensemaking influences the actions taken by the teams; and identify which team member behaviors facilitate and or inhibit project team sensemaking. The longitudinal case study design will facilitate the detection of meaning as it evolves; provide an opportunity to view relationships across organizational boundaries; capture rich data of events as they occur; and allow me to gather several different perspectives of the same event over the course of time. Sensemaking data will be collected through direct observation and organizational document analysis. Participant demographics will be used to explore variation in sensemaking patterns. Outcomes of this research will be new knowledge about sensemaking patterns of project teams; how sensemaking and action vary across multidisciplinary project teams as the team prepares for implementation; and identify team member behaviors which facilitate or inhibit project team sensemaking. These findings will lead to new methods of implementing HIT in hospitals. PUBLIC HEALTH RELEVANCE: Outcomes from this study will help healthcare project teams identify the needs of hospital personnel in order to customize software and therefore improve the likelihood that new systems will meet healthcare workers needs and improve patient outcomes.

描述（由申请人提供）：医院采用卫生信息技术系统（HIT）是减少医疗差错和减少与该差错相关的估计44，000例死亡和170亿美元医疗费用的关键。然而，在医院采用HIT继续发生缓慢和不一致，在很大程度上是由于医院护理环境的复杂性。实施新的做法，如电子护理文件系统，因此，往往是困难的，由于中断的高度协调，相互依存的过程（如信息交换，通信，关系）提供护理在医院。作为一项重要的组织功能，意义建构被定义为寻找答案和推动行动的意义的社会过程，导致统一的理解，学习和有效的问题解决;研究与成功变革有关的策略。项目团队工作是医院越来越多地使用的一种变革策略，它通过为团队成员提供一种正式的机制来分享想法，构建事件的意义，并采取下一步行动，从而促进意义构建。我的长期目标是从事护理研究的职业生涯，为促进床边和医院实践变化的知识做出贡献。我的研究将探讨项目团队的意义建构的作用，在实施新的信息技术在三级保健医院。目标包括：描述和比较不同层次的角色和成员的弟子方面的多学科项目团队的意义构建;描述多学科项目团队的意义构建如何随着时间的推移而变化;描述多学科项目团队的意义构建如何影响团队采取的行动;并确定哪些团队成员的行为促进或抑制项目团队的意义构建。纵向的案例研究设计将有助于检测意义的演变;提供了一个机会，以查看跨组织边界的关系;捕捉丰富的数据，因为他们发生的事件;并允许我收集几个不同的观点，随着时间的推移，同一事件。将通过直接观察和组织文件分析收集意义建构数据。参与者的人口统计数据将用于探索意义建构模式的变化。本研究的成果将是项目团队的意义建构模式的新知识;在团队准备实施时，多学科项目团队的意义建构和行动如何变化;并确定促进或抑制项目团队意义建构的团队成员行为。这些发现将导致在医院实施HIT的新方法。 公共卫生关系：这项研究的结果将帮助医疗保健项目团队确定医院工作人员的需求，以定制软件，从而提高新系统满足医疗保健工作者需求和改善患者预后的可能性。