Public mandate to control cost, while improving quality of service. leads health care administrators to look to information technology for innovative solutions. This case study of acute care registered nurses in a public hospital focuses on experiences, of the end-users, of a computerized medication system. Data was obtained by in-depth interviews and observation performed in the clinical setting. Findings fell into five challenging issues to the end-user and health care administration: end-user perceptions of inadequate training, negative experiences of implementation, perceived deficiencies in quality of technology, perceptions of lack of participatory design and a ensuing circumvention of the new system. Emphasis is on the relationship of the findings to the quality of public health care administration.
Get full access to this article
View all access options for this article.
References
1.
ArmstrongE. (2000, Oct.). “Electronic Prescribing and Monitoring are Needed to Improve Drug Use.” Archives of Internal Medicine, 160 (18): 2713–14.
2.
AttewellP. (1998). Research on Information Technical Impacts. Washington D.C.: National Academy Press.
3.
AustinC, BoxermanS. (1999). Information Systems For Health Services Administration. Chicago: Health Administration Press.
4.
BallM., Hannah, NewboldS., and DouglasJ. (2000). Nursing Informatics: Where Caring And Technology Meet, 3rd ed., New York: Springer.
5.
BannonL. (1996). “Use Design and Evaluation: Steps Towards an Integration”, in ShapiroD., TauberM. and TraunmuellerrR. (eds.). The Design of Computer Supported Cooperative Work and Groupware Systems (series ‘Human Factors m Information Systems’ volume 12) Amsterdam, The Netherlands: North Holland.
6.
Baskerville and Smithson (1995). “Information and Technology and New Organizational Forms: Choosing Chaos over Panaceas., European Journal of Information Systems4 (2), May: 66–73.
7.
BolesM. and SunooB. (1998, Jan.). “Three Barriers To Managing Change.” Workforce77 (1): 25–29.
8.
BrosnanM. (1998). Technophohia: The Psychological Impact of Information Technology. New York: Routledge.
CanD., HardK. and TrahantW. (1996). Managing the Change Process: A Field Book for Change Agents. Consultants, Team Leaders, And Reengineering Managers. New York: McGraw-Hill.
11.
CohenH. (2000, Dec). “Be a Watchdog.” Nursing Management31 (12): 53–52.
CoyneK. and SubramaniemS. (1996) “Bring Discipline to Strategy.” The McKinsey Quarterly4: 14–25.
14.
CurranC. (1999, Nov.-Dec.). “The Past as Prologue.” Nursing Economics17 (6): 6–7.
15.
EstabanM. and JoaquimV. (1998). “Interconnected Mindsets: Strategic Thinking and Strategy Concept, in HittM., RicartJ., CostaI. and NixonR. (eds.). New Managerial Mindsets, Organizational Transformation and Strategic Implementation.). New York: Wiley, pp. 15–35.
16.
FottlerM., CrawfordM., QumtanaJ. and WhiteJ. (1995). “Evaluating Nurse Turnover: Comparing Attitude Surveys and Exit Interviews.” Hospital and Health Services Administration40 (2): 278–295.
17.
FreedD. (1998) “Please Don't Shoot Me: I'm Only The Change Agent”. Healthcare Supervisor17 (1): 56–61.
18.
GarreltsJ., KoehnL., SnyderV., and RichD. (2001). “Automated Medication Distribution Systems and Compliance with Joint Commission Standards.” American Journal Health System Pharmacists58 (23) (December 1, 2000):2267–72.
19.
GaudryE. and SpielbergerC. D. (1971). Anxiety and Educational Achievement. Sydney: John Wiley and Sons.
20.
GebhartF. (2000, Nov.). “New California Law Requires QA to Cut Drug Errors.: Drug Topics144 (21): 58.
21.
HansethO. and BraaK. (1999). “Hunting For The Treasure at the End of the Rainbow: Standardizing Corporate Infrastructure.” in NgwenyainaO., IntronaL., MyersM., and De GrossJ. (eds). New Information Technologies In Organizational Process: Field Studies and Theoretical Reflections on Future Work. Boston: Kluver Academic, pp. 121–141.
22.
Health Care Advisory Board (1997). The Great Product Enterprise: Future State for American Health System. Washington DC: Author.
23.
HowardG. (1986). Computer Anxiety and the Use of Microcomputers in Management. Ann Arbor, Michigan: UMI Research Press.
24.
HultmanK. (1998). Making Change Irresistible: Overcoming Resistance to Hange in Your Organization. Palo Alto, CA.: Davies-Black Publishing.
25.
HughesS. (2000). “Point of Care Information Systems: State of the Art,” in BallM., HannahK., NewboldS. and DouglasJ. (eds). Nursing Informatics: Where Caring and Technology Meet (31 Ed.). New York: Springer.
JohnsonJ. (1990). Selecting Ethnographic Informants. Sage: Newbury Park, CA.
28.
Joint Commission on Accreditation of Healthcare Organizations (2000). Comprehensive Accreditation Manual for Hospitals: The official handbook. JCAHO: Baltimore.
29.
KinnairdJ. and LittleB. (1999). “Are Hospitals Facing a Critical Shortage of Skilled Workers?” Healthcare Supervisor17(4): 54–62.
30.
KleinK. and SonaJ. (1996). “The Challenge of Innovation Implementation.” Academy of Management Review21 (4): 1055–1078.
31.
LevyS. and WilliamsB. (1999). “Attitudes to Information Technolosy: Toys or Tool?” [On-line]. Nursing-Standard13 (52): 116–124. Abstract from: NURS STAN ONLLNE.
32.
LorenziN. and RileyR. (2000). “Managing Change: An Overview.” [On-line]. Journal of the American Medical Infonnatics Association7 (2): 116–124. Abstract from: J-AM-MED-INFORM-ASSOC.
33.
Mac DonaldS. (1998). Information for Innovation: Managing Change from an Information Perspective. New York: Oxford University Press.
34.
ManciniM. (1995, Nov.-Dec.). “Patient-Focused Care: A Response to the Healthcare Crisis.” Journal of Intravenous Nursing18 (6): 307–316.
35.
NelsonR. (2001, Nov.). “Physician Direct Order Entry.” Drug Topics: Hospital Pharmacists Report15 (8): 28–32.
36.
NielsenJ. (1986). Practitioner's Guide to California Drug Law. San Francisco: Hastings College of Law.
37.
O'DellC. (1998). If We Only Knew What We Know: The Transfer of Internal Knowledge and Best Practice. New York: Free Press.
38.
CorporationPyxis. (2000). What Your Colleagues are Saying about Pyxis Connect. [Brochure]. BondJ., McArthurD., RomeroG.: Authors.
39.
RaubA. (1981). Correlates of Computer Anxiety In College Students. (Doctoral Dissertation, University of Pennsylvania, 1981). Dissertation Abstracts International42:4775A.
40.
RingoldD., SantellJ. and ScheinderP. (1999). “ASHP National Survey of Pharmacy Practice in Acute Care Setting: Dispensing and Administration.” American Journal of Health System Pharmacists57 (October 1,2000): 1759–75.
41.
ShortellM. and KaluznyD. (2000). Health Care Management: Organization Design And Behavior (4th Ed.). Albany, New York: Dehnar.
42.
SievertM., AlbrittonR., RogerP. and ClaytonN. (1988). “Investigating Computer Anxiety in an Academic Library.” Information Technology and Libraries (Sept.): 243–252.
43.
SpielbergerC.D. (1966). “Theory And Research On Anxiety,” in SpielbergerC. (ed.), Anxiety and Behavior. New York: Academic Press.
44.
SpradleyJ. P. (1979) The Ethnographic Interview. Harcourt Brace Jovanovich College Publishers: New York.
45.
SuchmanL. (1983). Office Procedures as Practical Action: Models of Work and System Design. ACM Transactions on Office Information Systems1 (October, 1983): 320–328.
46.
TanJ. (2001). Health Management Systems: Methods and Practical Applications. Gaithersburg, Maryland: Aspen Publishers.
47.
TeichJ., MerchiaP. (2000, Oct.). “Effects of Computerized Order Entry on Prescribing Practices.” Archives of Internal Medicine.160(18), 2741–7.
48.
WorthleyJ. and Di SalviaP. (1995). Managing Computers in Healthcare: A Guide For Professionals (3rd ed.). Health Administration Press: Ann Arbor, Michigan.
