Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.http://deepblue.lib.umich.edu/bitstream/2027.42/78272/1/1748-5908-4-50.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/2/1748-5908-4-50-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/3/1748-5908-4-50-S3.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/4/1748-5908-4-50-S4.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/5/1748-5908-4-50.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/6/1748-5908-4-50-S2.PDFPeer Reviewe

ERP implementation methodologies and frameworks: a literature review

Enterprise Resource Planning (ERP) implementation is a complex and vibrant process, one that involves a combination of technological and organizational interactions. Often an ERP implementation project is the single largest IT project that an organization has ever launched and requires a mutual fit of system and organization. Also the concept of an ERP implementation supporting business processes across many different departments is not a generic, rigid and uniform concept and depends on variety of factors. As a result, the issues addressing the ERP implementation process have been one of the major concerns in industry. Therefore ERP implementation receives attention from practitioners and scholars and both, business as well as academic literature is abundant and not always very conclusive or coherent. However, research on ERP systems so far has been mainly focused on diffusion, use and impact issues. Less attention has been given to the methods used during the configuration and the implementation of ERP systems, even though they are commonly used in practice, they still remain largely unexplored and undocumented in Information Systems research. So, the academic relevance of this research is the contribution to the existing body of scientific knowledge. An annotated brief literature review is done in order to evaluate the current state of the existing academic literature. The purpose is to present a systematic overview of relevant ERP implementation methodologies and frameworks as a desire for achieving a better taxonomy of ERP implementation methodologies. This paper is useful to researchers who are interested in ERP implementation methodologies and frameworks. Results will serve as an input for a classification of the existing ERP implementation methodologies and frameworks. Also, this paper aims also at the professional ERP community involved in the process of ERP implementation by promoting a better understanding of ERP implementation methodologies and frameworks, its variety and history

Rámec pro posouzení kvalitativních hledisek informačních systémů

Záměrem předložené disertační práce je porozumět tomu, jak investoři v konkrétním společenském kontextu vnímají význam kvality informačních systémů. Ze studia literatury zabývající se přístupy a rámci hodnocení kvality informačních systémů vyplývá, že tato kvalita je obecně hodnocena z hlediska striktního přístupu. V této práci je ukázáno, že kvalitu informačního systému lze smysluplně pochopit použitím interpretačního paradigmatu a že kvalita informačního systému je definována společensky a ovlivňována kontextem tohoto systému. Studie byla zahájena průzkumem dvaceti libyjských organizací. Podrobnější data byla získána z případové studie dvou vybraných libyjských organizací působících ve veřejném sektoru. Při empirické analýze nashromážděných dat bylo využito rámce mnohočetné perspektivy, který zahrnuje hlediska teorie strukturalizace, pojem mnohočetných perspektiv a metodologii měkkých systémů. V práci se dospělo ke zjištění, že: a) kvalita informačních systémů je pojata šíře, než je tomu u tradiční definice kvality, b) mnohočetné perspektivy kvality informačních systémů jsou ovlivněny opakovanou interakcí mezi investorem a institucionálními vlastnostmi kontextu informačního systému a že c) rozdílné hodnoty v kulturním prostředí a vnějším kontextu ovlivňují rozsah působnosti investora a interakce v kontextu informačního systému. Ze závěru práce vyplývá, že společenská skladba mnohočetných perspektiv kvality informačního systému je ovlivněna strukturalizačními procesy mezi investory a vlastnostmi v kontextu informačního systému.This thesis is concerned with understanding how stakeholders in a particular cultural context construct the multiple meanings of ‘Information Systems Quality’ (IS Quality). A review of literature on approaches and frameworks for IS quality shows that the IS quality is generally examined through a ‘hard approach’. This study demonstrates that IS quality can be meaningfully understood through an interpretive paradigm, and that IS quality is socially constructed and influenced by the IS context. The study began with an exploratory survey of twenty Libyan organizations. Data were gathered through a case study of two public sector organizations in Libya. A Multiple Perspective Framework (MPF) that incorporates ideas from structuration theory, multiple perspectives concept, and soft systems methodology (SSM) was used to analyze the empirical work. The findings revealed that: (a) IS quality is a broader conception than the traditional quality definition, (b) the multiple perspectives of IS quality are influenced by repeated interaction between the stakeholder and institutional properties in the IS context, and (c) mediation of different values in the culture system and in the external context influence the extent of stakeholder agency and interaction in the IS context. The study concluded that the social construction of multiple perspectives of IS quality is influenced by the structuration processes between stakeholders and properties in the IS context.

The moderator role of Gender in the Unified Theory of Acceptance and Use of Technology (UTAUT): A study on users of Electronic Document Management Systems

Venkatesh et al. [1] tried to integrate predictability capabilities from the different existing models of technology acceptance. This produced the Unified Theory of Acceptance and Use of Technology (UTAUT). This comprehensive model resulted in the identification of common aspects. It proposed several constructs with a greater explanatory power and analyzed moderating drivers, such as age, Gender, experience and voluntariness of use. By doing so, UTAUT identifies three major drivers of behavioral intention: performance expectancy, effort expectancy and social influence. On the other hand, facilitating conditions and behavioral intention were identified as determinant factors of actual use [1]. In addition to previous considerations about UTAUT, empirical research has scarcely analyzed the moderating role of Gender [2]. This is why this paper particularly aims to fill this gap. Hofstede [3] describes strength, competitiveness and guidance for material success as social roles linked to male values, whilst modesty, tenderness, sensitivity and concern for the quality of life are values associated with women. With respect to UTAUT, existing studies have shown that performance expectancy positively influences behavioral intention more strongly for men (cf. [4], [5], [6] and [7]). Moreover, it has been observed that effort expectancy positively influences behavioral intention more strongly for women (cf. [4], [5] and [6]), while social influence positively affects behavioral intention more strongly for women (cf. [5], [7] and [8]). In our research, with the aim of testing the moderating effects of Gender, a sample of 2,175 users of Electronic Document Management Systems (EDMS) in Portuguese municipalities was used. Taking into account that Gender is a categorical variable, we have adopted a multi-group or multi-sample analysis [9] -dividing the sample into two groups (male = 748; female = 1,427) and estimating each group of observations separately. Before comparing the groups, an analysis of the measurement invariance was carried out to make sure that the construct measures were invariant between both groups [10]. Once the metric invariance had been assessed, we carried out a set of multi-group analyses –interpreting statistically-significant differences in path coefficients as moderating effects. On the one hand, the parametric approach considering both equal variances and different variances has been used [11, 12]. On the other hand, we have applied non-parametric approaches exemplified by the permutation test [13], and Henseler’s PLS multi-group analysis [10, 12, 14]. This study notes slight differences in the results of the aforementioned methods. As a result, the moderating effect of Gender on the relation between performance expectancy and behavioral intention showed that this relationship is stronger among men than women. Finally, a discussion on the implications of Gender as a moderator for the UTAUT model is included

Softer perspectives on enhancing the patient experience using IS/IT

Purpose – This paper aims to argue that the implementation of the Choose and Book system has failed due to the inability of project sponsors to appreciate the complex and far-reaching softer implications of the implementation, especially in a complex organisation such as the NHS, which has multifarious stakeholders. Design/methodology/approach – The authors use practice-oriented research to try and isolate key parameters. These parameters are compared with existing conventional thinking in a number of focused areas. Findings – Like many previous NHS initiatives, the focus of this system is in its obvious link to patients. However we find that although this project has cultural, social and organisational implications, programme managers and champions of the Connecting for Health programme emphasised the technical domains to IS/IT adoption. Research limitations/implications – This paper has been written in advance of a fully implemented Choose and Book system. Practical implications – The paper requests that more attention be paid to the softer side of IS/IT delivery, implementation, introduction and adoption. Originality/value – The paper shows that patient experience within the UK healthcare sector is still well below what is desired

On the User Perception of Configurable Reference Process Models - Initial Insights

Enterprise Systems potentially lead to significant efficiency gains but require a well-conducted configuration process. A configurable reference modelling language based on the widely used EPC notation, which can be used to specify Configurable EPCs (C-EPCs), has been developed to support the task of Enterprise Systems configuration. This paper presents a laboratory experiment on C-EPCs and discusses empirical data on the comparison of C-EPCs to regular EPCs. Using the Method Adoption Model we report on modeller’s perceptions as to the usefulness and ease of use of C-EPCs, concluding that C-EPCs provide sufficient yet improvable conceptual support towards reference model configuration

Reasons behind ERP package adoption: a diffusion of innovations perspective

Enterprise Resource Planning (ERP) packages have been widely adopted and it is becoming clear that this is driven by multiple rationales that may be simultaneously at odds and complimentary. In this paper, we aim to develop a greater understanding of these rationales by taking ERP packages to be innovations and analysing their adoption with reference to the theory of diffusion of innovations. In particular, we consider the attributes of ERP packages that may affect their adoption such as relative advantage, compatibility, complexiblity, trialability and observability. We argue that users’ perceptions of these attributes are not always accurate and these ’misconceptions’ can further explain reasons for ERP adoption or rejection. Although our analysis aims to provide rich insights into the adoption of ERP packages, the results of the study are arguably of further interest to the more general study of packaged software and the more established literature on custom development

Semantic discovery and reuse of business process patterns

Patterns currently play an important role in modern information systems (IS) development and their use has mainly been restricted to the design and implementation phases of the development lifecycle. Given the increasing significance of business modelling in IS development, patterns have the potential of providing a viable solution for promoting reusability of recurrent generalized models in the very early stages of development. As a statement of research-in-progress this paper focuses on business process patterns and proposes an initial methodological framework for the discovery and reuse of business process patterns within the IS development lifecycle. The framework borrows ideas from the domain engineering literature and proposes the use of semantics to drive both the discovery of patterns as well as their reuse

Towards a better understanding of the e-health user: comparing USE IT and Requirements study for an Electronic Patient Record.

This paper compares a traditional requirements study with 22 interviews for the design of an electronic patient record (EPR) and a USE IT analysis with 17 interviews trying to understand the end- user of an EPR. Developing, implementing and using information technology in organizations is a complex social activity. It is often characterized by ill-defined problems or vague goals, conflicts and disruptions that result from organizational change. Successfully implementing information systems in healthcare organizations appears to be a difficult task. Information Technology is regarded as an enabler of change in healthcare organizations but (information) technology adoption decisions in healthcare are complex, because of the uncertainty of benefits and the rate of change of technology. (Job) Relevance is recognized as an important determinant for IS success but still does not find its way into a systems design process