Nurses� perception of nursing services documentation barriers: A qualitative approach

Background: Researches has shown that the quality of nursing documentation services in the world, including Iran, is far from existing standards. Understanding the barriers to improving the documentation of nursing services is essential for the first step. The aim of this study was to identify barriers to improving the nursing documentation services using the experience of nurses in the emergency department of one of the Iranian hospitals. Materials and Methods: This study is based on content analysis in accordance with the style of Graneheim in 2017 in the emergency department of one of the Iranian hospitals. This qualitative study was performed on 20 participant from different nursing grades including 17 nurses, 1 head nurse, and 2 members of the accreditation committee. The data were collected through semi-structured interviews and using interview guide and field note. Results: Research data have been explained in four main themes of qualification of documentation including sub-categories of the need for effective training, the need for training in the standards of documentation, and the necessity of skills in reporting; job burnout including sub-categories of job stress and work pressure; perceived control including sub-categories of planned control and effective monitoring and control; intra-organizational coordination including sub-categories of improving health information system and documentation management time, legal barrier for documentation including sub-categories of escaping from the law and legal liabilities. Conclusion: In this study, 599 primary codes were extracted and the main themes documentation competency, job burnout, perceived control, intraorganizational coordination, and legal barrier extracted. © 2018 by the authors; licensee Modestum Ltd., UK

Nurses� perception of nursing services documentation barriers: A qualitative approach

Background: Researches has shown that the quality of nursing documentation services in the world, including Iran, is far from existing standards. Understanding the barriers to improving the documentation of nursing services is essential for the first step. The aim of this study was to identify barriers to improving the nursing documentation services using the experience of nurses in the emergency department of one of the Iranian hospitals. Materials and Methods: This study is based on content analysis in accordance with the style of Graneheim in 2017 in the emergency department of one of the Iranian hospitals. This qualitative study was performed on 20 participant from different nursing grades including 17 nurses, 1 head nurse, and 2 members of the accreditation committee. The data were collected through semi-structured interviews and using interview guide and field note. Results: Research data have been explained in four main themes of qualification of documentation including sub-categories of the need for effective training, the need for training in the standards of documentation, and the necessity of skills in reporting; job burnout including sub-categories of job stress and work pressure; perceived control including sub-categories of planned control and effective monitoring and control; intra-organizational coordination including sub-categories of improving health information system and documentation management time, legal barrier for documentation including sub-categories of escaping from the law and legal liabilities. Conclusion: In this study, 599 primary codes were extracted and the main themes documentation competency, job burnout, perceived control, intraorganizational coordination, and legal barrier extracted. © 2018 by the authors; licensee Modestum Ltd., UK

HOW SOCIAL CAPITAL BETWEEN MEDICAL AND IT PROFESSIONALS SHAPES THE OUTCOMES OF HEALTH INFORMATION SYSTEM IMPLEMENTATION ENDEAVOURS

Successful implementation of healthcare information systems (HIS) is tremendously difficult. Although few is known about the mechanisms enabling successful HIS implementation, effective learning pro-cesses and consciously implemented adaptations to HIS and medical reality are assumed to be pivotal. In this paper, we aim to gain understanding about the enablers of these processes. To that end, we conducted an in-depth case study of an HIS implementation project. Findings demonstrate that the success of HIS initiatives is particularly dependent on the capacity of involved actors to integrate their idiosyncratic knowledge and to develop congruent and actionable understanding. Looking at the conducting paths for integrating knowledge, our findings further show that stakeholders’ social capital reflected by their opportunity, motivation and ability to capitalize on existing knowledge and experiences are critical for aligning HIS and medical reality. Taking a qualita-tive approach, we extend existing research by illustrating how social capital and knowledge integration outcomes coevolve. Overall, our results highlight the importance of social capital for knowledge integration during HIS initiatives. Medical and IT professionals’ collaborative endeavours seem to produce valuable solutions that balance divergent stakeholders’ concerns when opportunity, motivation and ability to integrate their knowledge, expertise and interests are effectively managed

Operational Business-IT Alignment in Healthcare: Theoretical Foundation and Empirical Evidence

This thesis examines IT-related change in healthcare. Building on and extending prior research on operational business-IT alignment, new insights are derived that enable practitioners to align IT and medical reality to realize expected potentials of health IT. The results posit that strong social capital mitigates the challenges that come with structurally decoupled organizations and facilitates identification and implementation of necessary IT-related change in hospitals. Likewise, shared understanding about how health IT will affect and is affected by socio-organizational complementarities is found to be a critical requirement for effective change processes. Strong linkages between IT and medical professionals as well as sufficient shared understanding enables effective change processes. These processes are characterized by reciprocal adaptations to HIS and other elements of interrelated organizational activity systems, in which IT is embedded in. The empirical results demonstrate that iterative resolution of contradictions and mitigation of tensions within and between activity systems increases the efficiency of IT and leads to sustained alignment. Overall, this dissertation extends prior theories on alignment, helps scholars understand and account for the unique and complex characteristics of the healthcare domain and offers actionable guidance for practice.Diese Dissertation untersucht IT-bezogene Veränderungsprozesse in Krankenhäusern. Aufbauend auf dem Stand der Forschung zum operativen Business-IT Alignment erarbeitet diese Dissertation neue Erkenntnisse, die es Praktikern ermöglichen, IT und medizinische Realität bestmöglich aufeinander abzustimmen und damit den Wertbeitrag der IT in dieser Domäne zu steigern. Die empirischen Ergebnisse zeigen, dass starkes Sozialkapital die Herausforderungen strukturell entkoppelter Organisationen ausgleicht und die Identifikation und Realisierung notwendiger IT-bezogener Veränderungen in Krankenhäusern erleichtert. Ebenso ist ein gemeinsames Verständnis der Beteiligten darüber, wie sich die Gesundheits-IT auf die komplementären sozio-organisatorischen Charakteristika auswirkt und von diesen beeinflusst wird, eine entscheidende Voraussetzung für effektive Veränderungsprozesse. Enge Verbindungen zwischen IT- und Medizinern sowie ein ausreichendes gemeinsames Verständnis begünstigen effektive IT-bezogene Veränderungsprozesse. Diese Prozesse sind gekennzeichnet durch wechselseitige Anpassungen an der IT und anderer Elemente zusammenhängender organisatorischer Tätigkeitssysteme, in welche die IT eingebettet ist. Die empirischen Ergebnisse zeigen, dass die iterative Lösung von Widersprüchen und der Abbau von Spannungen innerhalb und zwischen Aktivitätssystemen die Effizienz der IT steigert und zu einer nachhaltigen Business-IT Alignment führt. Insgesamt erweitert diese Dissertation das theoretische Wissen zu operativem Business-IT Alignment und verbessert das Verständnis über die Charakteristika und Komplexitäten der Domäne Krankenhaus und bietet praktische Hilfestellungen zur Gestaltung IT-bezogener Veränderungsprozesse