Electronic Health Records: Cure-all or Chronic Condition?

Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential

Healthcare services managers: what information do they need and use?

Objectives: To gain insight into the information behaviour of healthcare services managers as they draw on information while engaged in decision making unrelated to individual patient care. Objectives – The purpose of this research project was to gain insight into the information behaviour of healthcare services managers as they use information while engaged in decision-making unrelated to individual patient care. Methods – This small-scale, exploratory, multiple case study used the critical incident technique in nineteen semi-structured interviews. Responses were analyzed using ‘Framework,’ a matrix-based content analysis system. Results – This paper presents findings related to the internal information that healthcare services managers need and use. Their decisions are influenced by a wide variety of factors. They must often make decisions without all of the information they would prefer to have. Internal information and practical experience set the context for new research-based information, so they are generally considered first. Conclusions – Healthcare services managers support decisions with both facts and value-based information. These results may inform both delivery of health library services delivery and strategic health information management planning. They may also support librarians who extend their skills beyond managing library collections and teaching published information retrieval skills, to managing internal and external information, teaching information literacy, and supporting information sharing

Assessing Nurses’ Knowledge Sharing Problems Associated with Shift Handover in Hospital Settings

In hospital settings, the quality and effectiveness of shift handover are critical for continuous and high quality patient care. This paper explores nurses’ knowledge sharing problems during shift handover in 6 Australian hospitals. A single focus group was conducted to collect empirical evidence of knowledge sharing problems during shift handover, across the hospitals. Findings indicate a broader set of problems that hinder effective knowledge sharing and suggest that handover standards, codification guidelines, the format of templates, and training in conducting handover need to be improved. Additionally, knowledge codification by health professionals other than nurses needs to be encouraged to improve shift handover. Finally, more guidance and training in using various IT hospital systems are necessary to give entry-level and graduate nurses adequate skills to ensure more effective shift handover. This study emphasizes the importance of people, technology, systems, standards and routine activities to capture and share important shift knowledge

Factors that affect scrub practitioner non-technical skills: A literature review

Non-technical skills are the cognitive and interpersonal behaviours that compliment clinical competence in surgery. Effective use of non-technical skills is essential for scrub practice, because they facilitate anticipation of the surgeon’s requirements and promote appropriate communication behaviours. This literature review analyses the factors that may influence a scrub practitioner’s use of non-technical skills during surgery. Recommendations are made that are intended to improve their use by reducing behavioural variations during surgery

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches

Assessing the impact of physicians' social capital on decision making quality mediated by knowledge sharing in a virtual community of practice: an empirical quantitative analysis

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London.Purpose - Healthcare (HC) is a globally expensive investment, suffering from service quality, due to medical errors caused by physicians’ poor decisions making (DM). Current published literature: (1) encourages clinical DM research to reduce diagnostic errors and (2) stresses on the dearth of means for practitioners’ knowledge shared DM; this research focuses on knowledge sharing for improving medical DM quality through physicians’ social capital (SC) in a virtual community of practice (VCoP). Physicians join a virtual community (VC) to share clinical practice knowledge to aid medical DM. This study aims to assess the effect of physicians’ SC on medical DM and assess the mediating role of knowledge sharing quality, between physicians’ SC and medical DM quality since research lacks to investigate the impact of knowledge management (KM) tools in a HC context. VCoP is a KM tool and medical DM quality is a HC topic of this study. Design/methodology/approach – This positivist, quantitative research utilizes non-experimental survey to empirically assess its conceptual framework. After attaining an ethical approval, from Brunel Business School Research Ethics Committee, online survey was pre-tested and pilot tested for clarity and validity. 10 non-physician Ph.D. academics voluntarily participated during the survey’s pre-test phase. The survey was amendment for its pilot study phase; conducted in “plastic surgery yahoo group” VC. 31 physician VC members voluntarily participated. Again, the survey was amended and distributed for main data collection from 204 voluntary SurveyMonkey’s VC’s physician members. Findings – Data was analysed using SPSS 20 and LISREL 8.80 by means of confirmatory factor analysis and Structural Equation Modeling. Empirical findings supported this study’s four main hypotheses as well as supported this study’s initially proposed conceptual framework. Originality/value – This study customized the Honeycomb framework to establish a definition of professional physicians; HC VCs followed by identifying 51 VCs from social networking platforms like LinkedIn, Facebook, etc. This study also fulfilled its aim and hence proposed a structurally fit conceptual framework. Keywords –Virtual Community of Practice; Healthcare Knowledge Management; Confirmatory Factor Analysis; Structural Equation Modelin

Proceedings of the Salford Postgraduate Annual Research Conference (SPARC) 2011

These proceedings bring together a selection of papers from the 2011 Salford Postgraduate Annual Research Conference(SPARC). It includes papers from PhD students in the arts and social sciences, business, computing, science and engineering, education, environment, built environment and health sciences. Contributions from Salford researchers are published here alongside papers from students at the Universities of Anglia Ruskin, Birmingham City, Chester,De Montfort, Exeter, Leeds, Liverpool, Liverpool John Moores and Manchester

Assessing the Impact of Electronic Health Record Systems Implementation on Hospital Patient Perceptions of Care

The delivery of health care services has been impacted by advances in Knowledge Management Information Systems (KMIS) and Information Technology (IT). The literature reveals that Electronic Health Records Systems (EHRs) are a comprehensive KMIS. There is a wide recognition in the body of knowledge that demonstrates the potential of EHRs to transform all aspects of health care services and, in consequence, the performance of Health Care Delivery Organizations (HCDO). Authors of published research also agree that there is a need for more empirical contributions that demonstrate the impact of EHRs upon HCDO. It is argued that in most cases, studies have been deployed with very limited data or in a specific health care setting. Small gains in performance and mixed results have made difficult to conclusively demonstrate a significant effect of EHRs on the quality of health care services. This study contributes to the knowledge base by empirically assessing the link between a hospital\u27s level of implementation of EHRs and patients\u27 perceptions of the quality of health care services through the analysis of 2,036 hospitals. Findings reveal that the level of implementation of EHRs has a positive impact, both on the percentage of patients who are willing to recommend the hospital to family and friends, and on the percentage of patients who give high ratings based on their last stay in the hospital