63 research outputs found

    Taxonomy of delays in the implementation of hospital computerized physician order entry and clinical decision support systems for prescribing:a longitudinal qualitative study

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    BACKGROUND: Implementation delays are common in health information technology (HIT) projects. In this paper, we sought to explore the reasons for delays in implementing major hospital-based HIT, through studying computerized physician order entry (CPOE) and clinical decision support (CDS) systems for prescribing and to develop a provisional taxonomy of causes of implementation delays. METHODS: We undertook a series of longitudinal, qualitative case studies to investigate the implementation and adoption of CPOE and CDS systems for prescribing in hospitals in the U.K. We used a combination of semi-structured interviews from six case study sites and two whole day expert roundtable discussions to collect data. Interviews were carried out with users, implementers and suppliers of CPOE/CDS systems. We used thematic analysis to examine the results, drawing on perspectives surrounding the biography of artefacts. RESULTS: We identified 15 major factors contributing to delays in implementation of CPOE and CDS systems. These were then categorized in a two-by-two delay classification matrix: one axis distinguishing tactical versus unintended causes of delay, and the second axis illustrating internal i.e., (the adopting hospital) versus external (i.e., suppliers, other hospitals, policymakers) related causes. CONCLUSIONS: Our taxonomy of delays in HIT implementation should enable system developers, implementers and policymakers to better plan and manage future implementations. More detailed planning at the outset, considering long-term strategies, sustained user engagement, and phased implementation approaches appeared to reduce the risks of delays. It should however be noted that whilst some delays are likely to be preventable, other delays cannot be easily avoided and taking steps to minimize these may negatively affect the longer-term use of the system

    Upstream Supply Chain Visibility and Complexity Effect on Focal Company’s Sustainable Performance: Indian Manufacturers’ Perspective

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    Understanding supply chain sustainability performance is increasingly important for supply chain researchers and managers. Literature has considered supply chain sustainability and the antecedents of performance from a triple bottom line (economic, social, and environmental) perspective. However, the role of supply chain visibility and product complexity contingency in achieving sustainable supply chain performance has not been explored in depth. To address this gap, this study utilizes a contingent resource-based view theory perspective to understand the role of product complexity in shaping the relationship between upstream supply chain visibility (resources and capabilities) and the social, environmental, and economic performance dimensions. We develop and test a theoretical model using survey data gathered from 312 Indian manufacturing organizations. Our findings indicate that supply chain visibility (SCV) has significant influence on social and environmental performance under the moderation effect of product complexity. Hence, the study makes significant contribution to the extant literature by examining the impact of SCV under moderating effect of product complexity on social performance and environmental performance

    A decision support system for the courier vehicle scheduling problem

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    The timely collection and transportation of checks from branches to the operations center is a primary concern to bank managers. Transit checks need to be cleared quickly to maximize available funds to the bank's cash managers. However, management must not over-commit resources, such as drivers and vehicles, to improve the movement of checks from branch banks to the operations center. Bank managers must make difficult decisions regarding courier fleet size, routing, and scheduling in order to balance these conflicting goals and to minimize overall system costs. We present a micro-computer based decision support system (DSS) that helps bank managers make good decisions for their vehicle courier service. This system, known as Chexpedite, helps establish the correct number of vehicles, the appropriate collection routes, the timing of the routes, and a view of the check flow pattern into the operations center (back office check processing center). The system has been implemented at a number of banks, indicating its value to bank management. In this paper, the logic of Chexpedite and its database, optimization, and simulation capabilities are presented. A case study application demonstrates the system. The final section concludes with a discussion of Chexpedite's strengths and weaknesses.
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