Information needs in the day-to-day operations management of hospital units

Day-to-day operations management of hospital units is complex due to several actors, changing situations and various information systems in use. Responsible professionals face challenges to obtain important information for managerial decision-making. The aim of this study was to model important information needed in the day-to-day operations management of hospital units. The study had an observational design. The professionals responsible are here referred to as ‘shift leaders’ and they included nurses and physicians in charge. Data were collected in 2012–2016. First, a literature review was done to describe information systems developed for the day-to-day operations management of hospital units. Second, an instrument for exploring information needed in the day-to-day operations management of hospital units was developed and tested. Third, a national survey was done to model important information needed in the day-to-day operations management of hospital units. Thereafter, one information model was clinically tested. The findings showed that numerous information systems have been developed for professionals responsible for the day-to-day operations management of hospital units, but these do not adequately support managerial decision-making. The instrument for exploring information needed in the day-to-day operations management of hospital units was valid and reliable, and data collected with it showed that the needs differed between professionals, time of day and types of units. The largest difference was between professionals. Nurses’ important information needs covered patients, personnel and materials, while physicians’ needs focused on patient care. Categories of important information for the model were determined by factor analysis for these different user groups. The final model of important information had ten information categories, all of which were needed by different user groups that had a different set of individual items. This model may be used to develop and improve information processing in the day-to-day operations management of hospital units to support the safe, efficient and cost-effective provision of care.Tiedon tarpeet sairaalayksikön päivittäisen toiminnan johtamisessa Sairaalayksikön päivittäisen toiminnan johtamien on haastavaa usean toimijan, muuttuvien tilanteiden ja lukuisten käytössä olevien tietojärjestelmien vuoksi. Toiminnasta vastaavilla ammattilaisilla on vaikeuksia saada tärkeää tietoa päätöksenteon tueksi. Tutkimuksen tarkoitus oli mallintaa sairaalayksikön päivittäisen toiminnan johtamisessa tarvittavia tärkeitä tietoja. Tutkimusasetelma oli havainnoiva. Toiminnasta vastaavat ammattilaiset olivat sairaanhoitajia ja lääkäreitä. Aineistot kerättiin vuosina 2012–2016. Aluksi kuvattiin sairaalayksikön päivittäisen toiminnan johtamiseen kehitettyjä tietojärjestelmiä kirjallisuuskatsauksella. Toiseksi, kehitettiin ja testattiin mittari, jolla voitiin tarkastella tiedon tarpeita sairaalayksikön päivittäisen toiminnan johtamisessa. Kolmanneksi, tehtiin kansallinen kysely, jonka perusteella sairaalayksiköiden päivittäisen toiminnan johtamisessa tarvittavia tärkeitä tietoja voitiin mallintaa. Lopuksi, yksi malli testattiin kliinisessä ympäristössä. Päivittäisen toiminnan johtamiseen on tulosten perusteella kehitetty lukuisia tietojärjestelmiä, mutta ne tukevat johtamisen päätöksentekoa vain osin. Sairaalayksikön päivittäisen toiminnan johtamisen tiedontarpeiden selvittämiseen kehitetty mittari osoittautui validiksi ja reliaabeliksi. Mittarilla kerätty tieto osoitti, että tiedontarpeet eroavat ammattiryhmän, ajankohdan ja sairaalayksikön mukaan. Suurin ero oli ammattiryhmien välillä. Sairaanhoitajat tarvitsivat tietoa potilaista, henkilöstöstä ja materiaaleista kun taas lääkäreiden tarpeet keskittyivät potilashoitoon. Käyttäjäryhmien tärkeitä tietosisältöjä jäsenneltiin faktorianalyysin avulla. Tärkeiden tietojen malli koostui yhteensä kymmenestä tietokategoriasta, jotka vaihtelivat käyttäjäryhmittäin. Myös kategorioiden sisällä olevat yksittäiset tiedon tarpeet vaihtelivat käyttäjäryhmillä. Tämä korostaa joustavien ja käyttäjälähtöisesti räätälöityjen tietojärjestelmien tarvetta. Mallia voidaan käyttää tietojen käsittelyn kehittämiseen sairaalayksiköiden päivittäisen toiminnan johtamisessa, jotta paremmin tuetaan turvallisia, vaikuttavia ja kustannustehokkaita palveluita

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.Peer reviewe

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

A Digital Service Logistics Information System for Emergency Department Care Coordination - Professionals' Experiences

The aim was to describe nurses' and physicians' perceptions of a digital service logistics information system from an operative management perspective in emergency departments (EDs). A total of 24 professionals were interviewed. Based on the results the information systems support operative management of EDs but the professionals desire more detailed information about patients and staff to support situational awareness in the operative management of these units.Peer reviewe