Implementation of change in most organizations is met with a lot of resistance as people resist moving from their comfort zones. In healthcare set up, change is gradual as new methods and discoveries are put forth in an attempt to make the quality of care given to patients better. In fact, much of the knowledge and research in the field of healthcare have a lifespan of five years, after which new research and knowledge is introduced. Although nurses are live to this fact, they are not always ready for change. Change can translate to fear and tension among nurses which raises the possibility of resistance. Successful implementation of a new technology system in healthcare is a function of dedicated leadership. The Rogers theory can be used to understand the best ways that a nursing facilitator in upstate New York can use to prepare nurses to embrace new technology system with minimal or no resistance. In addition, it is paramount that the role of nurses be understood from the perspective of being agents of change and how they can contribute to the successful implementation of EHR in a healthcare organization.
When nurses express reservation to a change or introduction of new technology, the nurse facilitator should respond to their concerns. To start with, nurses must feel that they are part of the change and that the new development is for their good. To ease resistance, nurses must own up the new development. Bakkabulindi (2014) notes that involving all stakeholders, especially staff in the change process, and ensuring that there is open and transparent communication leads to trust and ultimately to unwavering support to change. In the case in point, having a meeting with nurses to address any undertones they may have as well as explain to the possible benefits of the of electronic health record (EHR) will lessen the levels of resistance. Additionally, prior training of nurses of how to use EHR will prepare them well to accept change.
A nursing facilitator can use the Rogers Theory as the pillar for the meeting. The theory is founded on three pillars which are paramount in the change management process. The pillars are planning, communication and supports (McGonigle & Mastrian, 2015). Rogers's theory highlights five important qualities that inform peoples' attitude towards a change in the technology system. The qualities are listed below:
- The relative advantage in relation to existing systems or possible alternatives
- The simplicity of the system
- Compatibility with e values and practices that are already in place
- Ability to produce observable results
Before calling for the meeting, the nurse facilitator ought to prepare and give adequate notice (can range from a few days to weeks) given that upstate New York is a small healthcare facility. The meeting will be geared towards finding common ground under the following interventions: getting the nurses to share in the organization's vision in as far as EHR is concerned and simulation of the new HER system. The meeting can also seek to showcase a typical day for the nurses when utilizing the new system.
Nurses should be informed of the possible benefits of EHR to their patients when compared to the current system in use in the facility. Notably, if the nurses do not have a clear understanding of the improvement and the intended benefits of the systems, they are likely not going to support its implementations. The cliche on 'if not broken why fix it' should be clearly explained to the nurses in line with the new technology. As such, the nurse facilitators should be able to sell the vision that EHR would take relatively less time for the nursing in manual documentation and locating files translating to more time to use for direct care with the patients (Smith, 2015). Additionally, statistics of how EHR has been successfully introduced and used in other organizations would be shown to nurses to make the meeting more persuasive. Engaging in a conference call with an organization that has successfully used the EHR gives a nurse facilitator an upper hand to validate his sentiments on the possible benefits of EHR (Lee, 2004).
The nurse facilitators should also explain how EHR support the existing nursing framework. This can be made possible by simulating how a typical day for a nurse will change in light of the new technology. Ordinarily, training on new systems can be difficult and stressful. When nurses are being told what EHR is as compared to when they see the system in actions, there is room for doubts and misconceptions that are created (Lee, 2004). Thus, nurse facilitators should strive to help the nurses see the new technology in action in typical day to day activities. Simulation can thus be used to help nurses understand the expected workflow and periodic objectives get a preview of the process prior to the official training and be able to ask any question that might arise before the launch of the new system.
Notably, though, change is not an overnight event but a process. Although the nurse facilitator can put good efforts, it is impossible to weed out all elements of resistance. Nurses thus need perpetual one on one support and positive feedback. Both negative and positive attitudes can be contagious in organizations. Agents of change should thus be consistent in displaying a positive attitude in reference to EHR; chances are they will influence the others in the right direction.
Role of Nurses
Successful implementation of change must involve, as key players, those that are affected directly by the change. Maintaining health records is a nursing function. Any change, positive or negative, affecting health records must thus be implemented after consultation with the nurses. Nurses have the knowledge of the existing system, the challenges they face and the possible ways to solve them. In addition, nurses help in the development of organizational culture. For change to succeed there must be a supportive culture. Nurses, therefore, must be involved to try the change agenda both in words and actions (McGonigle & Mastrian, 2015).
The introduction of EHR has a massive positive impact on healthcare organizations. However, the implementation of EHR just like any change process is met with resistance and can be challenging especially to small organizations. Nurses are usually resistant to change and if there is not proper leadership in place, implementation of new systems can flop and fail desperately. The Rogers Theory is a good reference point to nurse facilitators as it offers a detailed list of nurses need and concern that must be addressed to make change process less stressful. The role of nurses in the change process cannot be underestimated. Implementation of EHR concerns nurses directly, they must be involved directly; otherwise, resistance to change should be expected.
Bakkabulindi, F. (2014). A call for Return to Rogers' Innovation Diffusion Theory. Makerere Journal of Higher Education, 6(1), 55. doi:10.4314/majohe.v6i1.4
Lee, T. (2004). Nurses' adoption of technology: Application of Rogers' innovation-diffusion model. Applied Nursing Research, 17(4), 231-238. doi:10.1016/j.apnr.2004.09.001
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning
Smith, T. (2015). Barriers to Technology Adoption by Baccalaureate Nursing Faculty. SSRN Electronic Journal. doi:10.2139/ssrn.2963177
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