Exploring the Implementation Process of Technology Adoption In Long-term care Nursing Facilities.

Integrated Technology Implementation Model;Long-term care;Nursing;Health Sciences;Nursing

Schoville, Rhonda R.Redman, Richard W. ;

University of Michigan

关键词: Integrated Technology Implementation Model;    Long-term care;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/113622/rhondas_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

There is little understanding of how long-term care settings implement and adopt technology.The study purpose was to set forth a model that integrates implementation science and technology adoption frameworks and to explore the process of EHR technology implementation leading to adoption.Research questions investigated key stakeholders’ experiences with the implementation, if adoption occurred, and what themes mapped to the new model.There were three components of the dissertation.Based on a critical analysis of the literature, a model was set forth that integrates implementation science and technology adoption frameworks.Next, the experiences of 30 key stakeholders in three nursing homes were explored to understand implementation strategies.The third was one in-depth case study to explore EHR implementation and adoption. The first study was an exploratory qualitative study using grounded theory methods with focus groups (nurses and certified nurse aides) and individual interviews (Directors of Nursing) conducted at three Midwestern nursing homes with various numbers of beds (99-200), locations, and stages of implementation.A stratified random sample was used for focus groups (nurses and certified nurse aides).Data analysis included constant comparison of data.The second study an in-depth case study at a 124 bed, inner-city nursing home.Data sources were interviews of nurses and nurse aides (15), observation sessions of key care events (15), and leadership meetings.Data analysis included using constant comparison of themes and descriptive statistics (activity frequencies and percentages).Integration of data occurred to illustrate the dynamics of implementing and adopting the EHR.Five major themes emerged which included:motivation and EHR adoption, factors that influence the implementation, audit and bi-directional feedback, benefits, and opportunities to improve the EHR.The studies supported the new model with the workflow concept broadened to work processes.The importance of this dissertation is that it added to the knowledge of individual’s and system’s perspectives about implementation and adoption of an EHR in LTC facilities.The study supported the new Integrated Technology Implementation model concepts.Future research that is designed prospectively using this new model is needed.Other types of users should be studied such as administrators, physicians, and residents.