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Hanne Tønnesen - One of the best experts on this subject based on the ideXlab platform.
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staff experiences with strategic Implementation of clinical health promotion a nested qualitative study in the who hph recognition Process rct
Sage Open Medicine, 2018Co-Authors: Jeff Kirk Svane, Hanne Tønnesen, Ingrid EgerodAbstract:Objectives: Health promotion is on the global agenda. The risks targeted include smoking, hazardous alcohol consumption, nutrition and insufficient physical activity. Implementation of clinical health promotion, however, remains a major challenge. While several Processes, models and frameworks for strategic Implementation exist, very few have been tested in randomized designs. Testing a strategic Implementation Process for clinical health promotion was only recently attempted via a randomized clinical trial on the World Health Organization Health Promotion Hospitals Recognition Process. The randomized clinical trial showed that the Process improved central parts of Implementation. To complement these findings, this nested qualitative study aimed to explore experiences and perceptions of staff and managers, who had completed the Process, and generate hypotheses for improvements.Methods: We interviewed a purposeful sample of 45 key informants from four countries, who worked at clinical departments and had undertaken the World Health Organization Health Promotion Hospitals Implementation Process. The informants included 14 managers, 14 medical doctors, 13 nurses and 4 other clinical staff. Interview transcripts were analyzed using qualitative content analysis and an inductive approach to coding and categorization supported by QSR NVivo.Results: The informants' experiences and perceptions centered around four global themes concerning (1) awareness, cultural re-orientation and integration; (2) learnings; (3) normalization and legitimacy and (4) a more evidence-based, structured and systematic approach to clinical health promotion. Informants were positive toward the Implementation Process, although it was sometimes challenging. The suggested improvements to increase acceptability related to the patient survey, time consumption, translation, tailoring to local circumstances and in-advance training.Conclusions: Managers and staff were positive toward the World Health Organization Health Promotion Hospitals Process, which was perceived to bring about positive changes and learnings. The findings also suggest that the Implementation Process may be improved by minor adjustments to Process elements and design. It is our recommendation to use the Process in clinical departments to further Implementation of clinical health promotion.
M A Venkataramanan - One of the best experts on this subject based on the ideXlab platform.
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enterprise resource planning managing the Implementation Process
European Journal of Operational Research, 2003Co-Authors: Vincent A Mabert, Ashok Soni, M A VenkataramananAbstract:Abstract Over the past few years, thousands of companies around the world have implemented enterprise resource planning (ERP) systems. Implementing an ERP system is generally a formidable challenge, with a typical ERP Implementation taking anywhere from one to five years. The story of the success of ERP systems in achieving the stated objectives is mixed. Some companies have had very successful Implementations while others have struggled. This paper empirically investigates and identifies key differences in the approaches used by companies that managed their Implementations on-time and/or on/under-budget versus the ones that did not using data collected through a survey of US manufacturing companies that have implemented ERP systems. Logistic regressions are used to classify on-time and on/under-budget firm groups based on the survey responses and to identify the significant variables that contribute to on-time and on/under-budget Implementation performance. The results indicate that many different factors ranging from pre-Implementation planning to system configuration influence performance, which managers should be sensitive about when implementing major systems like ERP.
Jos Aarts - One of the best experts on this subject based on the ideXlab platform.
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anatomy of a failure a sociotechnical evaluation of a laboratory physician order entry system Implementation
International Journal of Medical Informatics, 2010Co-Authors: Linda W P Peute, Jos Aarts, P J M Bakker, Monique W M JaspersAbstract:Abstract Objective To investigate the human, social and organizational issues surrounding a Computerized Physician Order Entry system for Laboratory ordering (CPOE-L) Implementation Process and to analyze their interrelated effects on the system Implementation failure in an academic medical setting. Second, to provide lessons learned and recommendations on to how to manage challenges of human, social and organizational nature surrounding CPOE-L Implementations. Methods The themes surrounding CPOE introduction were identified by a heuristic analysis of literature on CPOE Implementations. The resulting set of themes was applied as a reference model for 20 semi-structured interviews conducted during the CPOE-L Implementation Process with 11 persons involved in the CPOE-L project and in reviewing all CPOE-L related project documentation. Data was additionally gathered by user questionnaires, by user discussion rounds and through an ethnographical study performed at the involved clinical and laboratory departments. In analyzing the interview transcripts, project documentation and data from user questionnaires and discussion rounds a grounded theory approach was applied by the evaluation team to identify problem areas or issues deserving further analysis. Results Outlined central problem areas concerning the CPOE-L Implementation and their mutual relations were depicted in a conceptual interpretative model. Understanding of clinical workflow was identified as a key theme pressured by organizational, human and social issues ultimately influencing the entire Implementation Process in a negative way. Vast delays in CPOE introduction, system immaturity and under-functionality could all be directly attributed to a superficial understanding of workflow. Consequently, final CPOE integration into clinical and laboratory workflows was inhibited by both end-users as well as department managers and withdrawal of the CPOE-L system became inevitable. Conclusion This case study demonstrates which human, social and organizational issues relevant to CPOE Implementation cumulatively led to a failure outcome of the CPOE-L pilot introduction. The experiences and considerations described in this paper show important issues for CPOE systems to be successfully introduced and to be taken into account in future CPOE Implementations. Understanding and consideration of (clinical) workflow aspects by project managers and the involved clinical organization is of extreme importance from the very start of a CPOE Implementation Process.
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understanding Implementation the case of a computerized physician order entry system in a large dutch university medical center
Journal of the American Medical Informatics Association, 2004Co-Authors: Jos Aarts, Hans Doorewaard, Marc BergAbstract:Most studies of the impact of information systems in organizations tend to see the Implementation Process as a “rollout” of technology, as a technical matter removed from organizational dynamics. There is substantial agreement that the success of implementing information systems is determined by organizational factors. However, it is less clear what these factors are. The authors propose to characterize the introduction of an information system as a Process of mutual shaping. As a result, both the technology and the practice supported by the technology are transformed, and specific technical and social outcomes gradually emerge. The authors suggest that insights from social studies of science and technology can help to understand an Implementation Process. Focusing on three theoretical aspects, the authors argue first that the Implementation Process should be understood as a thoroughly social Process in which both technology and practice are transformed. Second, following Orlikowski's concept of “emergent change,” they suggest that implementing a system is, by its very nature, unpredictable. Third, they argue that success and failure are not dichotomous and static categories, but socially negotiated judgments. Using these insights, the authors have analyzed the Implementation of a computerized physician order entry (CPOE) system in a large Dutch university medical center. During the course of this study, the full Implementation of CPOE was halted, but the aborted Implementation exposed issues on which the authors did not initially focus.
Monique W M Jaspers - One of the best experts on this subject based on the ideXlab platform.
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anatomy of a failure a sociotechnical evaluation of a laboratory physician order entry system Implementation
International Journal of Medical Informatics, 2010Co-Authors: Linda W P Peute, Jos Aarts, P J M Bakker, Monique W M JaspersAbstract:Abstract Objective To investigate the human, social and organizational issues surrounding a Computerized Physician Order Entry system for Laboratory ordering (CPOE-L) Implementation Process and to analyze their interrelated effects on the system Implementation failure in an academic medical setting. Second, to provide lessons learned and recommendations on to how to manage challenges of human, social and organizational nature surrounding CPOE-L Implementations. Methods The themes surrounding CPOE introduction were identified by a heuristic analysis of literature on CPOE Implementations. The resulting set of themes was applied as a reference model for 20 semi-structured interviews conducted during the CPOE-L Implementation Process with 11 persons involved in the CPOE-L project and in reviewing all CPOE-L related project documentation. Data was additionally gathered by user questionnaires, by user discussion rounds and through an ethnographical study performed at the involved clinical and laboratory departments. In analyzing the interview transcripts, project documentation and data from user questionnaires and discussion rounds a grounded theory approach was applied by the evaluation team to identify problem areas or issues deserving further analysis. Results Outlined central problem areas concerning the CPOE-L Implementation and their mutual relations were depicted in a conceptual interpretative model. Understanding of clinical workflow was identified as a key theme pressured by organizational, human and social issues ultimately influencing the entire Implementation Process in a negative way. Vast delays in CPOE introduction, system immaturity and under-functionality could all be directly attributed to a superficial understanding of workflow. Consequently, final CPOE integration into clinical and laboratory workflows was inhibited by both end-users as well as department managers and withdrawal of the CPOE-L system became inevitable. Conclusion This case study demonstrates which human, social and organizational issues relevant to CPOE Implementation cumulatively led to a failure outcome of the CPOE-L pilot introduction. The experiences and considerations described in this paper show important issues for CPOE systems to be successfully introduced and to be taken into account in future CPOE Implementations. Understanding and consideration of (clinical) workflow aspects by project managers and the involved clinical organization is of extreme importance from the very start of a CPOE Implementation Process.
Sérgio Eduardo Gouvêa Da Costa - One of the best experts on this subject based on the ideXlab platform.
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Developing a quality management system Implementation Process for a medical device manufacturer
Journal of Manufacturing Technology Management, 2015Co-Authors: Eduardo Gadotti Martins, Edson Pinheiro De Lima, Sérgio Eduardo Gouvêa Da CostaAbstract:Purpose – The purpose of this paper is to develop and test a quality management system (QMS) Implementation Process for a medical devices manufacturer, which are covered by ISO 13485:2007 and RDC No. 59:2000 and based on operations strategy content definitions. Design/methodology/approach – The research strategy is based on the Cambridge approach which is supported by action research techniques for producing “application” Processes. This research strategy is also known as the “Process Approach” or “the Engineering Approach” and was developed in the mid-1990s by researchers from the “Institute for Manufacturing” (IFM/University of Cambridge). Findings – The results reveal how real conditions “shape” Implementation, indicating solutions for integrating procedures for performance and control indicators that represent manufacturing strategy objectives. The regulatory framework and the manufacturing environment offer these real conditions. The operations strategy that is underlying Implementation shows how to ...
