Working in the medical field today can be exhilarating, but it can also be a challenge. The technology and medical procedures involved are often evolving and changing, forcing medical staff to evolve with it. In some cases, the staff grows comfortable with the technology available to them; they even begin to prefer it. Being a nurse is difficult enough at times without constantly having to relearn procedures and systems. One of the greatest thorns in a nurse’s side is the implementation of an electronic health records system, or EHR. Though the change can be difficult, thanks to Everett Rogers’ work on the diffusion of innovation, among other strategies, it is possible to help nurses not only accept the new EHR implementation, but grow to like it.
Assuming I was a nurse facilitator in a hospital in upstate New York charged with addressing the staff’s concerns over the new EHR implementation, there are several strategies I would try in order to help the individuals be more comfortable with the switch. I would begin by observing Everett Rogers’ theory behind an individual’s concerns when adopting a new technology. His ideas are important if I were going to successfully present the system to the nurses. Rogers first suggests that, through relative advantage, the nurses must see the new system is an improvement over the old system . Therefore, as I am presenting the new electronic medical records system, I can draw contrasts between the easy file storage of the new system compared to the messy or chaotic storage of previous and current systems. If the old system were dedicated to keeping hard copies, or records on discs, it would be easy to show how electronic records are faster, easier to access, and take up less space. Having medical records at the nurse’s fingertips rather than potentially across the hospital may also save time and even lives .
Following Rogers’ theory further, I must show the nurses how simple the system is to use. If the system is difficult to learn it could potentially take up valuable time normally spent caring for patients, which would cause resistance among the nurses. Simplicity is key, and I would give several brief demonstrations on how to use the new system, showing how easy it is. I would also allow the nurses to try the system for themselves so they may see how simple the program was not only to use, but also to learn and remember. The “trialability” would help reassure nurses the implementation of the new program would not take too much time out of their day, would not hinder their time caring for patients, and would ease anxieties about learning the software. Using the software themselves would also ease tensions or worries that the staff would be unfamiliar the first day. It would also help negotiate any resistance later if I had to argue the nurses were now the facilitators of change in the hospital because they were now the only individuals with any experience using the system.
The final suggestion Rogers makes, which I would follow, is that the adopter of new technology sees observable results . Because I am the assumed facilitator of a small hospital, I also assume mine is not the first establishment to adopt the new EHR technology. To present the system adequately and successfully, I would need to gather information from other hospitals who had already implemented the software. With the information, I could graph the activity level, as well as the adequacy of patient care before and after the implementation of the EHR. It would also be helpful to present firsthand accounts from experienced nurses stating the program was easy to use, and helpful in the day-to-day activities the job demands. Nurses in my hospital could then see the new system factually made lives easier for staffs in other hospitals.
Getting official documentation that the EHR system presents quicker access to patient records and, thus, represents the best care we as a staff could provide the patient would also be helpful.
The presentation of the system is an essential part of the meeting. Even more crucial than that, however, would be addressing the concerns of the nurses. After my presentation, there may still be hesitation or blatant resistance to the implementation. If this were to occur, I believe what would be best is to make the individual’s voice feel heard; I want to make their concerns and their resistance feel validated. However, I also would want to point out that the medical field is constantly growing and changing, with new technological advancements becoming available every day. While it is important to make hesitance known, it is equally important the nurse understand that they are there for the patient and, surprisingly, the technology is there for the patient . Nurses and new technology sometimes do not get along, but medical staff must remember they are there to work with hospital resources in order to ensure the patient gets the best possible care they can receive.
In the event that nurses were still hesitant or unresponsive to the EHR implementation, I would remind them that they were a core group chosen at the hospital’s discretion to partake in this new step toward the hospital’s future. They alone have now used the technology and are more familiar with it than anybody else on site. As such, they are in a unique position to be agents of change . The bottom line, unfortunate as it may be for some to hear, is that the new system is coming whether they want it to or not. While hesitancy and resistance is understood, because this group was chosen specially for this project, a choice needs to be made. The nurses can continue to reject the new technology or, for the benefit of the patient, they can spread awareness and acceptance of the new system throughout the hospital. The latter choice would help facilitate an easier transition with other employees and continue helping patients to attain better health at a faster pace.
In sum, nursing is a difficult enough job without transitioning from a known system to an unknown system. I would attempt to be understanding of this as I followed Everett Rogers theory while presenting the new electronic health records system to the small group of nurses. I would try to make the technology relatable and relevant to the everyday activities of the staff, as well as better than the previous methods. I would also give the staff an opportunity to try the system so they may see how easy it is to use. I would then present observable results obtained from other hospitals. Any further resistance would be taken seriously. I would remind nurses they need to work with technological advancements because each one is to better the patient’s quality of life. I would also remind the nurses they could ease the transition by being facilitators of change because they, at that time, would be the only ones with knowledge of the system. Learning new technology is a difficult task but sometimes it is necessary and the staff would need to keep this in mind.
References
Battilana, J., & Casciaro, T. (2012). Overcoming Resistance to Organizational Change: Strong Ties and Affective Cooptation . Management Science, 819-836.
Englebright, J., Aldrich, K., & Taylor, C. R. (2013). Defining and Incorporating Basic Nursing Care Actions Into the Electronic Health Record. Journal of Nursing Scholarship, 50-57.
Galimany, M. J., Garrido, A. E., Roca, R. M., & Girbau, G. (2012). New technologies and nursing. Use and perception of primary health care nurses about electronic health record. Public Medical, 42-45.
Portoghese, I., Galletta, M., Battistelli, A., Saiani, L., & Penna, M. (2011). Change-related expectations and commitment to change of nurses: the role of leadership and communication. Journal of Nursing Management, 582-591.
Rogers, E. M. (2010). Diffusion of Innovations, 4th Edition. Boston: Simon & Schuster.
