Hospital adoption of health information technology systems (HIT) is promoted as essential to decreasing medical error and reducing the estimated 44,000 annual deaths and $17 billion in healthcare costs associated with that error. Yet, adoption of HIT in hospitals continues to occur slowly and inconsistently, due in large part to complexity of the hospital care environment. Implementing new practices, such as an electronic nursing documentation system therefore, is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g. information exchange, communication, relationships) of providing care on in hospitals. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning and effective problem solving;strategies which studies have linked to successful change. Project team work, a change strategy increasingly used by hospitals, facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. My long term goal is to engage in a career of nursing research, contributing to knowledge that facilitates practice change improvements at the bedside and in hospitals. My proposed study will explore the role of project teams'sensemaking during the implementation of new information technology in a tertiary care hospital.
Aims i nclude: describe and compare sensemaking across multidisciplinary project teams that differ in terms of hierarchical role and disciple of members;describe how sensemaking of multidisciplinary project teams changes over time;describe how multidisciplinary project teams'sensemaking influences the actions taken by the teams;and identify which team member behaviors facilitate and or inhibit project team sensemaking. The longitudinal case study design will facilitate the detection of meaning as it evolves;provide an opportunity to view relationships across organizational boundaries;capture rich data of events as they occur;and allow me to gather several different perspectives of the same event over the course of time. Sensemaking data will be collected through direct observation and organizational document analysis. Participant demographics will be used to explore variation in sensemaking patterns. Outcomes of this research will be new knowledge about sensemaking patterns of project teams;how sensemaking and action vary across multidisciplinary project teams as the team prepares for implementation;and identify team member behaviors which facilitate or inhibit project team sensemaking. These findings will lead to new methods of implementing HIT in hospitals.
Outcomes from this study will help healthcare project teams identify the needs of hospital personnel in order to customize software and therefore improve the likelihood that new systems will meet healthcare workers needs and improve patient outcomes.
