In January 2003, Childrens Hospital Los Angeles (CHLA) was funded to develop a Pediatric and Perinatal Research Information System across 4 hospitals in Los Angeles County. The System will be operational for 2 hospitals by June 2004, and when 2 hospitals are added in December 2004, it will capture > 10,000 deliveries yearly. This application has 2 Specific Aims: 1) To determine if the System was implemented successfully, identifying the critical milestones and organizational capacity required for the implementation; and 2) to develop and pilot test a framework to assess whether additional organizations have the capacity to implement the System. Three frameworks provide this study's foundation: 1) the PRECEDE-PROCEED model for evaluation of health interventions; 2) Snyder-Halpern's model for evaluation of organizational readiness for innovation; and 3) a definition of successful implementation as conceived by Anderson, Aydin and Jay. To meet Aim (1) we will conduct a case study of the System implementation in the first 2 hospitals with a focus on critical incidents occurring during the implementation in 8 domains: 1) organizational positioning of leadership; 2) project alignment with information technology (IT) staff; 3) organizational policies; 4) organizational culture; 5) perceived need; 6) strength of collaborative relationships; 7) financial, IT, and human resources; and 8) legal expertise. These domains will be operationalized through the design of organizational capacity measures to achieve critical milestones in each domain. For example, in the legal domain, a critical milestone would be to execute contracts with all appropriate parties, and capacity measures would include organizational legal expertise in software development. To meet Aim (2) an instrument would be developed to measure organizational capacity within these domains. It would then be pilot tested and refined using data collected during the implementation of the System at the second 2 hospitals to determine if it is predictive of successful implementation. It is anticipated that this proposal would produce a conceptual framework and instrument for determining the critical capacities of organizations that wish to implement a research information system.
| Korst, Lisa M; Aydin, Carolyn E; Signer, Jordana M K et al. (2011) Hospital readiness for health information exchange: development of metrics associated with successful collaboration for quality improvement. Int J Med Inform 80:e178-88 |
