In the modern world, information gives an excellent opportunity for the management of all productions, effective interaction on the horizontal and vertical communication lines, and solutions of a full range of tasks within the activity planning in any sphere of life. In addition, it plays one of the major roles in health care. The implementation of new technological systems is considered one of the main directions of the Electronic Health Records (EHRs) formation in the healthcare systems across the globe. Adoption of new technologies such as the EHRs is not a goal in itself but the means of the efficiency increase of the health care system. However, the personnel of hospital might resist different new technologies. To inform nurses about the details of the new technology is the best way to overcome the resistance, ensure the effective collaboration of the nursing personnel, and show them that they are change agents who should facilitate the adoption of the innovations.
Adoption of EHRs by Nurses
The general EHRs system will be implemented in a small hospital in New York. The introduction of the EHRs system is a long-term process of the transition from the paper methods of medical documentation to the electronic ones rather than a single action. This procedure can be successful in case nurses and IT specialists constantly search for the compromises and move towards each other. The early imposed standard decisions are absolutely not successful. Nevertheless, changes are inevitable.
The majority of researches show that each big idea starts from the resistance or refusal. At the same time, the reasons for resistance are often hidden not in the technology itself but in communication. New ideas can be so much technological that the nurses are not ready to accept them, thus forming social and cultural barriers to the consumption of innovative products. It is possible to specify two groups of the causes resisting the introduction of the new technologies. The first group is connected with the inefficiency of a definite innovation and a big risk of the possible negative experience while using. The consideration of these reasons is justified as the new technology is applied not for the sake of the process but for the sake of the result. The second group of the causes resists innovations. The two causes include wrong understanding of a situation and fear that there will be an infringement of the personal interests in case of innovation’s introduction.
However, it is important to overcome the resistance of nurses in the implementation of the EHRs system. Therefore, it is necessary to consider Roger’s five attributes of innovation’s perception during the meeting devoted to the new technology. Rogers distinguishes five attributes of perception influencing the speed of adaptation of the new technology. They include the comparative superiority of the new technology as compared to the old one, the compatibility of the new technology with the experiences and values already available for the user, the complexity of the development of technology from the user’s perspective, the existence of an opportunity to test this technology, and its external observability or the existence of the positive examples of its usage.
First, the idea should be explained, and its relative advantages should be fully revealed. It is insufficient to inform the nurses about the EHRs. The best way to introduce the innovation effectively is to involve the nurses into the test of the new technology, to study its efficiency, and to feel the advantage which it can bring. For example, the relative advantage of the EHRs system is that it is time-saving. To let nurses feel it, the following activity is performed: one nurse records information digitally while the other one does the same manually. Further, the time is compared.
Second, the compatibility with the existing values and practices should be considered. The nurse will have a chance to compare the experiences of different hospitals in the country in terms of using EHRs system along with the traditional one. There should be two groups, one of which will focus on the old technology while another one will consider the EHRs. After such activity, the nurses will see that the EHRs system is the same though digital way of a patient’s records, and it meets the requirements to the nursing process and its documentation.
Third, the presentation of the simple actions connected with the application of innovations is the way to the success of the innovation diffusion. It is necessary to show nurses that the EHRs system is simple and easy, thus can be quickly learned and applied in practice. In order to do it, it is necessary to involve the volunteering nurses for the testing of the new technology and to show the simplicity of the innovation on the personal example. An equal opportunity of the volunteer participation in the testing of the EHRs system will be offered to the nurses. The volunteer nurses will use the new system, after which they will share their feedbacks with the other nursing staff of the hospital.
The next step is the creation of conditions for the emergence of the positive reaction in nurses to the message on reforms and their active connection to the introduction of the innovative option for the hospital work. They should be informed about the unlimited possibilities of trials and testing of the new technology. The latter can allow nurses to discover the functionality of the EHRs system and its applicability in the nursing process. The activity will be based on using and exploring the new system so that the burses discover all functions by themselves.
Finally, the observable results of the innovation’s application should be discussed at the meeting with the hospital nurses. It is necessary to give the examples of the successful implementation of the new technology in different hospitals worldwide. Moreover, the examples of the successful implementation of the new digital technologies should definitely be given not only in nursing but also in different fields and spheres. It might persuade the nurses to openly adopt the technology.
Responding to Resistance
Further resistance of the nursing personnel in the hospital is an inevitable reaction to the introduction of the EHRs system and can be considered a dynamic phenomenon. According to Rogers, there are several resistance stages. However, there are also activities helping to overcome the resistance:
- Inaction (inertness). After the emergence of the information on the application of the EHRs technology in the hospital, many nurses may feel uncertain, show indecision, and be full of doubts. At the stage, it is necessary to be highly susceptible and flexible to any manifestation of such an attitude to innovations. The active listening of the fears and doubts of the nursing personnel will allow overcoming the resistance to the adoption of the new technology.
- The denial of innovation. The majority of nurses in the hospital are skeptics. They do not recognize the expediency of implementing developed plans for the activity improvement. The barrier of traditions is especially expressed in the nurses who were actively included into the developed organizational system. At this stage, it is necessary to assure the nurses in the efficiency of the technology, showing the personal steady position of the EHRs system’s usefulness for the hospital.
- Irritation. If the implementation of the planned changes proceeds, some irritated nurses can actively protest against it. At this stage, it is important not to allow the emergence of incidents, not to put the open pressure upon employees, and to continue positioning the innovation. The strategic changes and the application of the EHRs system should be done gradually within the long-term period. The conflicts should be solved by means of compromises, rotations of the nursing leaders or the delegation of authorities.
- Discussion and negotiations. At this stage, it is necessary to compromise with nurses through discussion and negotiations about the partial adoption of the offered plans, minimization of risks for nurses and provision of the guarantees of reliability.
Nurse as a Change Agent
After the denial and discussions of the new technologies, nurses will show either a passive behavior, which will eventually result in the decrease in counteraction, or an active implementation of the EHRs in the hospital. If the second situation arises, the nurses may become the agents of change. They observe the advantages of the new system’s introduction and the realization of the innovation and are willing to facilitate it. The roles of nurses as change agents in the innovative process might differ depending on the direction and impact it can have on the distribution and successful implementation of innovations. Moreover, nurses may compose both individual and group change agents of the innovative process. Gradually, the majority of nurses will accept the changes and will successfully apply the new technology. However, it will happen only if nurses understand their mission.
The meeting with nurses should give positive results in case of successful implementation of the aforementioned stages aimed at the elimination of the resistance to innovations. In order to be successful in the adoption of the new EHRs technology, it is necessary to spread the information about the innovation in a simple, easy and understandable form as well as stimulate and involve the personnel into the adoption of the innovated product.