Managing change during an information systems transition

AORN Journal,  June, 2002  by Barbara J. Barr

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THE KNOWLEDGE PHASE

Trust in the organization's leaders is the foundation on which successful health care organizations build the environment necessary for social change and inspire people to achieve excellent clinical outcomes. To create a sustained trusting environment, leaders must act in ways that produce constancy, congruity, reliability, and integrity when interacting with those being led. (17) During the knowledge phase at this facility, it was necessary for the perioperative leader to introduce the information system to nursing staff members. She realized that staff members needed her to be available and accessible. She also needed to communicate with staff members, ensure confidentiality, and be willing to invest time in staff member development.

The steps taken by the perioperative leader to establish and sustain trust included providing computer updates and other pertinent unit information during weekly meetings. This information also was shared in a written memo that was posted for staff members unable to attend meetings. The perioperative leader visited each perioperative department daily to be available for staff members seeking information. This also provided her with timely and reliable feedback related to current issues. In addition, the perioperative leader established open meeting times for staff members who wanted to discuss individual concerns.

The plan for the hands-on phase of computer education involved computer-learning modules that recognize each individual staff member's ability to learn basic computer skills. The initial nursing staff member computer skills assessment included typing and basic computer functions. It is important to identify staff members with significant computer knowledge. These people can serve as in-house super users who can solve minor user problems.

After a series of information sharing sessions with staff members, a survey was prepared to collect data to assess staff members' computer skills and their attitudes toward computer documentation and data analysis for improving practice. The sample for this survey consisted of 43 staff nurses in the perioperative area, including the OR suite, PACU, endoscopy suite, and day surgery unit. The survey comprised 10 true or false questions designed to assess basic computer skills, such as typing, word processing (eg, edit, copy, delete, insert, format), saving information to disk, and opening files. The survey also assessed attitudes toward computers via positive readiness statements, such as

* do you think computerized documentation is valuable,

* would you like to learn more about computers, and

* do you think having data to analyze will help improve nursing practice.

Respondents could answer true or false to each question. One week after distribution, 37 completed questionnaires were returned (ie, 86%).

The results show that 81% of nursing staff members have typing skills, but only 8% have an understanding of computer functions used consistently when working with text (Table 1). When asked about the value of computer documentation and the desire to increase their computer skills, 94% of respondents answered positively. When asked about the value of having data to analyze, 54% answered positively about using this method to improve practice.