Medical and Nursing Staff Perspectives on an Electronic Health Record Implementation in Hospital Outpatient Departments - A Qualitative Study in Four English Hospital Trusts

Kate Marsden, Tony Avery, Sarah P. Slight, Nicholas Barber

2013

Abstract

Objective: The authors sought to investigate the attitude of the staff using computers in outpatient departments and whether their perceptions altered as a result of the NHS Care Record Service (CRS) implementation. Design: Qualitative study using semi-structured interviews and observations. Participants: A total of 70 interviews were undertaken representing a broad range of staff involved in the outpatient department including doctors, nurses, managers, medical records staff, clerks and IT staff. In addition, 361 hours of observations were carried out in the outpatient departments over a six week period. Setting: UK Results: This study highlighted the dependence that outpatient department staff placed on IT and the complexity of issues surrounding their use of computer systems. All outpatient staff used a computer to some degree in their work and were relatively computer literate but recognised that there were problems with the technology such as the length of time it took to get information from the system, the number of times it crashed and the lack of interoperability between different systems. The implementation of the NHS in one trust created additional problems for the outpatient staff, especially during the rather protracted bedding-in time. As the software was more complex than the previous system, it required a greater number of clicks to find the information needed. The added scale and complexity of the NHS CRS was perceived to have resulted in an overall slower system, with problems finding relevant patient information on the screen. The clinic booking system configuration created difficulties with double or triple booking of clinics or clinics cancelled. During this process, staff did not feel that senior managers were listening to their concerns. Conclusions: The outpatient department has different and unique requirements which must be considered during the development stage of any new electronic health record system. IT development processes must acknowledge that new software systems require a degree of maturity and undergo testing in the different departments prior to the implementation process. Staff need to feel part of the software implementation process and their problems addressed to reduce stress and anxiety. The software design flaws described decreased the acceptance of the NHS CRS by staff but it is important to recognise that staff opinions and views may change over time as the system becomes embedded and matures.

Paper Citation

in Harvard Style

Marsden K., Avery T., P. Slight S. and Barber N. (2013). Medical and Nursing Staff Perspectives on an Electronic Health Record Implementation in Hospital Outpatient Departments - A Qualitative Study in Four English Hospital Trusts . In Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013) ISBN 978-989-8565-37-2, pages 394-398. DOI: 10.5220/0004321803940398

in Bibtex Style

@conference{healthinf13,
author={Kate Marsden and Tony Avery and Sarah P. Slight and Nicholas Barber},
title={Medical and Nursing Staff Perspectives on an Electronic Health Record Implementation in Hospital Outpatient Departments - A Qualitative Study in Four English Hospital Trusts},
booktitle={Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013)},
year={2013},
pages={394-398},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0004321803940398},
isbn={978-989-8565-37-2},
}

in EndNote Style

TY - CONF
JO - Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013)
TI - Medical and Nursing Staff Perspectives on an Electronic Health Record Implementation in Hospital Outpatient Departments - A Qualitative Study in Four English Hospital Trusts
SN - 978-989-8565-37-2
AU - Marsden K.
AU - Avery T.
AU - P. Slight S.
AU - Barber N.
PY - 2013
SP - 394
EP - 398
DO - 10.5220/0004321803940398