CHANGE THEORIES, SYSTEMS THINKING, IMPLEMENTATION SCIENCE
Discussion Response
CHANGE THEORIES, SYSTEMS THINKING, IMPLEMENTATION SCIENCE
PEER#1
Shinu Mary Rajan
Change Theories, Systems thinking, Implementation Science.
Understanding and enhancing the adoption, application, and sustainability of evidence-based methods in real-world settings is the goal of the diverse discipline of implementation science. It examines aspects impacting the effective integration of innovations into practice by drawing on various disciplines, including economics, sociology, psychology, and organizational behavior. This discussion emphasizes the significance of many theories and models in change management, understanding intricate systems, and applying evidence-based approaches in healthcare institutions and nursing practice. The goal is to highlight the relevance and significance of systems thinking, implementation science, and Lewin’s Change Theory in solving the dynamic challenges encountered in healthcare settings and examine and assess models and frameworks in informatics that are pertinent to nursing practice and healthcare organizations. The researcher applied Lewin’s change theory to conduct a pre/post-test quasi-experimental study. Results: Following implementing a new policy, an educational intervention, and a simulation intervention, data showed a statistically significant improvement in staff understanding of Safe Haven events, roles, and teamwork, Bassitt, S. (2023).
The objective is to gain insight into the principles that guide and optimal methods that facilitate the efficient integration and application of technology in healthcare environments by exploring these frameworks. Implementation science is essential in the healthcare industry to transform research results into efficient clinical interventions and enhance patient outcomes. Healthcare organizations use Lewin’s Change Theory as a foundational framework for managing organizational change. Healthcare practitioners are more equipped to handle changes like introducing new technology or enhancing patient care procedures by adhering to its phases of unfreezing, altering, and refreezing. Systems thinking is equally critical because it enables healthcare organizations to comprehend the many interconnections inside their systems and develop all-encompassing solutions to dilemmas. Encouraging administrators and nurses to think about how changes in one part of the system could affect others promotes a more sustainable and all-encompassing approach to problem-solving. Understanding complex systems as interconnected wholes, where each component affects the behavior of the whole, is the foundation of the system’s thinking approach to problem-solving and decision-making. Instead of concentrating only on individual parts, it emphasizes comprehending the connections and feedback loops inside systems. Systems thinking is essential in the healthcare industry for handling complicated problems, including organizational performance, quality improvement, and patient care delivery. Besides these fundamental beliefs, Kotter’s Eight-Step Change Model offers healthcare executives a tactical roadmap to lead their teams through revolutionary projects. This strategy contributes to successful change implementation by strongly emphasizing empowerment, communication, and cultural alignment. Moreover, the Plan-Do-Study-Act (PDSA) Cycle provides a valuable framework for incremental change in healthcare environments. Nurses may continually improve patient care delivery and operational efficiency by methodically testing and fine-tuning adjustments. This will ultimately lead to The Technology Acceptance Model (TAM), another pertinent model focusing on the variables impacting consumers’ attitudes and intentions toward embracing new technology. Researchers created and experimentally verified a model to explain why people embrace PHRs using an expanded technology acceptance model (TAM). A quantitative cross-sectional design was employed to survey 389 Saudi Arabian respondents, Alsyouf, A. et al. (2023).
TAM highlights perceived utility and perceived usability as the main factors influencing people’s adoption of new technology. By identifying adoption hurdles and implementing initiatives to increase user engagement, nurses may evaluate the usability and usefulness of informatics systems in their practice using TAM principles. TAM is further expanded by the Unified Theory of Acceptance and Use of Technology (UTAUT), which adds elements like social impact and enabling circumstances. By keeping these things in mind, nurses may create a culture of innovation and cooperation in healthcare organizations by encouraging technology adoption in a supportive setting. In addition, the Plan-Do-Study-Act (PDSA) Cycle offers a helpful framework for incremental advancement in healthcare informatics. This methodology includes planning a change, implementing it on a small scale, analyzing the outcomes, and acting on the lessons discovered to produce even more changes. Researchers said practice change was implemented over four months using several Plan-Do-Study-Act (PDSA) cycles. During the first few months of the pandemic, the use of PDSA cycles by nurses created innovative procedures that guaranteed the provision of guideline-based treatment, Hamilton, J. L., Snuggerud, A. E., Meihls, S. M., Toledo, H., & Stewart, J. (2022).
Using the PDSA Cycle, nurses may test new informatics efforts, assess how they affect patient outcomes and clinical processes, and adjust their deployment plans in response to feedback and result data. Using a systematic approach to installing and assessing informatics, nurses may promote ongoing practice improvement and optimize the utilization of technology to provide superior, patient-focused care. In summary, nursing practice and healthcare organizations may benefit significantly from the guidance offered by informatics frameworks and models to use technology appropriately. Nurses may evaluate how health information technology affects clinical processes and patient outcomes using frameworks like the Health Information Technology Evaluation Framework (HITREF). This allows nurses to ensure that the technology aligns with organizational objectives. Nurses may foster an innovative atmosphere in their practice settings by utilizing frameworks such as the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), which provide insights into the elements that influence technology adoption. Additionally, nurses may trial new projects, assess their efficacy, and adjust implementation techniques in response according to the Plan-Do-Study-Act (PDSA) Cycle, which offers a systematic strategy for iterative development in healthcare informatics. Nurses may streamline clinical processes, promote continuous improvement in patient care delivery, and ultimately raise the standard and efficacy of healthcare services by utilizing these frameworks and models.
Alsyouf, A., Lutfi, A., Alsubahi, N., Alhazmi, F. N., Al-Mugheed, K., Anshasi, R. J., Alharbi, N. I., & Albugami, M. (2023). The Use of a Technology Acceptance Model (TAM) to Predict Patients’ Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021347
Bassitt, S. (2023). Low Volume, High Risk: Increasing Staff Knowledge and Teamwork During Safe Haven Events. Journal of Perinatal & Neonatal Nursing, 37(2), 131–137. https://doi.org/10.1097/JPN.0000000000000727Links to an external site.
Hamilton, J. L., Snuggerud, A. E., Meihls, S. M., Toledo, H., & Stewart, J. (2022). Quality improvement and rapid PDSA cycles to maintain routine surveillance of pulmonary pathogens during the COVID-19 pandemic in a pediatric cystic fibrosis clinic. Journal of Pediatric Nursing, 63, 131–135. https://doi.org/10.1016/j.pedn.2021.11.006
PEER #2
Chinyere M Ofoegbu
Change Theories, Systems Thinking, Implementation Science
Change Theories, Systems Thinking, Implementation Science
Informatics frameworks and models are crucial in optimizing patient care delivery, enhancing efficiency, and improving outcomes within healthcare organizations and nursing practice. Nursing Informatics Framework is one of the widely utilized frameworks, and it integrates nursing science, computer science, and information science to help manage information, knowledge, and wisdom in nursing practice (American Nurses Association, 2015). The framework highlights the importance of technology in supporting nursing processes, which include documentation, decision-making, and patient education. Nurses can streamline workflows, reduce and minimize errors, and enhance interdisciplinary collaboration. The framework also effectively promotes evidence-based practice by facilitating access to the latest research and clinical guidelines, thus empowering nurses to make informed healthcare decisions.
The Electronic Health Record (EHR) system is a vital model in healthcare informatics. EHR is a comprehensive digital repository of patient information, enabling healthcare to capture, store, and exchange information, thus promoting continuity and coordination of care (American Nurses Association, 2015). EHRs in healthcare delivery and nursing practice enable nurses to access medical history and patient treatment plans in real time, facilitating timely and informed interventions. EHRs enhance patient safety and adherence to best practices by supporting clinical decision-support tools, such as alerts and reminders (Ye, 2021). However, successful implementation and utilization of EHRs require adherence to standardized data formats, interoperability standards, robust privacy, and enhanced security measures.
Moreover, the quality improvement framework provides a systematic approach to evaluating and improving healthcare processes and outcomes. The framework involves identifying areas for improvement, setting measurable goals, implementing evidence-based interventions, and monitoring progress over time. One of the benefits of the EHR to nurses includes identifying gaps in care delivery, such as medication errors and patient falls, and implementing targeted interventions to address issues arising during patient medication (Debono et al., 2017). The collection and analysis of data on key performance indicators, including readmission or infection rates, enable nurses to track the effectiveness of interventions and ensure continuous quality improvement efforts. However, collaboration with interdisciplinary teams and stakeholders is essential for successful quality improvement initiatives as this fosters a culture of transparency, accountability, and continuous learning.
Furthermore, the Human Factors Framework recognizes the influence of human behavior, cognition, and ergonomics on the design and implementation of healthcare technologies. The Human Factors Framework emphasizes the critical role of user-centered design principles, usability testing, and training programs in optimizing the usability and acceptance of informatics solutions among healthcare providers (Carayon & Hoonakker, 2019). Nurses can advocate for user-friendly interfaces, intuitive workflows, and tailored training programs that ensure effective adoption and utilization of informatics tools. According to Bergey et al. (2019), the active participation of nurses in the design and implementation of informatics solutions enables nurses to contribute valuable insights into workflow optimization, customization needs, and ensuring patient safety. By adopting frameworks such as the Nursing Informatics Framework, Electronic Health Record system, Quality Improvement Framework, and Human Factors Framework, nurses can enhance efficiency, improve patient outcomes, and promote a culture of continuous learning and innovation. Fundamental principles and best practices to be considered in these frameworks include evidence-based practice, interoperability, data security, quality improvement initiatives, and prioritization of user-centered design principles. Therefore, embracing informatics as an integral component of nursing practice will enable nurses to harness the power of technology towards delivering high-quality, patient-centered care in the contemporary complex healthcare environment.
References
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.).
Carayon, P., & Hoonakker, P. (2019). Human factors and usability for health information technology: Old and new challenges. Yearbook of medical informatics, 28(01), 071-077.
Debono, D., Taylor, N., Lipworth, W., Greenfield, D., Travaglia, J., Black, D., & Braithwaite, J. (2017). Applying the theoretical domains framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitals. Implementation Science, 12, 1-13.
Ye, J. (2021). Design and development of an informatics-driven implementation research framework for primary care studies. In AMIA Annual Symposium Proceedings (Vol. 2021, p. 1208). American Medical Informatics Association.
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