The purpose of this essay is to reflect on the five characteristics as identified in the theory of diffusion of innovations (Rogers, 2003) and discuss how these features can be applied by a nurse facilitator to deal with change resistance from nurses and facilitate successful implementation of a new electronic health records in a small hospital. According to (Hunt, Sproat, & Kitzmiller, 2004), the introduction of a new technology system requires nurses working at the points of care at all levels to be involved for a smooth transition and high adoption rate. Rogers (2003) defines adoption rate as “the relative speed with which an innovation is adopted by members of a social system” (206). In this case, it is concerned with how fast the hospital stakeholders, particularly the nurses will adopt the new system.
Resistance
There is some resistance against the new technology expressed by the nurses. Basically, resistance against change is a normal reaction by various stakeholders in any organization. However if the concerns raised by those stakeholders are ignored, the rate of adoption of the new system will be slowed significantly. Therefore as a nurse facilitator, it is important to find ways to manage resistance by addressing the concerns raised by the nurses (Cresswell, & Sheikh, 2009).
Resistance to change can due to many reasons including mistrust, lack of communication, fear of the unknown and lack of skills. To address their concerns, step one will be to understand their reasons for resisting the new system and deal with it accordingly. Some of the techniques employed to manage resistance include making the staff part of the change through consultations (HealthIT.gov, 2013), good communication, assuring them that the change is positive, assuring them that they will be duly trained and using the five qualities by Rogers, (2003) to present the proposed system.
Using the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
Relative Advantage
The quality of relative advantage is related to individual social perception. With this feature in place, the stakeholders perceive the new system to be superior or better than the one they are using. According to Rogers (2003), relative advantage is the extent to which the new idea is alleged to be more advantageous than the idea preceding it. When the relative advantage is high, the rate of adoption will also be high (Lee, 2004). In order to present the new idea in a way that will help the nurses see its advantages, Visual presentations such as graphs and charts will be used. Also, comparing the advantages and disadvantages of the new system side by side will be helpful (McGonigle, & Mastrian, 2014). Lastly, testimonials from people who have successfully implemented the new EHR will be given to assure the nurses of the benefits of the proposed change thus enhance their perception.
Compatibility
This quality is concerned with the consistency between the new system and the existing values, current needs of the hospital and experiences over the years (Rogers, 2003). Nurses have care goals and they should be assured that the new system is compatible with those goals. Additionally, nurses need to put meaning in what they do and they want the time spent with the computer and the new electronic health record system to be helpful to the patients. To win the approval of the nurses, I will highlight the specific advantages of using the new system over the old way in relation to improved service to customers, time-saving due to quick data retrieval and safety of the records stored electronically.
Complexity
Complexity quality is concerned with ease or difficulty in operating the new system (Rogers, 2003). Nurses could resist the new system if they fear that it will be hard to master and operate. To increase chances for acceptance, the first step is to acquire a user-friendly system. The staff will be assured that the technology is easy to master in order to increase the adoption rate and reduce resistance. A model could be used to demonstrate basic steps in the new system. Communicating to the nurses about the scheduled training will reassure them that they will resolve any complexity issues during then. Also, I would present the idea in a way that emphasizes on the benefits of the new system like that nurses will have more time to spend with their patients and assessing the progress because the new technology will help them perform tasks better and faster with higher accuracy rate (Bates, 2010). Trialability
The trialability quality according to (Rogers, 2003) focuses on the degree of experimenting with the new system. The nurses will want to know if they can make adaptations or alter the system and to what extent. They want a system they can explore and play around with while learning. A system that can be compromised by a click of one wrong key may face more resistance than that which allows the nurses to explore on their own figuring things out as they do. A flexible system makes the nurses more confident as they can twist it to fit their needs thus increasing the rate of adoption (Lee, 2004). To address this concern, I will ensure that the system acquired is flexible and easy to explore. Also, the planned training should be effective enough to guide nurses on how to explore the system without causing any damage. Observability
The observability quality is concerned with showing evidence that the EHR proposed has been successfully adopted in other circumstances. The nurses want to know for sure that the new system will work as explained in order to raise their trust. According to Rogers (2003), ideas with clear and observable results have a high rate of adoption than those with understated outcomes (Rogers, 2003). The likelihood to adopt the new system increases with the ability to see the outcomes. To make use of this feature, testimonials will be used whereby other institutions who have adopted the EHR confirm of its benefits by comparing the work before and after implementation. Also, a model can be used to demonstrate certain tasks using the system such as plotting charts of the patients’ progress. Showing the nurses how fast and effective making charts is while using the system as compared to the old ways increases adoptability rate.
Conclusions
Adopting the five qualities by Rogers (2003) while presenting the new system to the nurses can help reduce resistance and increase adoptability. As a nurse facilitator, addressing the concerns raised by the nurses and emphasizing the benefits of the new system will increase chances for approval. As a change agent, I should encourage the other nurses to see the necessity of implementing the new system in order to improve services to our patients as well as make the hospital more efficient.
References
Bates, D. W. (2010). Getting in step: electronic health records and their role in care coordination.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service (NHS CRS): recommendations from the literature on successful implementation and adoption. Journal of Innovation in Health Informatics, 17(3), 153-160.
HealthIT.gov, June 2, 2013. How Do I Overcome Resistance Within My Organization During Electronic Health Record Implementation? Retrieved from https//www.healthit.gov/providers-professionals
Hunt, E. C., Sproat, S. B., & Kitzmiller, R. R. (2004). The nursing informatics implementation guide. New York: Springer.
McGonigle, D., & Mastrian, K. (2014). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.