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- W2503831183 abstract "Since the turn of the century, many residential aged care homes in Australia have made the transition from paper-based documentation to computer-based health records. This thesis explores issues pertaining to organisational change associated with this process based on longitudinal interviews with care staff in three residential aged care homes under the same management group over an eighteen month period during and after the system’s introduction. There is an expansive theoretical and empirical literature on organisational change in the organisational studies literature. However research on organisational change in health informatics has been limited, although researchers acknowledge its importance. Most evaluation research in health informatics takes a hypothetico-deductive (positivist, statistical) approach to developing research problems, and reaching conclusions. However in organisational studies, an exploratory, narrative based approach to understanding organisational change is a more frequent approach. This approach emphasises understanding multiple competing points of view within an organisation, and mapping these to key events and outcomes related to the research situation. This approach has been in health informatics used in large scale summative capstone research of a national e-health implementation, and as a single case study as part of a theoretical paper. This thesis presents a case study using a heuristic approach to reasoning to bear on a meso-scale healthcare environment studying an organisation which provides up to approximately fifteen percent of the residential aged care service in the regions which it operates in. The goal of the research was to understand the context of these homes’ operations, what and how the successful outcomes occurred, whether these outcomes were sensitive to the initial conditions at each aged care home; how staff affected by the introduction of the electronic health record, and how the staff perceived the introduction of the software. Chapter one of the thesis introduces the research problem space, and the research questions to be answered. Chapter two provides broader academic and industry context, examining key literature concerning organisational change and existing evaluation work on electronic nursing documentation, and our knowledge of computer usage in nursing and aged care. Chapter three details the methods used to collect and analyse the research data. Chapter four presents basic demographic information, as well as interpretive research results related to staff demographics. Chapter five provides a detailed description of the key stakeholders encountered in the research. The research was conducted mainly from the perspective of internal stakeholders, however this chapter also discusses the regulatory environment. Chapter six discusses care staff’s experience with the electronic health record, in particular examining their positive and negative experiences with the software. Finally chapter seven discusses the impact of the electronic health record on the provision of care. The final chapter concludes by presenting a summary of findings expressed in terms of the research questions presented in chapter one. The major benefits encountered were related to a much better computer-assisted funding process. This outcome was easily achieved at each site, and beyond ensuring adequate information technology hardware at each site seemed to pose few management challenges. Encouraging appropriate usage of the electronic health record by all staff was a challenge, which I conclude could be addressed by managers ensuring that they take account of the multiple competing points of view of the nature of nursing work and the role of electronic documentation for site managers and care staff." @default.
- W2503831183 created "2016-08-23" @default.
- W2503831183 creator A5060180584 @default.
- W2503831183 date "2015-01-01" @default.
- W2503831183 modified "2023-09-24" @default.
- W2503831183 title "Organisational change associated with introduction of an electronic health record in residential aged care homes" @default.
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