At the recent clinic strategic planning meeting, the team members (administrator
ID: 469848 • Letter: A
Question
At the recent clinic strategic planning meeting, the team members (administrators, healthcare providers, clinic staff, and community mem-bers) decided it was time to upgrade the patient management system to include a comprehensive electronic medical record (EMR) system, including converting all paper medical records to e-records, implement-ing patient exam room e-charting, and installing an e-patient communi-cation system for making appointments, requesting prescription refills, and making payments. Fortunately, the clinic had enough money in its reserve account to pay for this system upgrade. It was decided that the project would begin with establishing a training computer lab so every employee would be trained on the mock computer software prior to any clinic implementation. Because Ms. Hill, the training administrator, was familiar with behav-ioral theories, she used the Social Learning Theory to evaluate the train-ing process instead of merely implementing the training without any evaluation plans. Ms. Hill wanted to make the training a positive experi-ence, so she used the Diffusion of Innovations Theory and let employ-ees volunteer to attend the training sessions. She selected this theory instead of conducting the training by department because she knew that the innovators would seek out the training first and their positive com-ments would encourage the early adopters to sign up next. After word spread through the clinic, the early majority employees completed the training. Lastly, Ms. Hill had to get a bit creative with a small incentive to get the late majority and laggards to attend the last training session. After each group of employees received 20 hours of computer training, she conducted a satisfaction survey. The categories of survey questions followed the constructs of the Social Learning Theory
Read Perrin (2014).Principles of Evaluation and Research for Health Care Programs Case Study Chapter 4 p.104-106 Theories and Models: What other theories could have been used? How should Ms.Hill form the staff implementation team?
Explanation / Answer
Ms. Hill could also have used Theory of Reasoned Action. This theory is based on 4 constructs:
1. People believe there is an outcome, for every behaviour. Clinic staff will believe if they receive training, the outcome will be there of increased learning.
2. Behaviour of people is motivated by the will to comply with the social norms. Staff when identifies that the social norm is going to change, and new technology is going to be used, then they would be interested in training to comply with that social norm.
3. Positive or negative attitude of the person showcasing the behaviour, affects the outcome accordingly. People taking up the training with positive attitude will be able to derive more knowledge from the whole experience, as opposed to the people with negative attitude for the training.
4. If the social peer group of a person favours or rejects certain behaviour, the person will try to comply with the peers and will favour or oppose the behaviour. If the innovators and the early adopters undergo the training with appositive attitude, the rest of the staff will follow them to comply with the peers.
The Health belief Model could also be used, where the fear of losing out on the training, as the new software implementation will make the employee knowledge outdated for efficiently performing the daily activities, will motivate the employees to take the training.
To form staff implementation teams, Ms. Hill can invite trained employees from all the functional departments of the clinic to send or assign a representative of their department for the implementation team. Having a member representative from each department, will help Ms. Hill to assess individual departmental needs from the EMR.
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