Academic journal article Journal of Nursing Measurement

Measuring Hospital Readiness for Information Technology (IT) Innovation: A Multisite Study of the Organizational Information Technology Innovation Readiness Scale

Academic journal article Journal of Nursing Measurement

Measuring Hospital Readiness for Information Technology (IT) Innovation: A Multisite Study of the Organizational Information Technology Innovation Readiness Scale

Article excerpt

The Institute of Medicine has stressed the need for health care organizations to increase their use of information technology (IT) to create safer health care environments, particularly in the area of medication safety. However, the rate of successful organizational IT innovation remains low and this is primarily attributed to a lack of organizational IT innovation readiness. The reported study completes the fourth phase in the development of the 48-item Organizational Information Technology Innovation Readiness Scale (OITIRS). The aim of this study was to re-examine the psychometric adequacy of the OITIRS to determine the readiness of three community hospitals to implement a commercial computerized provider order entry (CPOE) medication safety system. Findings supported internal consistency reliability with alpha coefficients from .78 to .92, and mean interitem correlations for the eight subscales ranging from .38 to .65 with a significance level of .01. Construct validity was supported with an overall factor loading range of .49 to .92 across the eight subscales and an explained variance ranged from 33% to 66%. The study findings supported the use of the OITIRS to assess hospital readiness for computer provider order entry system innovation.

Keywords: computer provider order entry; information systems; information technology; innovation readiness; Organizational Information Technology Innovation Readiness Scale; organizational innovation

In its 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine emphasized the need for health care organizations to increase their use of information technology (IT) to support development of safer health care environments (Institute, 2001). In 2000, the Leapfrog Group specifically endorsed the use of computerized provider order entry (CPOE) systems as one of three changes that would most improve patient safety in American hospitals (Birkmeyer, Birkmeyer, Wennberg, & Young, 2000). Others have also recommended CPOE systems as a primary means by which to reduce medication errors and prevent adverse drug events (ADE) (Agency, 2001; Leape et al., 1995).

While it is clear that CPOE systems are viewed as a valuable tool for improvement of patient safety, implementation of these complex systems represents a major organizational innovation that is difficult to accomplish and poses significant challenges (Bates, et al., 1998). These challenges are associated with several factors that include a large up-front investment of financial and human resources, a substantial impact on clinician practice processes, and a need for close integration with multiple information systems such as laboratory and pharmacy systems (Kaushal & Bates, 2001). Statistics indicate that a small percentage (13%-15%) of hospitals in the United States have actually implemented CPOE systems (Ash, Gorman, & Hersh, 1998; Ringold, Santell, & Schneider, 1999). Given system variability, cost, and associated challenges, CPOE system innovation is a high-risk organizational endeavor (Shojania, Duncan, McDonald, Wachter, & Markowitz, 2001).

In 2000, Kaplan estimated the health care organization failure rate for overall IT innovation at around 50%. This was primarily associated with a lack of assessment of organizational IT innovation readiness (Douglas, 2000; Southon, Sauer, & Dampney, 1999). The concept of organizational innovation readiness has been characterized very generally as the level of fit between the IT innovation and the organization (Happ, 1996; Snyder-Halpern, 2001; Southon, Sauer, & Dampney, 1997). Theoretically, a higher level of innovation readiness leads to a lower level of innovation risk, and a more successful IT innovation outcome. Increased information about IT innovation readiness enhances decision makers' ability to mitigate IT innovation risks (Dewan & Lorenzi, 2000; Zaltman, Duncan, & Holbek, 1973). …

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