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首页> 外文期刊>BMC Medical Informatics and Decision Making >Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry
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Implementation of an Electronic Medication Management System in a large tertiary hospital: a case of qualitative inquiry

机译：大专院校电子药物管理系统的实施：定性查询的案例

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Hospitals across Australia are implementing Clinical Information Systems, e.g. Electronic Medication Management Systems (EMMS) at a rapid pace to moderate health services. The benefits of the EMMS depend on the acceptance of the system by the clinicians. The study hospital used a unique patient-centric implementation strategy that was based on the guiding principle of “one patient, one chart” to avoid a patient being on a?hybrid medication chart. This paper aims to study the factors facilitating or hindering the adoption of the EMMS as viewed by clinicians and the implementation team. Four focus groups (FG), one each for (1) doctors, (2) nurses, (3) pharmacists, and (4) implementation team, were conducted. A guide for the FG was based on the Unified Theory of Acceptance and Use of Technology (UTAUT). A total of 23 unique subthemes were identified and were grouped into five main themes (1) implementation strategy, (2) organisational outcome of EMMS, (3) individual impact of EMMS, (4) IT product, and (5) organisational culture. Clinicians reported improvement in their workflow efficiency post-EMMS implementation. They also reported some challenges in using the EMMS that centered around the area of infrastructure, technical and design issues. Additionally, the implementation team highlighted two crucial factors influencing the success of EMMS implementation, namely: (1) the patient-centric implementation strategy, and (2) the organisation readiness. Overall, this study outlines the implementation process of the EMMS in a large healthcare facility from the clinicians’ and the implementation team’s perspectives using UTAUT model. The result suggests that clinicians’ acceptance of the EMMS was highly influenced by the unique implementation strategy (namely, patient-centric approach and clinical leadership in the implementation team). Whereas the level of adoption of EMMS by clinicians was determined by their level of perceived and realised benefits. On the other hand, a number of barriers to the adoption of EMMS were discovered, namely, general training instead of customised training based on local needs, technical and design issues and lack of availability of computer systems. It is suggested that promptly resolving these issues can improve the adoption of the EMMS.
机译：澳大利亚的医院正在实施临床信息系统，例如临床信息系统。电子药物管理系统（EMMS）以快速的步伐到适度的健康服务。 EMM的好处取决于临床医生的验收。研究医院使用了一个独特的患者为中心的实施策略，这是基于“一名患者，一张图表”的指导原则，以避免患者在杂交药物图表上。本文旨在研究临床医生和实施团队所观看的促进或阻碍采用EMM的因素。四个焦点小组（FG），每个人（1）医生，（2）护士，（3）药剂师和（4）实施团队进行了进行。 FG指南基于统一的接受和使用技术理论（UTAUT）。确定了23个独特的次节，并分为五个主要主题（1）实施策略，（2）EMM，（3）EMM，（4）IT产品和（5）组织文化的个人影响。临床医生报告了改善其工作流程效率后EMM实施。他们还报告了使用围绕基础设施领域，技术和设计问题的EMM的挑战。此外，实施团队突出了影响EMM实施成功的两个关键因素，即：（1）以患者为中心的实施策略，以及（2）本组织准备。总体而言，本研究概述了临床医生的大型医疗机构中EMM的实施过程，并使用UTAUT模型的实施团队的观点。结果表明，临床医生的接受因素受到独特实施策略的影响（即，以患者为中心的方法和实施团队的临床领导）。虽然临床医生的EMM采用水平取决于他们的感知和实现福利水平。另一方面，发现了许多对EMM采用的障碍，即一般培训，而不是根据当地需求，技术和设计问题以及计算机系统缺乏可用性的定制培训。建议及时解决这些问题可以改善EMM的采用。

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