Objective:
This thesis investigates the barriers to why a newly implemented web based patient communication system "My Pathway" (in Danish “Mit forløb”) on Silkeborg Regional Hospital, is not being used in daily routines nurses and staff, after being made fully functional in 2013/14. The main issue is use of new digital communication technologies and web based information systems during hospitalization, has proven very efficient in decreasing the mental stress of patients, due to a higher information level about the process and progress of the treatment. Thereby the length of recovery and hospitalization has been significantly decreased by implementing digital information system in Silkeborg Regional Hospital.
Method:
A case study of section K on Silkeborg Regional Hospital is performed to investigate the causes and barriers of not using the system currently. This study triangulates quantitative questionnaires of 60 members of the staff, subject matter expert interviews with 6 members of the staff who participated in developing the system, and empirical data from key theories on learning (Illeris 2000), Communities of practice (Wenger 2004) and reflection (Dewey).
The thesis develops its research design around Engströms activity analysis, to develop an in-depth understanding of the complex relations between patient staff and organization.
Results:
This study clarifies 3 key reasons for failed use and implementation of the system "My Pathway";
1.) Among staff there is a clear lack of understanding of the importance and potential benefits of the system, and therefore the needed change of deeply rooted use of traditional systems (analogue information) has not taken place.
2.) There have been no clear placements of responsibility for implementation in the management teams, and therefore the required change of daily routines, follow up procedures and educational focus, has not taken place as is necessary for successful implementation.
3.) Structural issues in basic technical design, such as lacking wireless network coverage, simple login procedures and loss of connection has caused resistance among staff. This is due to several frustrations and experience with degreased efficiency during simple work routines, when first testing this new technology.