عنوان انگلیسی مقاله:

Organisational Factors Associated with Electronic Health Information Management Systems Success in two Nigerian Teaching Hospitals

ترجمه عنوان مقاله: عوامل سازمانی مرتبط با موفقیت سیستم های مدیریت اطلاعات سلامت الکترونیک

$$$: فقط 4500 تومان

سال انتشار: 2013

تعداد صفحات مقاله انگلیسی: 6 صفحه

تعداد صفحات ترجمه مقاله: 8 صفحه

منبع: Health Informatics in Africa Conference

نوع فایل: word

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ترجمه چکیده

پیشینه و هدف: امروزه سیستم های مدیریت اطلاعات سلامت الکترونیک (EHIMS) در موسسات درمانی دولتی مهم تلقی می شوند زیرا کیفیت ارائه خدمات درمانی را افزایش می دهند. تلاش برای پیاده سازی این سیستم در موسسات درمانی دولتی در کشورهای در حال توسعه معمولاً با شکست های زیادی همراه بوده است، در نتیجه مزایای پیش بینی شده آن محقق نشده است. یکی از دلایلی که برای این شکست ذکر می شود این است که به جای عوامل سازمانی بیشتر به عوامل تکنولوژیکی توجه شده است. بنابراین این مقاله رابطه بین عوامل سازمانی و موفقیت EHIMS را در بیمارستان های آموزشی نیجریه بررسی کرده است.
روش ها: از یک طرح پژوهش پیمایشی مبتنی بر همبستگی استفاده شد در حالی که جامعه مورد مطالعه شامل 212 پرسنل مدیریت اطلاعات سلامت (HIM) در دو بیمارستان آموزشی دولتی در جنوب غربی نیجریه بود. برای پوشش212 پرسنل پاسخ دهنده از تکنیک شمارش کامل استفاده شد. برای جمع آوری داده ها از یک ابزار محقق ساخته موسوم به «عوامل سازمانی موفقیت EHIMS» استفاده شد در حالی که برای تحلیل داده های جمع آوری شده از تحلیل همبستگی ساده استفاده شد.
نتایج: مشخص شد که بین تمام عوامل سازمانی شناسایی شده و موفقیت EHIMS (ساختار سازمانی (0.443= r، 0.05>p)؛ پشتیبانی مدیریت ارشد (0.613= r، 0.05>p)؛ سبک رهبری (0.645= r، 0.05>p)؛ آموزش کاربران (0.521= r، 0.05>p)؛ وجود منابع مالی (0.331= r، 0.05>p)؛ و مشارکت کاربران در طراحی سیستم (0.633= r، 0.05>p)) رابطه ای مثبت وجود دارد.
نتیجه گیری: نتیجه گرفتیم که شناسایی عوامل سازمانی شناسایی شده برای تحقق پیاده سازی موفق EHIMS در بیمارستان های آموزشی نیجریه حائز اهمیت هستند.
کلیدواژه ها: سیستم مدیریت اطلاعات سلامت الکترونیک، عوامل سازمانی، موفقیت سیستم اطلاعاتی، بیمارستان های آموزشی، نیجریه

ترجمه قسمتی از مقدمه

بیمارستان های آموزشی سومین سطح از تأمین کنندگان خدمات درمانی در سیستم ارجاع ارائه خدمات درمانی نیجریه هستند. این بیمارستان ها به عنوان محلی برای آموزش و پژوهش شناخته می شوند که خدمات درمانی باکیفیت و ارزان سطح سوم را نیز به شهروندان این کشور ارائه می کنند. بدون وجود یک سیستم اثربخش و کارا و سازمان یافته برای مدیریت اطلاعات سلامت، انجام وظایف مورد انتظار برای این بیمارستان ها دشوار می شود.

اطلاعات مورد نیاز برای تصمیم گیری مبتنی بر شواهد در موسسات درمانی در طول این سال ها همواره افزایش یافته است، در حالی که ساختار و دسترس پذیری آن کاهش یافته است. این امر به تصمیمات نامناسب و خطاهای پزشکی منجر شده است[1]، در نتیجه برای بهبود دسترس پذیری و مدیریت اطلاعات پزشکی به سیستم های مدیریت اطلاعات سلامت الکترونیک (EHIMS) نیاز داریم[2].

بخش درمان بدون شک یک بخش وابسته به اطلاعات است بنابراین برای تضمین کیفیت ارائه خدمات درمانی باید یک سیستم اطلاعاتی سازمان یافته داشته باشیم[3]-[5]. همچنین، همان طور که در نسخه اصلاح شده سیاست بهداشت ملی نیجریه[6] بیان شده است «وجود اطلاعات بهداشتی دقیق، بهنگام، قابل اطمینان و مرتبط مهم ترین گام در جهت اقدام آگاهانه بهداشت عمومی است (ص 43)».

سازمان های درمانی سراسر دنیا سرمایه گذاری در فناوری اطلاعات را به عنوان ابزاری برای ارائه خدمات درمانی باکیفیت از طریق بازیابی سریع اطلاعات و مدیریت داده ها شناسایی کرده اند. مطالعات نشان داده اند که سیستم اطلاعاتی سنتی کاغذی را می توان با ابزارهای الکترونیکی منعطف جایگزین کرد که می تواند به کاهش هزینه و اثربخشی از نظر ارائه بهنگام خدمات درمانی منجر شود [7]-[10]. در این مقاله به کارگیری فناوری اطلاعات و ارتباطات (ICT) برای مدیریت اطلاعات سلامت در سازمان های درمانی در بیمارستان ها با عنوان سیستم مدیریت اطلاعات سلامت الکترونیک (EHIMS) نامیده شده است.

ترجمه نتیجه گیری

نتایج حاصل از تحلیل همبستگی نشان دهنده رابطه معنادار بین تمام متغیرهای عوامل سازمانی و موفقیت EHIMS بود. یعنی رابطه ای مثبت بین ساختار سازمانی و موفقیت EHIMS (0.443= r، 0.05 >p)؛ بین پشتیبانی مدیریت ارشد و موفقیتEHIMS(0.613= r، 0.05 >p)؛ بین سبک رهبری و موفقیت EHIMS(0.645= r، 0.05 >p)؛ بین آموزش کاربران و موفقیت EHIMS (0.521= r، 0.05 >p)؛ بین وجود منابع مالی و موفقیت EHIMS (0.331= r، 0.05 >p)؛ و بین مشارکت کاربران در طراحی سیستم و موفقیت EHIMS (0.633= r، 0.05 >p) وجود دارد. این نتایج در جدول 1 نشان داده شده است.

Model

مدل عوامل سازمانی مرتبط با موفقیت سیستم های مدیریت اطلاعات سلامت الکترونیک

 http://modir3-3.ir/article-english/article234.PNG 

منبع:(اوجو، 2013: 23)

ترجمه مدل در فایل ترجمه آمده است

Abstract

Background and Purpose: Electronic Health Information Management Systems (EHIMS) are seen as crucial in public health institutions today, as they enhance quality care delivery. Efforts at implementing this system in public health institutions of developing countries have usually been
fraught with failure, thus preventing it from delivering its intended benefits. One reason adduced to be responsible for failure is that more attention is given towards technological factors at the expense of organisational factors. Hence, this paper examined the relationship between organisational factors and EHIMS success in Nigerian Teaching Hospitals.
Methods: A correlational survey research design was adopted, while the study’s population comprised 212 health information management (HIM) personnel in two south-western public teaching hospitals in Nigeria. Total enumeration technique was used to cover the 212 personnel who
served as respondents. A self-developed instrument titled “EHIMS Success Organisational Factors” was used for data collection, while simple correlation analysis was used in analysing the collected data.
Results: It was revealed that a positive relationship exists between all the identified organisational factors and EHIMS success; organisational structure (r = 0.443, p < 0.05); top management support (r = 0.613, p < 0.05);; leadership style (r = 0.645, p < 0.05);; users’ training (r = 0.521, p < 0.05);; financial resources availability (r = 0.331, p < 0.05);; and users’ involvement in system design (r = 0.633, p < 0.05).
Conclusions: It was concluded that an understanding of the identified organisational factors are crucial in attaining successful implementation of EHIMS in Nigeria Teaching Hospitals.

Keywords: Electronic health information management system, Organisational factors, Information system success, Teaching hospitals, Nigeria

Introduction

Teaching Hospitals are tertiary level health care providers inherent in the Nigerian health care delivery referral system. They are known as sites of education and research, also providing qualitative and affordable tertiary health care to the nation’s citizenry. Without an organised, effective and efficient health information management system in place, the functions expected of these hospitals become difficult to accomplish. Over the years, the information required for evidence-based decision making in health care institutions has continued to increase, while its organisation and accessibility dwindles. This has led to inappropriate decisions and medical errors [1], thus calling for electronic health information management systems (EHIMS) to enhance accessibility and management of medical information [2]. The healthcare sector is no doubt an information intensive one, hence there’s a need to have in place an organised information system to ensure quality of care delivery [3]-[5]. Also, as noted in the revised version of Nigeria’s National Health Policy [6], “the availability of accurate, timely, reliable and relevant health information is the most fundamental step towards informed public health action (p.43).” Investing in information technology as a means of delivering high quality care through rapid information retrieval and data management, have been recognised by health care organisations around the world. This, studies have shown that traditional paper-based health information system can be replaced with flexible electronic means which could lead to cost reduction and effectiveness in terms of timely delivery of health care services [7]-[10]. The application of information communication technology (ICT) for the management of health information in healthcare organisations in hospital is tagged Electronic Health Information Management System (EHIMS) in this paper. EHIMS can be defined as a massive, integrated system that supports the comprehensive information requirement of hospitals; including patient, clinical, ancillary and even financial management. It is an instance of a holistic health information system which has been designed to store, manipulate, and retrieve clinical and administrative information [11]. Studies have shown that the use of EHIMS will bring about increased digitization which makes the management of comprehensive medical records easier; and has significant potential to improve patient safety, patient satisfaction and organizational efficiency, thereby improving health outcomes for patients [12]-[15]. Furthermore, an objective correlation between the degree of adoption of technologies in health care and reduction of complications and mortality in hospitals has also been shown [16][17]. As lofty as the introduction of EHIMS seems, attempts by developing countries governments in its introduction in public health institutions has usually been a difficult process of change, recording more failure instead of successes [18]-[20]. It is important however, that for public health institutions to benefit from their investment in EHIMS implementation, it must attain a state of success. A successful EHIMS in this paper is seen as that which is serving its intended purposes after implementation and subsequent use. The success of EHIMS can be measured along several themes of quality dimension (system quality, information quality, and service quality) [21]-[24]; which were adopted as means of measuring EHIMS success in this paper. A number of factors have been identified as impeding EHIMS success in health institutions of developing countries. While efforts have usually been concentrated on technological factors, studies have shown that the successful implementation of EHIMS in hospitals is more of a human endeavour that technological sophistication. This is so, because according to Lorenzi in Aarts et al. [25], information systems implementation is subject to the vagaries of the human mind and the culture, politics and power that tie human groups together. While organisational factors in technology implementation especially in healthcare settings of developing countries are not receiving adequate research question, studies have shown that successes and otherwise failure of EHIMS are due to organisational factors and not just technological factors which always seem to be the focus of attention [25]. In a study conducted in Tanzania and Nigeria, proper planning, good managerial skills, top management commitment, leadership styles and end-user consideration were considered as organisational factors necessary to ensure EHIMS success [26]. Furthermore, many systems fail because of issues related to the organization itself. In developing countries, this means that issues like the national and organizational culture play a big role in EHIMS implementation. Kuhn and Giuse [27] allocate the success rate of a technology project as 80 percent dependent on the development of the social and political interaction skills of the developer and 20 percent or less on the implementation of the hardware and software technology. Also, a formative evaluation study of EHIMS conducted by Herbst, Littlejohns, Rawlinson, et al. [28] concluded that concentrating on technological issues (i.e. hardware and software) to the detriment of human ware is a risky strategy for implementing and sustaining EHIMS. However, there are challenges related to understanding and optimizing the complex interaction between people (healthcare professionals, patients and laypeople) and computer systems. While efforts have been made to implement EHIMS in the nation’s health sector, there are issues challenging its continuous use and overall use. It is therefore crucial that this system is successfully implemented and continuously used over time if it is to bring about any of its intended benefit to healthcare delivery. The objective of this study therefore is to ascertain the relationship between organisational factors and EHIMS Success in Nigeria Teaching Hospitals. It is believed that understanding these organisational factors could help to contribute to the discourse on factors affecting EHIMS Success in health institutions, especially in the context of developing countries. It is pertinent to state that this study surveyed the perceptions of EHIMS end-users, which in this study are health information management personnel. This is because the use of EHIMS is not in a steady state yet among other supposed users like physicians and nurses. Health information management personnel in Nigeria are professionals who have undergone a specialized training in the management of patients’ data. However, for the purpose of this study, data entry personnel though not having been trained in health information management are also considered users. This study focused on two University Teaching Hospitals in South-West, Nigeria that have had experience implementing an EHIMS. The Hospitals are Lagos State University Teaching Hospital(LASUTH), Ikeja, Lagos State and University College Hospital (UCH), Ibadan. More importantly, this  study focused on organisational factors such as organisational structure, top management support, leadership style, users’ training, financial resources availability, and users’ involvement in system design which were all derived from a review of existing literature.

Conclusions

The results from the correlation analysis revealed a significant relationship between each constructs of organisational factors and EHIMS success. That is, there exists a positive relationship between organisational structure and EHIMS success (r = 0.443, p < 0.05); top management support and EHIMS success (r = 0.613, p < 0.05);; leadership style and EHIMS success (r = 0.645, p < 0.05);; users’ training and EHIMS success (r = 0.521, p < 0.05); financial resources availability and EHIMS success (r = 0.331, p < 0.05);; and users’ involvement in system design and EHIMS success (r = 0.633, p < 0.05). This is summarised in Table 1.

 

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