Callen Joanne, Braithwaite Jeffrey, Westbrook Johanna
Health Informatics Discipline, The University of Sydney, Australia.
Stud Health Technol Inform. 2008;136:15-20.
The organisational culture of a health facility has been identified as a significant factor for successful implementation of clinical information systems. There have been no reported studies exploring the link between sub-cultures and the use of information systems. This study utilises cross sectional surveys to measure doctors' and nurses' perceptions of organisational culture and relate this to their use of a hospital-wide mandatory computerised pathology order entry (CPOE) system. Data were collected by administering an organisational culture survey (Organisational Culture Inventory, OCI) along with a user-satisfaction survey to a population of 103 doctors and nurses from two clinical units in an Australian metropolitan teaching hospital. We identified subcultures based on professional divisions where doctors perceived an aggressive/defensive culture (mean percentile score = 43.8) whereas nurses perceived a constructive culture (mean percentile score = 61.5). There were significant differences between doctors and nurses on three of the attitude variables with nurses expressing more positive views towards CPOE than doctors. The manifestation of subcultures within hospitals and the impact this has on attitudes towards clinical information systems should be recognized and addressed when planning for system implementation.
医疗机构的组织文化已被视为成功实施临床信息系统的一个重要因素。目前尚无研究探讨亚文化与信息系统使用之间的联系。本研究采用横断面调查方法,以衡量医生和护士对组织文化的认知,并将其与他们对全院强制性计算机化病理医嘱录入(CPOE)系统的使用情况相关联。通过向澳大利亚一家大都市教学医院两个临床科室的103名医生和护士发放组织文化调查问卷(组织文化量表,OCI)以及用户满意度调查问卷来收集数据。我们根据专业划分确定了亚文化,医生们感知到一种攻击性/防御性文化(平均百分制得分=43.8),而护士们感知到一种建设性文化(平均百分制得分=61.5)。在三个态度变量上,医生和护士之间存在显著差异,护士对CPOE的看法比医生更为积极。在规划系统实施时,应认识并解决医院内部亚文化的表现形式及其对临床信息系统态度的影响。