As the system of healthcare is undergoing a major structural shift, technologies are becoming a foundation for providing quality patient care. Elimination of medical errors is one of the top priorities shaping the current healthcare reform, and technologies are expected to facilitate the system’s transition towards a new level of quality. Geibert (2006) confirms that health information technologies create favorable conditions for enhancing the quality of patient care, patient safety, as well as continuity of care and patient outcomes. Nurses play one of the central roles in fostering the successful adoption of technologies, including electronic health records (EHR). Everett Rogers’ diffusion of innovations theory provides a comprehensive map for integrating EHR into nursing care. Nurses should be ready to overcome the resistance of their colleagues and act as change agents and facilitators in the adoption of EHR.
Diffusion of innovations is the theory developed by Everett Rogers to speed up and facilitate the adoption of complex technologies in diverse environments. According to Starkweather and Kardong-Edgren (2008), all stakeholders bear responsibility for adopting technological innovations. They should be aware of the benefits such technologies promise to bring and be ready to overcome resistance to change. When it comes to EHR, the diffusion of innovations theory provides a roadmap for nursing leaders and nurse facilitators, as they strive to establish a technology-friendly atmosphere in the workplace. It can serve as the foundation for outlining the activities and information to be provided to nurses, if they resist to the rapid adoption of EHR in their workplace setting. During a meeting with nurses to address the most relevant areas of EHR adoption, I will have to address each of the five areas outlined by Rogers. These areas include: relative advantage, compatibility, complexity, trialability, and observability (Geibert, 2006).
The success of any technology and the process of its adoption are based on the effectiveness of communication among all stakeholders. Rogers’ theory positions diffusion as “the process in which an innovation is communicated over time among members of a social system” (Geibert, 2006, p. 206). Thus, the meeting with nurses will be organized in ways that allow free exchange of information related to the adoption of EHR. I will present EHR as an extremely advantageous solution to the problems facing nurses in their daily practices. It is not enough to say that the EHR system will enhance care safety and patient outcomes; much more important is explaining to nurses how each of them will benefit from the new technology (Geibert, 2006). I will emphasize the fact that nurses will experience less paperwork and have more time for research and development. EHR will alleviate excessive workloads and reduce the risks of medication errors, making some processes more or less automatic. As nurses seek to become more effective in their roles and, at the same time, avoid stresses, burnout, and fatigue, the adoption of the EHR system will be fully compatible with their values and needs (Geibert, 2006). This is how I will communicate the compatibility principle of Rogers’ theory.
I will explain the major complexities of the new system and ways to overcome them, being honest with other nurses that the system presents many challenges but they can be adequately resolved. Nurses will learn to see the system not as threatening to their current position as they used to believe. In relation to trialability, I will say that the training course will allow every nurse to test the new system and see its benefits and pitfalls. The latter will be addressed, before the system runs on a full scale. As for observability, the implementation results will be presented to every nurse during regular meetings, which will be organized to communicate the achievements made by nurses with the help of EHR.
Overcoming nurses’ resistance to EHR adoption is a challenging endeavor. Such resistance is likely to impact other stakeholders, including physicians and patients (Ajami & Bagheri-Tadi, 2013). Yet, the nurse facilitator must realize that resistance is inevitable in the context of technological and organizational change. The discussed meeting and the use of Rogers’ theory as a meeting agenda are just some of the many ways that can help overcome such resistance. One of the best ways to respond to resistance is by letting nurses speak out their concerns openly. Overcoming resistance is impossible without understanding its causes. The meeting will become a time for an open and honest discussion of everything that makes nurses feel uneasy about EHR. Nurses’ responses will guide the development of effective strategies to overcome resistance.
Rogers’ diffusion of innovations theory can also empower the nurse facilitator in becoming an agent of change. It is no secret that individuals pass several stages, before they are ready to make new technologies an important part of their work. In this sense, the most responsible is the persuasion stage of diffusion, when individuals integrate their perceptions of the new technology into the new system (Hilz, 2000). Here, the task the nurse facilitator must accomplish is two-fold. On the one hand, positive perceptions of the new technology should be strengthened. On the other hand, any perceptions that are negative should be rechanneled and reshaped to reduce resistance to EHR among nurses. All proposed actions will create a solid foundation for the successful integration of technologies into nursing practice.
To conclude, any nurse facilitator can use Rogers’ diffusion of innovations theory as an instrument for setting the agenda of change. The meeting with nurses who resist the adoption of EHR should be organized around the five core components of Rogers’ theory. These components will serve as persuasive arguments to change nurses’ perceptions of the new technology and eliminate their fear of innovations. The meeting itself and the training provided will create a strong foundation for pursuing the benefits of technological innovations in nursing practice.