Understanding Antecedents of Nurses' and Physicians' Workaround Behavior Regarding Hospital Information Systems:...

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Healthcare Management

Background:

• Hospital Information Systems (HISs) aim to provide timely information but can impede workflows.
• Workarounds by healthcare professionals are common responses to HIS-related workflow blockages.
• Understanding workaround antecedents is crucial for enhancing patient safety and system design.

Purpose of the Study:

• To explore antecedents of nurses' and physicians' workaround behavior concerning HISs.
• To analyze how these antecedents influence behavior, interrelate, and the intentions behind workarounds.
• To identify factors contributing to deviations from intended HIS use in clinical settings.

Main Methods:

• Qualitative interviews with 26 nurses, physicians, and health information technicians in Germany and the US.
• Grounded theory analysis techniques applied to interview transcripts.
• Identification and categorization of HIS-related workaround antecedents.

Main Results:

• 506 open codes derived, clustered into 3 direct causes: organizational prerequisites, human factor, and system.
• 4 influencing factors identified: regulations, sector funding, software providers, ownership/management.
• Influencing factors shape conditions for direct causes, indirectly impacting user behavior.

Conclusions:

• Provides a structured understanding of HIS-related workaround antecedents and user behavior.
• Establishes cause-effect relationships to inform strategies for preventing workarounds.
• Addressing identified causes can improve working conditions, patient safety, and healthcare quality with digital support.