The Computerized Medication Administration Record Mar Was A
The Computerized Medication Administration Record Mar Was A Chart Of
The computerized medication administration record (MAR) was a chart of all of the medications administered to a patient by a hospital. Kate, a programmer/analyst in the Management Information Systems department, led a team to computerize the MAR. The team had been working on the pilot project for a year and hoped for a smooth execution. The computerized MAR was launched and immediately failed. By 10:00 a.m., floor nurses and staff pharmacists complained that the system did not work and was too complicated. After hearing nurses’ complaints, physicians expressed concern about patient safety. At 1:30 p.m., the computer system crashed, and the MAR project was suspended. Kate assembled the project team to study the project failure. Kate will make a presentation to Central Hospital’s management group on the MAR project failure. What structural change is indicated at Integrated Health? What caused MAR to fail? Why are the nurses resisting the MAR project? What techniques should be used to overcome the barriers to change? Prepare your responses in a Word document that is a minimum of 2 pages in length. At least two references are required. Please be sure to cite and reference in APA.
Paper For Above instruction
Introduction
The implementation of technological innovations in healthcare, such as computerized medication administration records (MAR), offers significant benefits, including improved accuracy, efficiency, and safety. However, the failure of such systems indicates underlying issues that need to be addressed through organizational and technological changes. The case of Central Hospital’s failed MAR project exemplifies common pitfalls and highlights the necessity for structural change, understanding resistance factors, and applying effective change management techniques.
Structural Change Indicated at Integrated Health
The failure of the MAR project suggests the need for a comprehensive organizational restructuring that facilitates better integration of technology within clinical workflows. One key structural change is the development of interdisciplinary teams that include not only IT personnel but also clinicians, nurses, pharmacists, and administrators. This collaborative approach ensures that the system design aligns with clinical needs and workflow processes (Spathis & Demirbag, 2019). Additionally, establishing a governance structure that prioritizes user-centered design, continuous training, and phased implementation can mitigate resistance and reduce system failure. Organizationally, fostering a culture that promotes open communication, feedback, and shared responsibility for technological adoption is crucial (Larrivee & Hersh, 2020).
Causes of MAR System Failure
Several factors contributed to the failure of the computerized MAR. Firstly, inadequate user involvement during the system design phase resulted in a product that was too complex for end-users, particularly nurses who are often the primary users (Cresswell et al., 2013). The system did not fit seamlessly into existing workflows, causing frustration and resistance. Secondly, insufficient training and change management contributed to confusion, errors, and ultimately system crashes. Technical issues such as poor interface design, lack of testing, and system instability further exacerbated user dissatisfaction, leading to the crash at 1:30 p.m. These issues reflect a failure to adequately plan, test, and engage end-users in the development process.
Reasons for Nurses’ Resistance
Nurses' resistance to the MAR project primarily stems from increased workload, disrupted workflow, and lack of familiarity with the new system. Since the system was perceived as too complicated and time-consuming, nurses feared that it might compromise patient safety or reduce their efficiency (McAlearney et al., 2018). Resistance is often rooted in a fear of the unknown, loss of autonomy, and concerns over increased cognitive load, which hampers acceptance (Hee et al., 2019). Moreover, inadequate training and poor communication about the benefits and functionalities of the system further fueled resistance, as nurses did not feel equipped or supported during the transition.
Techniques to Overcome Barriers to Change
Effective change management techniques are essential to overcoming resistance and ensuring successful implementation. Kotter’s eight-step change model offers a useful framework: establish a sense of urgency, form a guiding coalition, develop a vision and strategy, communicate the vision, empower broad-based action, generate short-term wins, consolidate gains, and anchor change in the culture (Kotter, 1997). Applying this model, hospital leadership should involve frontline staff early in the design process, provide comprehensive training, and clarify how the new system enhances patient safety and workflow efficiency.
Furthermore, employing participatory design approaches enables nurses and other clinicians to contribute their perspectives, making the system more user-friendly. Providing ongoing support, feedback mechanisms, and recognizing early successes can build confidence and acceptance. Change agents or champions can also advocate for the new system, addressing concerns and modeling positive behaviors. Such strategies create a supportive environment conducive to technological adoption and cultural change (Vakili et al., 2020).
Conclusion
The failure of Central Hospital’s MAR project underscores the importance of strategic organizational restructuring, user-centered design, effective training, and change management. Addressing these areas through interdisciplinary collaboration, participatory design, and leadership-driven initiatives can significantly reduce resistance and enhance system success. Healthcare organizations must view technology implementation as a comprehensive change process that requires attention to technical, human, and organizational factors to realize its full benefits.
References
Cresswell, K., Mozaffar, H., Lee, L., Williams, R., & Sheikh, A. (2013). Safety risks associated with the lack of integration and interfacing of hospital health information technologies: a qualitative study. BMJ Quality & Safety, 22(10), 840-850.
Hee, S. H., Lee, Y. H., & Choi, E. (2019). Nurses’ resistance to health information technology: The effect of perceived organizational support. Journal of Nursing Administration, 49(7-8), 363-369.
Kotter, J. P. (1997). Leading change. Harvard Business Review Press.
Larrivee, B., & Hersh, R. (2020). Organizational change in healthcare: Creating a culture of safety and patient engagement. Healthcare Management Review, 45(2), 123-132.
McAlearney, A. S., Hefner, J., & Moffatt, M. E. (2018). Structural barriers to health IT implementation: Implications for quality improvement. Journal of Healthcare Management, 63(4), 281-294.
Spathis, C., & Demirbag, M. (2019). Evaluating the impact of organizational structure on healthcare technology adoption. Information Systems Frontiers, 21, 815-829.
Vakili, A., Heidari, M., & Shabestari, O. (2020). Change management strategies in healthcare: Overcoming resistance to new technology. Journal of Healthcare Leadership, 12, 27-36.