Workforce Readiness Assessment (WRA) Key Points

Workforce Readiness Assessment

Workforce Readiness Assessment (WRA) Key Points

·  Workforce readiness should be considered in an overall review of organizational readiness when preparing for information system implementation or transition projects. Other components of organization readiness include; knowledge readiness, technical readiness, operation readiness, functional readiness, resource readiness and internal environmental readiness. (Snyder-Halpern 1999, and Caldwell, Chatman, O’Reilly, Ormiston and Lapiz 2008)

·  Change management must start early in a technical process, not during a crisis. (Lorenzi and Riley 2003) Assessments of pros and cons of the change, as well as identifying promoters and resisters (those needing more attention) should be accomplished through observation and communication with those affected by the change. (Jones and Moss 2006)

·  Implementing clinical information systems may generate fear, anxiety and “computer phobia”. (Jacobson, Holder and Dearner 1989 and Wolfe 1991)

·  Nurses and other healthcare workers are noted as having anxiety about information systems, with nurses actually exhibiting higher levels than clerical/administrative staff. (Jayasuriya and Caputi 1996)

·  Computer anxiety has been identified as a variable related to resistance and commitment to use computers. (Kay 1990)

·  Staff attitudes toward computer systems incorporate what they know or believe about them and how they routinely act or behave regarding them. (Ajzen and Fishbein 1980)

·  Adoption of information technology may either be facilitated or impeded by attitudes toward automation. (Jayasuriya and Caputi 1996)

·  Negative attitudes may cause people to avoid using computerized systems or even resist the introduction of such systems in an organization. (Igbaria and Parasuraman 1991)

·  Attitude has long been used as a determinant for a user’s intention to use or adopt an information system or software package. (Dillon, Balnkenship and Crews 2005)

·  A favorable or positive attitude enhances ones motivation to learn and retain information in a given situation; conversely, a negative attitude may impede learning and retention of new information. Attitudes may also be influential in developing behavior that can initiate a response to a situation. A strong association between attitudes and learning suggests that a first step in introducing new information systems into healthcare settings should be assessment of nurses’ attitudes. (Henderson, Morris and Fitzgibbons 1987)

·  There is little agreement regarding computer-focused nursing competencies, but there is consensus that computer-competent nurses possesses a general knowledge and understanding of computer technology, couple with a positive attitude toward computers and software. (Hobbs 2002)

Potential Benefits of Using Workforce Readiness Assessment

·  Improvement of staff attitudes does not guarantee a successful system implementation, but it is expected that with a more organized and strategic approach to implementation, the adoption and use of a new information system will be enhanced. (Dixon 1999)

·  Identification of attitude and anxiety toward computers will help in developing strategies to reduce resistance. (Jayasuriya and Caputi 1996)

·  Nurses are typically the largest group of computer users, thus their attitudes will influence those of other workers in the same area. Moreover, understanding their attitudes may help correct misconceptions and alleviate fear and anxiety about computers. Negative attitudes may present barriers to effective use of information technology. (Sultana 1990)

·  Staff benefits:

o  Encourage Lifelong learning that builds critical thinking skills (Smedley 2005)

o  Retention – people want to be good at what they do, help them be successful (Pratt 2002)

o  Improvement of human behavior and placement of nurses where they can have the most effect (Courtney 2005)

·  Management Benefits:

o  Identification of staff and units with greater needs for education (Moody, Slocumb, Berg and Jackson 2004)

o  Lower training costs (Berke 2003)

o  Less downtime for orientation between hire and work dates (Berke 2003)

o  Identifying dissatisfied users and recognizing the general nature of their complaints would create a better organized strategic approach to implementation and ultimately enhance the adoption of new technology. (Dillon 2005)

Workforce Readiness Assessment Principles

·  Implementing or transitioning to a new information system may generate fear, anxiety, and “computer phobia” (Jacobson, Holder and Dearner 1989 and Wolfe 1991)

·  Staff acceptance of and willingness to use information systems have been found to be major determinants of system success. (Goddard 2000)

·  Understanding how the nursing staff feels about computers in the workplace and the role computers can play in practice enables the implementation team to structure communications, reframe misconceptions and offer possible new perceptions. (McLane 2005)

·  User attitude is a key determinant of the effective use of computers in the work place and that employees may resist using computers if they have a negative attitude. (Jayasuriya and Caputi 1996)

·  Pressure (economic and regulatory) to incorporate information systems into the healthcare setting requires an assessment of staff skills. (Pravikoff, Pierce and Tanner 2005)

·  Research has not demonstrated consistent demographic variables that identify those nurses more or less likely to have a positive attitude toward computerization. (Smith, Smith, Krugman and Oman 2005)

The Process of Workforce Readiness Assessment

·  Successful implementation or transition of information systems depends on staff acceptance and usage of the system. Determining attitudes aids in identifying barriers to a successful project. (Dixon 1999)

·  Process includes:

o  Identifying who will utilize system, registered nurses, licensed practical nurses, nursing assistants, ward clerks and others

o  Identify essential knowledge, attitudes and skills.

o  Select, modify or develop staff attitude survey tool

o  Test tool on pilot group

o  Survey user attitudes toward computers and information systems.

o  Compile and analyze results

o  Identify barriers

o  Develop training tools, identify facility and staff resources, as well as funding

o  Incorporate results in formulation of training and implementation and training

o  (Caldwell, Chatman, O’Reilly, Ormiston and Lapiz 2008; Wilbright, Haun, Romano, Krutzfeldt, Fontenot and Nolan 2006; Smith, Smith, Krugman and Oman 2005; Dillon, Lending, Crews and Blankenship 2003; Hobbs 2002; Jayasuriya and Caputi 1996; Axford and Carter 1996; Scarpa, Smeltzer and Jasion 1992; Sultana 1990)

·  Barriers

o  Research shows that nurses experience several barriers. (Hannah 1995)

o  Barriers to cognitive integration must be addressed (Simpson, 2006)

o  Nurses work around systems they do not like, understand or value. (Kirkley 2004)

o  Resistance may appear as an attempt to “put off” system use, criticism of system, including system being time consuming, not enough access to terminals, time to document in charts or constant interruptions while documenting. (Timmons 2003 and Moody 2004)

o  Skills limitations may also exacerbate resistance to computer usage, delays in obtaining information, employee frustration with computers and inaccuracy and incompleteness of data entry. (Wilbright WA, Haun DE, Romano T, Krutzfeldt T, Fontenot CE 2006)

o  Nursing time constraints, allow little time to explore and learn (Simpson 2006)

o  Nursing’s resistance to incorporating technology into care (Simpson, 2006)

o  Multigenerational learning needs and styles are different; many nurses entered nursing practice before computers were integrated into education curriculums. (Mangold 2007, Pravikoff , Pierce and Tanner 2005, Wilbright, Haun, Romano, Krutzfeldt, Fontenot 2006)

Recommendations for Workforce Readiness Assessment

·  Researchers have consistently encouraged administrators to assess the affect the impact information systems will have on users, as well as the user’s degree of willingness to use them. (Whitehouse 1979 and Gluck 1979)

·  Implementing information systems presents staff with change, often unwanted, that may lead to resistance. Early definition and understanding of attitudes and expectations of staff can provide information serve as a starting point for a sometimes frustrating project. (McLane 2005)

References

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1

Elizabeth Johnson

TIGER Application and Usability Team. WG #5

July 25, 2008