Case Study: Clinic Strategic Planning Process
At the recent clinic strategic planning meeting, the team members (administrators, healthcare providers, clinic staff, and community members) decided it was time to upgrade the patient management system to include a comprehensive electronic medical record (EMR) system, including converting all paper medical records to e-records; implementing patient exam room e-charting; and installing an e-patient communication system for making appointments, requesting prescription refills, and making payments. Fortunately, the clinic had enough money in its reserve account to pay for this system upgrade. It was decided that the project would begin with establishing a training computer lab so every employee would be trained on the mock computer software prior to any clinic implementation.
Because Ms. Hill, the training administrator, was familiar with behavioral theories, she used Social Learning Theory to evaluate the training process instead of merely implementing the training without any evaluation plans. Ms. Hill wanted to make the training a positive experience, so she used Diffusion of Innovations Theory and let employees volunteer to attend the training sessions. She selected this theory instead of conducting the training by department because she knew that the innovators would seek out the training first and their positive comments would encourage the early adopters to sign up next. After word spread through the clinic, the early majority employees completed the training. Ms. Hill then had to get a bit creative with a small incentive to get the late majority and laggards to attend the last training session.
After each group of employees received 20 hours of computer training, Ms. Hill conducted a satisfaction survey. The categories of survey questions followed the constructs of Social Learning Theory (Table 6-9).
Table 6-9 How Social Learning Theory Constructs Guide Research Questions
Construct |
Question |
Behavioral capability |
Did the staff leave the training with enough knowledge and skills to utilize the specific EMR system that affects their clinic duties? |
Expectations |
At the training, did the staff receive an overview of how the EMR system benefits the overall clinic operation as well as expectations for specific outcomes in their areas of the clinic? |
Self-efficacy |
Did the staff experience enough hands-on computer time during the training to feel confident in implementing specific behavioral changes with the new EMR system? |
Environment |
Is the clinic environment changing to accommodate individual staff needs—for example, location of new computers, online screen viewing, and so on—to implement the EMR system in the patient exam rooms and staff work areas? |
Reinforcement |
What type of reinforcement is planned within the clinic to persuade the staff to continue to make individual behavioral changes related to how the EMR system affects their daily routine? |
After the survey data were analyzed, Ms. Hill realized that the training was well received among all levels of clinic staff. Her next step was to move the EMR system from the training classroom to full operation. For this phase, she formed a staff implementation team to minimize any clinic disruption during the EMR training and implementation.
After seven months, the EMR system was fully operational with the clinic staff. Ms. Hill then began working on the patient education side of the EMR system, by conducting focus groups with clinic patients and presenting the results to her implementation team to plan the next step.
Read the above case study “Clinic Strategic Planning Process”.
After you have read the case study answer the following questions:
1. What other theories could have been used? Provide a brief justification for your answer.
2. How should Ms. Hill form the staff implementation team?
Your responses should not be less than 75 words for each question.