Adoption of New Technology

That there is resistance to the adoption of this new technology should not surprise. There is often a fair amount of inertia within any organization when it comes to organizational change in general, and rolling out new technology in particular. Structural inertia has long been studied in organizational change literature – people become accustomed to doing things a certain way, they have fallen into routines, and many people really do not like being broken out of their comfort zones (Hannan & Freeman, 1984). This phenomenon can be observed on the macro level, but it will also manifest on the micro level, with respect to individual changes that are non-structural in nature. A good example is the rolling out of new technology. There are a few things that a nurse leader can do to ensure that the rollout of the new electronic health record system is successful.

Those who do this for a living have a pretty good overview of how to overcome resistance. While not specific to the nursing setting, Day (2016) rightly points out that leadership needs to be able to highlight the value of the new technology up front, in order to overcome resistance based on "why is this needed." Once there is some understanding that the change is needed, it will be a little bit easier – though not necessarily problem-free – to roll out the new technology. There needs to be champions in management, which is where the nurse leader comes in, and then there needs to be a plan. That plan should be based on the principles that Rogers (2003) laid out.

Rogers (2003) starts with that the point above – that the proponents of the new technology must be able to demonstrate that it is better than the existing way of doing things. An interesting dynamic to this is that this benefit might be obvious to management (i.e. it makes the business more profitable) but that won't matter to the nurses – they need the benefit conveyed to them in their context (i.e. how it benefits them specifically).

The next step that Rogers has identified is that it needs to be compatible. This should have been assured during the vetting stage as discussed in prior papers; for the implementation aspect it is only important that the compatibility point is explained to the nurses so that they understand how the new technology is aligned with the values and missions of the organization. In other words, if what the new technology does is poorly aligned with the values and mission of the organization, then there is a much lower likelihood than the nurses will drop their resistance.

The next step as identified by Rogers is simplicity. At the end of the day, the technology has to be usable by the people who are supposed to use it. Makes sense, right? This is why there needs to be a nurse involved during the technology selection process – if there is not then it is conceivable that the technology chosen will be beyond the skills of the nurses who are supposed to use it. At this point, we can reasonably expect that the nurse's input was taken into consideration that that it is possible for this technology to be used relatively simply by the nurses at large.

The fourth step is trialability. This touches upon something that was written about disruption in hospitals (Edmondson, Palmer & Pisano, 2001). The introduction of a new technology is disruptive – it needs to be, in order to add value. As such, the nurse leader needs to be able to explain to the team what aspects of their roles will be disrupted, why this is necessary, what the value is, and why the new system will deliver superior results on the other side of the learning curve. The full context is important because otherwise the nurses will simply see the disruption – the pain – and will not have a great sense of why they must undergo this pain. But by showing them that you understand how this change will affect them, having empathy with that, and then explaining why that pain is necessary in the long run, there is much better chance of buy-in, and that buy-in is essential to the full-scale adoption of this new technology. The key to trialability is that you remove some of the pain by allowing the nurses to learn the system during a trial. There are no lives on the line; no risk; so if they struggle or make mistakes there is no price to pay. Nurses are naturally going to be risk averse with new technology if they think it will put them in a position where the mistakes they will inevitably make during the learning curve will harm either patients or their own careers.

The last component for Rogers is observable results. This is not just important for management. Organizational change literature is quite clear on the need for management to demonstrate results – quick wins – with the team. Schaffer & Thomson (1992) noted that results are key because they provide the nurse leader with the opportunity to deliver wins – good vibes – with the team. This encourages the team to continue when there are struggles, a few quick wins early can help to overcome stragglers who are still resisting. During that initial training meeting, the nurse leader should make it clear to the nursing team what the metrics are, and then let them know that when success occurs, it will be celebrated – set a target and them provide some incentive, and that will help to focus the team on moving forward rather than looking backwards at what they might be missing in the old technology.

Overall, the nurse leader plays an important role. There is a wealth of literature on organizational change, and on implementing new technology, that can be applied fairly directly to this situation. Doing so will help the nurse leader take the new technology y to the team, overcome resistance and get a high level of buy-in for the adoption and implementation of the new electronic health record system.