Working in the Veterans Affairs Administration means being ready to meet the changing healthcare needs of older veterans, whom are managing the complexities of their chronic diseases both in medical centers and at their homes. Successful introduction of major information systems into such complex health care organizations, like the Veteran Health Administration has been proven to improve patients outcomes, safety and satisfaction with healthcare (Chumbler, et al., 2011). Though the implementation of health information technologies like Telehealth and electronic health records was associated with certain challenges and barriers, required an effective blend of theoretical frameworks, good technical and organizational skills, the administration of the Veterans Affairs Administration managed to succeed in this task.
Telehealth, being a technology that allows to deliver health-related information and services via telecommunications and digital information is recognized to be a major innovation at the social, technological and cultural levels, increasing patients safety, timeliness, efficiency, and equity of care (Espensen, 2009). On the other hand, electronic health records, providing immediate access to the key information like diagnoses, lab test results, allergies and medications improve health care professional`s ability to make relevant and well-timed medical decision (Jha, et al., 2009). Both of these major innovations had to be introduced in order to help nurses coordinate the in-hospital and home care of the patients.
The change has witnessed numerous challenges and barriers. The first attempt to introduce the health information technologies was met with resistance, as nurses generally avoided using the innovation. It was discovered that the majority of nursing stuff was unwilling to work with innovative technologies due to the lack of knowledge and training in this field. Several decades ago computers played insignificant role in healthcare. Nurses got used to the fact that patient`s health was in the hands of only one person – the physician. However, those days are gone.
To overcome resistance and successfully introduce necessary changes the administration used an approach based on the Lewin’s change theory (Shirey, 2013). The first step included “unfreezing” the change – making nurses and staff realize that the change was really necessary. Training and supporting sessions were conducted in order to educate nurses about the Telehealth and electronic health records functions and increase their desire to improve the care and documentation systems. The second step included actually implementing the change. Professional IT specialists continued communicating with the nursing staff, acknowledging their opinions, suggestions and closely monitoring for changes in the nurses’ attitudes and behaviors. Once the staff has fully accepted the change, the administration proceeded to the final stage of the change implementation – the refreezing stage. The last stage aimed to stabilize and reevaluate the change. An IT team providing a 24 hours support to the staff was created in order to provide nurses with ongoing advice and education regarding the innovation. A full-scale training program was developed for the new employees to help them better adapt in the technological settings. After four month of the innovation successful implementation employees of all departments have shown good results in mastering new technologies. The change management was successful.