Clinical team functioning and IT innovation: a study of the diffusion of a point-of-care online evidence system.
OBJECTIVE
To investigate the association between clinical team functioning and diffusion (awareness, use, and impact) of a 24-hour online evidence retrieval system. To examine the relationships between clinical team characteristics and the adoption of the online evidence system.


METHODS
18 clinical teams, consisting of 180 clinicians from three Australian hospitals, were identified and studied. Teams were categorized as small (<or= 15 members) or large (> 15).


METHODS
Clinical team functioning was assessed using the Team Climate Inventory (TCI). Awareness, use, and impact of an online evidence retrieval system were measured using a self-administered questionnaire. The relationships between TCI scores and awareness, use, and impact were examined using t-tests and one-way ANOVAs. Chi square analyses were used to examine differences between small and large teams. RESULTS were interpreted within a diffusion of innovations framework.


RESULTS
Clinical team functioning was not related to awareness or use of the online evidence retrieval system. However, clinical team functioning was significantly associated with the impact of online evidence in terms of reported experience of improved patient care following system use. Clinicians in small teams (<or= 15 members) had higher levels of system awareness compared to large (> 15) teams.


CONCLUSIONS
Team functioning had the greatest impact on the fourth stage of innovation diffusion, the effective use of online evidence for clinical care. This supports Rogers' diffusion of innovation theory, to the effect that different types of communication about an innovation are important at different stages in the diffusion process. Members of small teams were more aware of the system than members of large teams. Team functioning is amenable to improvement through interventions. The findings suggest that the role of team climate in the diffusion of information systems is a promising area for future research.
Gosling
A Sophie
AS
Centre for Health Informatics, Faculty of Medicine, University of New South Wales, Sydney, Australia. s.gosling@unsw.edu.au.
Westbrook
Johanna I
JI
Braithwaite
Jeffrey
J
D000704:Analysis of Variance; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006801:Humans; D007257:Information Theory; D007400:Interprofessional Relations; D009862:Online Systems / Q000706:statistics & numerical data; D015279:Organizational Culture; D009936:Organizational Innovation; D010346:Patient Care Management / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D019095:Point-of-Care Systems; D011795:Surveys and Questionnaires