Development of a measure of clinical information systems expectations and experiences.
OBJECTIVE
The purpose of this study is to describe the development and initial psychometric properties of a measure of expectations and experiences regarding the impact of clinical information systems on work process and outcomes.


METHODS
Basic item analysis, confirmatory factor analysis, cross-validation factor analyses, and reliability analysis were used to assess the psychometric properties of the scale.


METHODS
The initial validation sample included registered nurses from a large Midwestern rural referral hospital that implemented electronic medical records and computerized provider order entry systems. Nurses from 3 other hospitals were used to cross-validate the factor structure of the scale.


METHODS
The scale assesses respondents' perceptions related to communication changes, changes in selected work behaviors, perceptions of the implementation strategy, and the impact on quality of patient care. The instrument can be used to assess perceptions before and after implementation.


RESULTS
Confirmatory factor analysis generally supported the a priori factor structure for both expectations and experiences regarding the clinical information system. The consistency of the fit to the factor models was also high across the cross-validation samples. The scales demonstrated acceptable internal consistency in all the samples.


CONCLUSIONS
Our findings suggest that the measure of clinical information systems expectations and experiences offers a valid and reliable tool for assessing the perceived impact of new clinical technology on work process and outcomes. This instrument can be useful before and after technology implementation by assisting in the identification of staff perceptions and concerns, thus allowing for targeted interventions to address these issues.
Wakefield
Douglas S
DS
Center for Health Care Quality, University of Missouri-Columbia, Columbia, Missouri 65212, USA. wakefieldDS@health.missouri.edu
Halbesleben
Jonathon R B
JR
Ward
Marcia M
MM
Qiu
Qian
Q
Brokel
Jane
J
Crandall
Donald
D
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006751:Hospital Information Systems / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009936:Organizational Innovation; D011594:Psychometrics / Q000295:instrumentation*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires