SmartCrowding™ : Bruk av SmartCrowding™ i komplekse situasjoner ved Stavanger Universitetssykehus

Abstract

Background: Over the past years, over-filled hospital wards, critical and complex situations has created an increased amount of difficulties in Norwegian hospitals. This is also true for Stavanger University Hospital. In order to better tradethese challenging situations, Stavanger University Hospital decided to implement «plan for høy aktivitet»(«plan for high activity»), and «Smartcrowding™» as Multi Criteria Decision Analyses Software. The intended purpose of these tools is to ensure a higher level of patient safety, as well as to generate a common understandingof the activity level at Stavanger University Hospital. Purpose: The purpose of this paper is to identify factors that may influence clinicianssystematic use of the tools, as well as how systematic use canlead to increased patient safety. The findings are discussed in light of a theoretical framework and suggestions for how to increase effectiveness are offered. Method: The paper is based on a cross-sectional study. Using quantitativemethod,a questionnaire was filled out by registered users in the Smartcrowding™database of Stavanger University Hospital. The questionnaire was based on the 2003 model by DeLone & McLean, as well as the TechnologyAcceptance model (1989). Results: factors such as user-friendliness, usefulness, training, implementation and communication wereidentifiedas relevant in clinicians systematic use of the tool. Further, the study shows that there exitsa varyingdegree ofuse within the organization that may affect patient safety as well as proper handling of complex situations. Conclusion: In order to increase patient safety through the use of electronic user-support systems there is a strong need for more than simply developingand implementing a system. For the implementation to be useful, and beneficial, there must be a mutual understanding of the purpose, idea and use of the solution across the entire organization. This can be achieved through structured training for each of the users, early use for all involved, as well as developing tools that are user -friendly. Further, it is essential that there is open communication on all levels. The main conclusionof this study is that the solution in use today (Smartcrowding™) is not adequate and does not serve its intended purpose due to its administrative nature. Keywords:decisionsupport,patientsafety,userexperience,patientflow,overcrowding