This assignment will explore a hypothetical situation in which I will assume the role of a nurse facilitator in a hospital in upstate New York. I will be introducing a new electronic health records system, and I will analyze the best approach(es) in order to prepare the nurses for this new system. It is to be noted that in this hypothetical situation there has been an undercurrent of resistance to the new technological system, and I will address the most efficient ways in which I could deal with any resistance should it arise. This hypothetical scenario will be guided by Rogers’ (2003) Diffusion of Innovations Theory and its corresponding process of achieving the implementation of a new innovation. Obviously, however, it is prudent to outline the theory’s process first, then address the hypothetical scenario in line with his 5 stages.

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Rogers’ Diffusion of Innovations Theory
In implementing a new technological innovation, Rogers’ (2003) sets out the manner in which groups and the individuals within them respond to such innovations and how they are implemented. This is broken down into 5 stages: knowledge, persuasion, decision, implementation, and confirmation. The knowledge stage refers to the point in which an individual (that would be subject to the innovation) learns about the innovation and would like to know more – this represents the three types of knowledge contained within this stage. Awareness knowledge refers to the point in which the person is aware and would like to know more. This leads to how-to knowledge, in which the individual would like to know how the individual could use the innovation correctly – leading the the last type of knowledge which is principles knowledge. This kind of knowledge refers to the point in which the individual wants to know why and how it works. If the implementation is adopted without the individuals within the group possessing this type of knowledge it is unlikely that it would work in the long term or used correctly. The persuasion stage is the stage in which an individual has formed an independent opinion on the merits of the innovation and would seek to be exposed to the opinions of others to either confirm or deny their opinion.

The implementation stage is as it sounds, the point in which an individual rejects or adopts the innovation – obviously the innovation can be implemented over one or many objections, but this would lead to a possible lack of effectiveness or misuse if that particular individual does not like the innovation. The implementation stage is when the innovation is put in effect and everyone monitors how it works in the real world, and whether reinvention would take place in light of it not working. The final stage is the confirmation stage, in which the innovation is either firmly embraced (even in a reinvented form) or firmly rejected due either to the uselessness of the innovation itself or the disapproval of all that use it (leading to ineffectiveness). It should also be noted how Rogers sets out five characteristics of innovations. They must have a relative advantage over the preceding system, be compatible, limited in their complexity, possess an element of “trial-ability”, and the results must be fairly observable.

With these stages outlined, it can be seen how they would be relevant to the hypothetical exercise undertaken in this assignment. Each stage, for the individual responsible for implementing the innovation, can be a guide for how others (in this exercise nurses) may react within the practice.

Hypothetical Exercise
In going into this meeting with the nurses, they will have already reached the first knowledge stage and have a great deal of awareness knowledge. They are resistant to it based on this awareness knowledge and the obvious next step to take immediately at the beginning of the meeting is to fully provide the nurses with how to and principles knowledge in order to ensure everyone is on the same page before proceeding – this decreases the amount of negative impact at the persuasion stage. With everyone better informed, it is more likely they can come to their own judgements rather than be exposed to negative rumors and so on. How can this be done? It would be best to provide a presentation dealing with what exactly the electronic records system is, how it is implemented, and how it has worked elsewhere and provide hard copies of notes and so on for the nurses to take home. The emphasis on how it has worked elsewhere is intentional, as this factors into my efforts to provide my own narrative in order to persuade reticent nurses who are resisting the innovation. Not only that, this also contributes to the “observability” characteristic referred to in Rogers as results, although not ones pertaining directly to my facility, can be seen and remarked upon.

In this meeting I would also strive to outline how the training will work. Though I would not provide a practical example, I would attempt to provide some sort of instructions in order to prepare them for their encounter with the actual system during the training course. This would benefit their amount of knowledge in the system, allow them to see that the system can be operated effectively in a way that can be easily grasped by the nurses. This action would have the knock on effect of increasing the nurses’ grasp of the system in the training stage, leading to faster and more effective implementation and “trial-ability”. Moreover, this makes the electronic records more “simple” and more compatible as by understanding the system better it can be seen how it will work within existing structures easily and effectively.

By doing these two main things in this meeting, it is evident that the nurses come to the fore as agents of change within a medical facility. As they are the “doers” in the facility any innovation that makes this more efficient will have to be operated by the nurses. This, in my opinion, is where training is key. Familiarity with the processes of any system allows many obstacles to be surmountable. Unless the innovation is borderline useless, as does occur, significant operational training can be used to make certain most innovations have a use. This reflects, however, how key nurses are to making sure an innovation works. Without this training, nurses will never allow the innovation to become effectively operated, either through their own misuse or misunderstanding of the innovation itself.

This assignment undertook an exercise in which a meeting with nurses was to be held in order to discuss the upcoming implementation of a new electronic record system. This was done in consideration of Rogers’ theory of the diffusion of innovations, detailed in full before the exercise, where it was demonstrated that by providing more knowledge and preparation for the upcoming training session will increase the positive characteristics of the innovation in the eyes of the nurses, hopefully leading to the general adopting and successful implementation of the innovation. Rogers’ theory was useful in specializing how I could make my meeting more effective by providing certain things and doing certain activities. It was also seen how by using Rogers’ theory it is obvious that the nurse is the center of change in medical facility.

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