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The Evaluation of the Implementation Process of E-Rostering System in Letterkenny University Hospital, which was recently published by the HSE, found the new system has resulted in a significant amount of change within the hospital.
Factors related to successful implementation include: Ease of use; sufficient training and support available for frontline staff; access to technical support; positive staff attitudes and beliefs; leadership support; staff champions; and evidence of the advantages of the new system.
Perceived barriers included: Limited engagement and consultation; lack of assessment of prior skills and recourses; unstandardised training and a lack of communication regarding e-rostering benefits; and consequences on work practice.
“Negative perceptions were linked to those occupying more junior roles, indicating a negative climate for implementation in those groups. Interaction with the technology was reported to be straightforward to use and convenient and this enhanced the uptake,” according to the report.
“However, criticism of the technology centred on the operational set-up relating to the number of requests by each staff member and an inability to see colleagues’ requests which influenced how participants interacted with the technology.”
In 2015, LUH was nominated as the first Irish pilot site for a national e-rostering project, initially for nursing and midwifery.
Following procurement, the HealthRoster, an e-rostering cloud-hosted system was launched across five wards and, since then, roll-out has continued across the hospital site.
Whilst a national scoping study was undertaken prior to the implementation, no internal scoping, economic evaluation or consultation exercise was undertaken prior to the implementation within LUH.
“Many believed this had repercussions for the development, implementation and engagement process. The provision of adequate human, financial and technical support was acknowledged as integral to the success of the implementation and the continuing maintenance of the system,” according to the report.
“However, inadequate resources were recognised as diminishing the process of implementation and questioned future roll-out. Overall, a lack of consultation, transparency in how and why decisions were made and role clarity among stakeholders resulted in misunderstandings and gradual disengagement from certain business functions that required further senior management facilitating and navigating communications to progress project through challenging processes. This had consequences on the delivery of the work packages and was perceived as a barrier to implementation.”
The report stated that despite this, valuable learning has occurred, resulting in LUH providing a blueprint for the integration of HealthRoster to SAP HR payroll in Ireland and demonstrating the importance of engaging and harnessing the energy and knowledge of experts from the outset.