Head nurses' experiences of the information and support they received and needed to lead operational change in the implementation of Health Village’s digital care pathways

Authors

• Hanna Mikkonen Oulu University of Applied Sciences, Social and Health Care, Oulu, Finland
• Janika Wahlberg Oulu University of Applied Sciences, Social and Health Care, Oulu, Finland; Oulu University of Applied Sciences, Information Technology, Oulu, Finland
• Karoliina Paalimäki-Paakki Oulu University of Applied Sciences, Social and Health Care, Oulu, Finland https://orcid.org/0000-0001-6559-3773
• Jukka Jauhiainen Oulu University of Applied Sciences, Information Technology, Oulu, Finland
• Pia Liljamo Finnish Institute for Health and Welfare, Helsinki, Finland https://orcid.org/0000-0002-5271-1483

DOI: https://doi.org/10.23996/fjhw.122875

Keywords:

telemedicine, health services, change management, digitalisation

Abstract

Digitalisation enables the reform of healthcare. The implementation of digital services requires changes in the internal structures and work processes within the organisation. Leaders have a key role in supporting the implementation of digital services and in making new operational models part of everyday practice. Digitalisation also changes leadership and the behaviour of leaders. Leaders need competence related to the utilisation of digitalisation. In addition, they need support and education on the implementation of digital services.

The purpose of this qualitative study was to describe head nurses’ experiences of the information and support they have received on leading operational change and the factors affecting the management of operational change in connection with the implementation of Health Village’s digital care pathways. Digital care pathways are a web-based service that can be used to replace or complement traditional healthcare visits. The data were gathered through a thematic interview with the head nurses of one university hospital (n = 6). The data were analysed using content analysis.

The head nurses felt they had received support and information from their networks about the implementation of the digital care pathway and operational change as well as concrete support for development. On the other hand, there were perceived shortcomings and challenges in the knowledge and support received during the development process. Management of the operational change was promoted by realisation of resourcing and funding, a positive attitude towards development and knowledge accrual, a goal-oriented development process, inclusion and co-development, as well as support received from networks and active deployment of digital services. Factors that challenged the management of the operational change included resourcing and scheduling, resistance to change, operational change, shortcomings in support and digital competence, and technical issues of the information system.

Head nurses receive knowledge and support to manage the operational change, but the information should be directed at supervisors. Higher management support is needed, especially for setting goals and concretising the benefits of the digital care pathway. For successful operational change, the implementation of the digital care pathways requires sufficient time and human resources.

The information obtained in the study can be utilised in the development and implementation of digital care pathways and other e-services and in leading the operational change in social and health care, and in planning education and training aimed at superiors.