Interview summary

During one of the workshops on Artificial Intelligence in Precision Medicine for Diabetes and Other
Chronic Diseases, I had the opportunity to interact with a colleague who works as a nurse in the
emergency department of a hospital. We shared a rich discussion about how recent technological
advancements have impacted our careers and healthcare delivery. As we conversed, we exchanged a
variety of experiences from our respective roles, which highlighted the dynamic nature of our
profession. The conversation naturally evolved into a discussion on the challenges and changes
occurring in the organizations we work for, particularly with the integration of new technologies in the
workplace.

Given that we had just attended a technology-focused workshop, our attention quickly shifted to how
our workplaces were adapting to the rapid changes in healthcare technology. We specifically focused on
the technologies being adopted in hospitals, including the introduction of new systems and tools that
aim to improve patient care. A recurring issue that emerged in her concerns was the implementation
and challenges surrounding clinical decision support systems (CDSS). This piqued my curiosity,
prompting me to ask further questions about how her hospital was embracing this technology, thus
turning the discussion to an interview at that point. She shared that her hospital had adopted a CDSS
only eight months prior, which was a recent transition for the organization.

The discussion provided deep insights into the struggles her hospital faced in fully embracing the CDSS,
especially among staff members. She expressed concerns about the lack of collaboration across
departments, which hindered the effective use of the system. Additionally, she shared how the
leadership was handling the adoption process. The open-ended nature of the conversation allowed for a
genuine exchange of opinions with unrestricted lengths of responses hence providing as much
information on the topic as possible. The friendly rapport we had established helped foster an honest
and productive discussion. It was a truly enlightening experience that deepened my understanding of
how healthcare institutions are adapting to new technologies and the challenges that come with such
transitions.

Issue Identification

The primary issue identified in the interview was the unwillingness of some hospital staff to embrace the
Clinical Decision Support System (CDSS) recently implemented at my colleague's hospital. A survey
conducted by the hospital management six months after the adoption of CDSS revealed a usage rate of
only 26.7%, well below the targeted rate of 100% by the end of the first year. This low usage rate
highlighted staff hesitancy toward integrating CDSS into their daily routines. My colleague attributed this
reluctance to two main factors: concerns over the potential inaccuracies of the system and lack of digital
literacy, particularly among older staff members. Many staff feared that relying on CDSS could lead to
errors in patient care, while others struggled with system use due to limited familiarity with digital
technologies. These concerns underscore the need for an interdisciplinary approach to support staff and
address their apprehensions effectively, as fostering a supportive and collaborative environment is
crucial for technology adoption in healthcare.
CDSS systems are integrated across numerous areas in a hospital, including the Emergency Department,
Intensive Care Unit, Operating Room, Pharmacy, and various specialty units like Cardiology, Oncology,
and Mental Health, as well as administrative areas such as Nursing Stations and Patient Admission. The
system's utility in these diverse areas necessitates involvement from various specialists to maximize
coverage and usability. To improve adoption rates, the hospital must foster collaboration across these
departments, encouraging interdisciplinary engagement and support. Achieving the hospital’s goal of
full CDSS adoption within the first year would require dedicated leadership, inter-professional training,
and ongoing support to address both practical and psychological barriers. A combined effort from
hospital leadership and the diverse healthcare staff will be essential in overcoming resistance and
integrating CDSS into patient care practices across all units.

Applicable change theories and leadership strategies

Technological change represents a significant shift in how people work, often met with various
obstacles. These challenges, however, can be mitigated through a well-organized, collaborative
approach. Kotter's model has been validated based on a comparison study and models analysis,
counting among the most generally used change management models (Alrabie, 2023). The model has
been applied to adopt technological changes in health care such as adoption of Artificial intelligence by
many peer reviewed study by experienced authors such as Alrabie (2023). The model constitutes of
eight steps from creating urgency to solidifying the new practices (Graves et al., 2023). The first step is
establishing a sense of urgency, where management should present data on how CDSS can enhance
patient outcomes. Next, a guiding coalition, such as a cross-departmental team, can advocate for CDSS
integration. Developing a vision and strategy with clear goals follows, providing staff with a roadmap for
successful implementation. The fourth step is to communicate the vision to ensure everyone
understands the goals. Empowering staff for broad-based action follows, this can be done through
training sessions on CDSS usage. Short-term wins such as reduced error rates are then established to
showcase immediate benefits of the adoption processes. Building on these gains then follows are the
seventh step where the system’s use can be expanded hospital-wide, and finally, the change can be
instituted by embedding it in protocols and performance evaluations.

The change process can be enhancing by applying appropriate leadership strategies through the change
process. A transformational leadership approach inspires employees to embrace change (Usman, 2020).
Usman’s article is a peer reviewed article by the International Business Education Journal (IBEJ) which is
recognized a reliable entity for research by many scholars making the study’s credible for
use.Transformational leadership should be applied through the change process by fostering innovative
ways to encourage the employees to use the technology through strategies such as awarding best
performing employees. Another leadership style that can significantly contribute to the change is
collaborative leadership. Collaborative leadership foster teamwork (Bourgault & Goforth, 2021) hence
this can be helpful when drafting solutions plans for the problem.

Collaboration Approaches for Interdisciplinary Teams

Collaboration between stakeholders is important for change to be successful. Effective collaboration

requires application of best practices. Some of the best practices for effective collaboration is setting of
clearly defined goals, enhancing an atmosphere of trust between the team members and enhancing of
intra and interterm communication (Nancarrow et al., 2013). The article by Nancarrow et al (2013) is
peer reviewed article that was published in the BMC public health database that an open-access journal
that publishes original research, articles, and reviews across the entire field of public health. The
database is professionally recommended in health by many scholars hence making the information draw
from it credible. Establishing of trust in these issue’s scenario will enable the hospital staff to trust the
management’s decisions with regard to CDSS technological changes. The trust can be obtained by
enhancing interterm communication between the management and staff groups. Additionally, setting of
clearly defined goals will guide the change process to the desired direction.
References

Alrabie, M. (2023). Accelerating Change in Healthcare: Leveraging Kotter's Model for a Successful
Integration of Artificial Intelligence.

Graves, L., Dalgarno, N., Van Hoorn, R., Hastings-Truelove, A., Mulder, J., Kolomitro, K., ... & van Wylick,
R. (2023). Creating change: Kotter’s change management model in action. Canadian Medical Education
Journal, 14(3), 136.

Bourgault, A. M., & Goforth, C. (2021). Embrace teamwork to create and maintain a positive workplace
culture. Critical care nurse, 41(3), 8-10.

Usman, M. (2020). Transformational leadership and organizational change: In the context of today’s
leader. International Business Education Journal, 13(1), 95-107.

Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten principles of good
interdisciplinary team work. Human resources for Health, 11, 1-11.