Informatics Research Seminar: Sustaining high reliability in the face of Organizational Change: Study Proposal

 September 2 @ 4:00 – 5:00 pm


Speaker: Rebecca Kitzmiller, PhD, MHR, MSN
Presented from UNC-CH

Broadcast Link: Seminar

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During organizational change in hospitals, staff members are expected to learn how to effectively use new processes while maintaining care quality and patient safety. However, studies indicate that the effort to transition to new practices may negatively affect staff and patients alike. For example, during electronic health record (EHR) implementation, hospital staff report significant burden in terms of the time and cognitive effort needed to learn how to use EHRs as well as disruption to care processes and interprofessional communication. Further, studies suggest that patients may be at increased risk of harm, such as decubitus ulcer and failure to rescue, perhaps because staff attention is diverted to the EHR. Unfortunately, there is little evidence to suggest how long staff need to adjust to new processes or how best to support them during the adjustment period.  Common implementation strategies such as training, coaching and reduced patient care assignments lack systematic evidence as to their efficacy. We will explore potential research strategies for capturing the effect of significant organizational change (EHR implementation) on hospital staff work and patient outcomes. Based upon quality and safety research we will discuss possible methods of supporting staff through the adjustment period.


Rebecca Kitzmiller, PhD, MHR, RN-BC, is an assistant professor at the School of Nursing and the Carolina Health Informatics Program at the University of North Carolina, Chapel Hill. Dr. Kitzmiller’s research examines ways to improve organizational change effectiveness from the perspectives of leadership, teamwork and training. Dr. Kitzmiller has published on these top­ics in Implementation Science, Advances in Health Care Management; Journal of Continuing Education in Nursing; CIN: Computers, Informatics, Nursing; Caring; and the TarHeel Nurse. She is coauthor of The Nurs­ing Informatics Implementation Guide as well as two chapters in Introduction to Nursing Informatics (3rd ed). Since 1998, she has presented at national, state and local conferences including the Academy of Management Annual Meeting, Southern Nursing Research Society Annual Conference, University of Maryland Summer Institute for Nursing Informatics, and Rutgers University International Nursing Infor­matics Conference.

Prior to doctoral training, Dr. Kitzmiller served more than two decades in the U.S. Army Nurse Corps leading both patient care units and large-scale organizational process improvement and technology projects. She also served as the Director for Nursing Informatics at Duke University Health System. Dr. Kitz­miller received her PhD and MSN from the Duke University School of Nursing, MHR from the Oklahoma University and BSN from the University of Pennsylvania School of Nursing.