A change model for a chemotherapy management system : a case study

Abstract

Management at Mater Dei Hospital started to introduce a digitalised medicines management system throughout the hospital. A pilot project for the introduction of a Computerised Provider Entry System for cancer chemotherapy at the Oncology Day Ward was being started. This study aimed to develop a change model which best supports the digitalisation of the chemotherapy management system (CMS). The literature showed that a variety of systems were used to support the implementation of digitalised systems in health, and that the implementation of change takes place as a stepwise process. The study was conducted using an exploratory approach ingrained within a pragmatic philosophy. The methodology was designed longitudinally in three phases using quantitative and qualitative methods to collect data. The Organisational Change Readiness Assessment was used to analyse organisational readiness. 35 stakeholders (66%) filled in the questionnaire. Most of the healthcare professionals showed impartiality towards the change effort, with the Working Group (WG) being the most aligned and the Pharmacists least in favour. Observations of the chemotherapy process and interviews with the chairperson of the WG were conducted over a seven-month period, with an outcome evaluation conducted at the end. Process mapping of the sequence and the flow of the steps of the process, and their interactions was conducted. A needs assessment and gap analysis were conducted and these identified issues with the workflow, problems with resources, gaps in training, and lack of stakeholder alignment. The interviews with the chairperson of the WG involved the sharing of results from the study to support decision-making, and gathering of the management perspective along the study period. A change model for the CMS was proposed, consisting of six interconnected aspects in five implementation steps, developed from the literature and the results of this study. Some of the tools identified in the literature were utilised in this study and showed to have worked to carry out evidence-based change management process. The proposed model was found to be applicable for digitalisation of the CMS and the model and tools can be applied for further rollout of the medicines management system across the hospital. The themes identified can also be applied for other digitisation projects.