The SDLC is crucial to the outcomes of the software and systems in use in a health care facility. The use of the software is dependent on its users and their preparedness, as well as their capabilities. Failing to involve nurses in the SDLC, yet they are the target end-users of the system amounts to a design and project management failure (McMurtrey, 2013). It leads to an increased level of user frustration, possible resistance in the adoption of the new system, and limited functionality due to the resulting distress.
Nurses are experts in the field of patient care, and if a technology is to have positive effects on patient care, then the technologists implementing it must involve nurses in the process of developing it (Kaipio et al., 2020). The reason for involving the nurses is to facilitate a smooth transition from the deployment to the training of users and eventually to the transformation of the organization because of the new system. Apart from increasing the buy-in for the new development, the approach will also allow nurses to have input into the development process. As with many projects, change requests that come early before the commencement of tasks that are critical to the project might be easier to incorporate. Failing to involve nurses would mean that the developers lack insights into the types of routines the nurses have in their patient, caring jobs (Restuccia et al., 2012). These routines and the philosophy behind them affect the manner of working with technology, the need for information, and the collaboration demands and opportunities in the workplace.
It is vital to map the work processes of the nurse in the legacy system and the technology-enhanced system. The mapping must happen in tandem with the designing process. The leading manager in the SDLC should ensure that the details of all users are the ones used for the design process (McLean et al., 2015). Getting firsthand information and possible trials in the real world make better data for decision making than projects that might rely on wrong assumptions. The involvement of nurses should improve organization learning during the implementation and when using the new program or system.
A specific example showing nurse involvement in the SDLC was in the introduction of the bar-code system in a midsized hospital where I worked. The first part of the implementation was to offer an overview of the system and its benefits to the organization. After that, the organization organized forums and allocated times for attendance for all staff, away from regular work. The forums worked like tutorials and question and answer sessions as well as discussion avenues about the new system. The implementing team learned of people’s fears, the problems with the current system, and the challenges users expected. They also learned of new concerns arising because of the design and the management expectations of the bar-coding infrastructure.
Being involved in the process to offer suggestions and to vote of features to include or leave out, as well as when to include them in the system, was an essential step in staff involvement. Most of the staff members ended up anticipating the completion of the project, and they were eager to try new features when they became live. The increased communication also leads to a faster turnaround for the challenges that emerged and were reported by the participating employees. It was also easy to prioritize the changes and the raised issues based on the earlier voted order of priority of user issues in the project.
Kaipio, J., Kuusisto, A., Hyppönen, H., Heponiemi, T., & Lääveri, T. (2020). Physicians’ and nurses’ experiences on EHR usability: Comparison between the professional groups by the employment sector and system brand. International Journal of Medical Informatics, 134, 104018. https://doi.org/10.1016/j.ijmedinf.2019.104018
McLean, A., Frisch, N., & Roudsari, A. (2015). Nursing’s voice in healthcare IT acquisition decisions. Canadian Journal of Nursing Informatics, 10(3). http://cjni.net/journal/?p=4248
McMurtrey, M. (2013). A case study of the application of the systems development life cycle (SDLC) in 21st-century health care: Something old, something new? Journal of the Southern Association for Information Systems, 1(1). https://doi.org/10.3998/jsais.11880084.0001.103
Restuccia, J. D., Cohen, A. B., Horwitt, J. N., & Shwartz, M. (2012). Hospital implementation of health information technology and quality of care: are they related? BMC Medical Informatics and Decision Making, 12(1), 101–109. https://doi.org/10.1186/1472-6947-12-109
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