RESUMO
OBJECTIVES: This study aims to gain more insight in whether care programming in health care can be supported by IT and what is needed for successful implementation. We evaluated a case where an organization structured its care processes into care programs and used a planning tool for planning and control of the care programs. The results of this evaluation contribute to existing knowledge about the relation between care processes and IT as well as IT implementation. METHOD: We used multiple data sources to support and complete the results. The evaluation of the case took place by means of face-to-face interviews, a document study and analyses of emails. RESULTS AND DISCUSSION: The care programs and the planning tool were not compatible and did not achieve the intended goals. The professionals failed to appreciate flexibility of the care programs. The implementation of the planning tool failed because of too little user involvement in the implementation. Moreover, care programs were in general not accepted by the professionals. All this resulted in a non-fit between the care programs and the planning tool. We advise for routine processes as care programs to develop a balance between flexibility and standardization. This is a process of trial and error and requires adaptive information technology and user involvement in development and implementation.
Assuntos
Serviços de Saúde da Criança , Implementação de Plano de Saúde/métodos , Implementação de Plano de Saúde/estatística & dados numéricos , Assistência Técnica ao Planejamento em Saúde/organização & administração , Atitude do Pessoal de Saúde , Criança , Serviços de Saúde da Criança/organização & administração , Pré-Escolar , Fidelidade a Diretrizes , Humanos , Sistemas de Informação Administrativa/estatística & dados numéricos , Modelos Organizacionais , Estudos de Casos Organizacionais , Assistência Centrada no Paciente/métodos , Assistência Centrada no Paciente/organização & administração , Técnicas de Planejamento , Garantia da Qualidade dos Cuidados de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Recursos HumanosRESUMO
More doctors would like to work parttime. Since research on fitting healthcare system design with the structure of parttime jobs is lacking, we studied how parttime work for medical doctors could be enabled from a system design perspective. A theoretical analysis was performed, illustrated by two case studies. We conclude that introducing parttime work can provide the opportunity for improving system design and, therewith, performance. From the case studies it seems that work redesign can enable parttime work, and at the same time improve system performance. Better managing variability in the system contributed to this. The case studies results also showed that systems characterized by different levels of variability fit with different work contracts.