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HSR&D 2004 National Meeting Abstracts

1030. Clinicians' Perceptions About Implementation of Computerized Protocols at VA-SLC
Shobha Satsangi, BS Pharm, GRECC, Salt Lake City VAMC and University of Utah, CR Weir, GRECC, Salt Lake City VAMC and University of Utah, AH Morris, University of Utah and LDS Hospital, HR Warner, University of Utah

Objectives: Implementation of evidence-based techniques, like computerized protocols, decreases variation in patient care and likelihood of clinical errors. We developed and validated a questionnaire, for assessing VA clinicians’ perceptions about implementation of computerized protocols.

Methods: Drawing from the constructs of a cognitive model that we developed previously, a 35-item questionnaire was administered to 240 clinicians in three health care institutions. Seventy-seven VA clinicians (48 nurses, 20 physicians and 9 respiratory therapists) participated. Principal components analysis was used for extraction of the factors. Comparisons between VA-SLC and two other hospitals were made on the basis of the questionnaire.

Results: We extracted 9 factors explaining 66% of the total variance. ‘Beliefs regarding Self-Efficacy’ (ß=.185, p<0.001) itself explained 26% of the total variance. Other factors were Environmental Support, Role Relevance, Work Identity, Beliefs regarding Control, Behavioral Intention, Information Quality, Social Pressure and Culture. Results supported the reliability and construct validity of the instrument. VA clinicians were significantly different from clinicians at other institutions on the basis of Behavioral Intention (p=0.005) and Culture (p=0.001) and Beliefs regarding Control (p=0.008).

Conclusions: Clinicians’ perceptions are critical in predicting adoption of computerized protocols in routine practice. Building explicit protocols that meet the perceptual needs of clinicians should enable the dissemination of computerized protocols.

Impact: Modification of organizational attributes can enhance readiness to adopt computerized protocols at the VA. This approach provides definition and metrics for factors that influence implementation of computerized protocols among VA clinicians.