Understanding the dynamics of information technology implementation: The case of clinical information systems

The ultimate intent of this dissertation was to broaden and strengthen our understanding of IT implementation by emphasizing research efforts on the dynamic nature of the implementation process. More specifically, efforts were directed toward opening the "black box" and providing the story that explains how and why contextual conditions and implementation tactics interact to produce project outcomes. In pursuit of this objective, the dissertation was aimed at theory building and adopted a case study methodology combining qualitative and quantitative evidence. Precisely, it examined the implementation process, use and consequences of three clinical information systems at Jackson Memorial Hospital, a large tertiary care teaching hospital.^ As a preliminary step toward the development of a more realistic model of system implementation, the study proposes a new set of research propositions reflecting the dynamic nature of the implementation process.^ Findings clearly reveal that successful implementation projects are likely to be those where key actors envision end goals, anticipate challenges ahead, and recognize the presence of and seize opportunities. It was also found that IT implementation is characterized by the systems theory of equifinality, that is, there are likely several equally effective ways to achieve a given end goal. The selection of a particular implementation strategy appears to be a rational process where actions and decisions are largely influenced by the degree to which key actors recognize the mediating role of each tactic and are motivated to action. The nature of the implementation process is also characterized by the concept of "duality of structure," that is, context and actions mutually influence each other. Another key finding suggests that there is no underlying program that regulates the process of change and moves it form one given point toward a subsequent and already prefigured end. For this reason, the implementation process cannot be thought of as a series of activities performed in a sequential manner such as conceived in stage models. Finally, it was found that IT implementation is punctuated by a certain indeterminacy. Results suggest that only when substantial efforts are focused on what to look for and think about, it is less likely that unfavorable and undesirable consequences will occur. ^

The eye of the beholder: The impact of a district implementation plan of state mandates as perceived by the implementers

The purpose of this inquiry was to investigate the impact of a large, urban school district's experience in implementing a mandated school improvement plan and to examine how that plan was perceived, interpreted, and executed by those charged with the task. The research addressed the following questions: First, by whom was the district implementation plan designed, and what factors were considered in its construction? Second, what impact did the district implementation plan have on those charged with its implementation? Third, what impact did the district plan have on the teaching and learning practices of a particular school? Fourth, what aspects of the implemention plan were perceived as most and least helpful by school personnel in achieving stated goals? Last, what were the intended and unintended consequences of an externally mandated and directed plan for improving student achievement? The implementation process was measured against Fullan's model as expounded upon in The Meaning of Educational Change (1982) and The New Meaning of Educational Change (1990). The Banya implementation model (1993), because it added a dimension not adequately addressed by Fullan, was also considered.^ A case study was used as the methodological framework of this qualitative study. Sources of data used in this inquiry included document analysis, participant observations in situ, follow-up interviews, the "long" interview, and triangulation. The study was conducted over a twelve-month period. Findings were obtained from the content analysis of interview transcripts of multiple participants. Results were described and interpreted using the Fullan and Banya models as the descriptive framework. A cross-case comparison of the multiple perspectives of the same phenomena by various participants was constructed.^ The study concluded that the school district's implementation plan to improve student achievement was closely aligned to Fullan's model, although not intentionally. The research also showed that where there was common understanding at all levels of the organization as to the expectations for teachers, level of support to be provided, and availability of resources, successful implementation occured. The areas where successful implementation did not occur were those where the complexity of the changes were underestimated and processes for dealing with unintended consequences were not considered or adequately addressed. The unique perspectives of the various participants, from the superintendent to the classroom teacher, are described. Finally, recommendations for enhancement of implementation are offered and possible topics for further research studies are postulated. ^

An examination of attitude toward change as a predictor of policy/program implementation

Policy/program implementation, e.g., the process of fulfilling policy/program directives, is fundamentally tied to change. Implementation studies have examined the process, identifying many critical organizational variables although individuals perform the activities.^ Many of the studies are predicated on the rational, goal oriented model of organizations and examine implementation, presenting only the goal-oriented view. Organizational change and its resistance, however, are not fully explained by the rational model of organizations. There are other schools of thought providing different views of organizations from which explanation may emerge. Bolman and Deal (1984, 1991a, 1994) provide a different perspective for examining organizations Bolman and Deal argue organizations should be viewed through four different frames or lenses. Framing and reframing organizational action captures the complexity of action and provides better understanding of organizational processes. Understanding of implementation of policies/programs also will benefit from the use of the four-frame approach.^ The goal of this research is to provide a better understanding of the implementation process by examining individual attitudes toward change, the dependent variable of this research, and studying the relationship between the dependent variable and frame. The research was conducted in two phases. In Phase One, a survey was sent to 306 school administrators and teachers in magnet programs in Dade County, Florida. The survey instrument was composed of 55 questions including six from Bolman and Deal's Leadership Orientation Survey (1988) and 38 questions about organizational change. In Phase Two, more in-depth analysis of four school was conducted, to further explore the relationship between frame and attitude toward change.^ The results revealed that frame was a factor in explaining differences in personal Attitude Toward Change and Comfort Level with Change. Individuals using the symbolic frame had more positive attitudes toward change and were also more comfortable with change. The results of Phase Two of the research partially supported this finding in that the most fully implemented program was the product of an administrator who had chosen the symbolic frame. ^

Office of Information Technology

Outline detailing the planning and implementation process for the establishment of the College of Medicine's Office of Information Technology. Includes a timeline of the Office of IT's development, a strategic roadmap, and a technology analysis.

Truancy reduction: Extension of a county program

The primary purpose of this research was to examine the effect of the Truancy Intervention Program (TIP) on attendance patterns of elementary school students. Longitudinal archival data were used from Miami-Dade County Public School system's data system, ISIS. Data included the students' school information from fifth through ninth grade for attendance, academic grades, referral information, and referral consequences. The sample for this study was drawn from students at TIP-participating M-DCPS elementary schools in Miami-Dade County. Data collected spanned five years for each participant from the fifth grade to the ninth grade. To examine the effect of TIP on attendance, participation in middle school TIP was compared with non-TIP participation. In addition to immediate effects on attendance, the durability of the effects of TIP was studied through an analysis of attendance at the ninth grade level. A secondary purpose was to examine the relation of TIP participation to Grade Point Average (GPA). ^ The data were analyzed using 2 (group) x 3 (grade) Repeated Measures Analysis of Variance (ANOVA) on yearly attendance (number of absences), and grade point average for each year. The interaction between group and grade was significant. Post hoc tests indicated that absences were not significantly different in the two programs in seventh, eighth or ninth grade. Students enrolled in a middle school with TIP showed a significantly higher number of absences in ninth grade than for seventh or eighth grade. There were no differences by grade level for students enrolled in non-TIP middle schools. GPA analysis indicated that students enrolled in a non-TIP middle school had a significantly higher GPA across seventh, eighth, and ninth grades when compared to students enrolled at a TIP middle school. ^ An examination of attendance disciplinary referrals and consequences further revealed that the referral rates for students enrolled at a TIP middle school were higher at the seventh, eighth, and ninth grade level, then for students enrolled at a non-TIP middle school. This pattern was not readily apparent at non-TIP middle schools. Limitations of the research were noted and further research regarding program implementation (process evaluation) was suggested. ^

Assessing administrative and political factors in implementing a living wage ordinance

Since 2000, the number of living wage ordinances has steadily increased throughout the country. While most of the current research has focused on the beneficial outcomes of living wages, little has been published on their administrative practices. To address this shortcoming, this study focused on the identification of key administrative and political factors involved impacting the implementation of living wage ordinances in Miami-Dade and Broward Counties. The study utilized a triangulation of interviews, surveys, and direct observation. The author conducted interviews of administrators and members of the living wage oversight boards in both counties and observed the monthly meetings held by each county's oversight board from January 2006 to June 2007. These findings were buttressed with a national survey of senior staff in other living wage communities. The study utilized descriptive statistics, Chi Square, Cronbach's Alpha, and Spearman's Rank Correlation Coefficient (Spearman's rho). Interviews indicated that administrators in Dade and Broward are seriously under-staffed and budgeted. Ambiguities in the enabling ordinances have lead to loopholes that undermine implementation and accountability for participating contractors. Survey results showed that policy ambiguity, organizational politics, and a lack of organizational capacity were significant negative factors in the implementation process while an organizational culture emphasizing consistent enforcement was a positive factor. Without the proper inputs, an organization hinders itself from meeting its outputs and outcomes. This study finds that Broward and Miami-Dade Counties do not provide the necessary administrative support to implement a living wage effectively – in stark contrast to the high hopes and strong political support behind their passage. For a living wage to succeed, it first needs an organizational culture committed to providing the necessary resources for implementation as well as transparent, consistent accountability mechanisms.

Assessing Administrative and Political Factors in Implementing a Living Wage Ordinance

Since 2000, the number of living wage ordinances has steadily increased throughout the country. While most of the current research has focused on the beneficial outcomes of living wages, little has been published on their administrative practices. To address this shortcoming, this study focused on the identification of key administrative and political factors involved impacting the implementation of living wage ordinances in Miami-Dade and Broward Counties. The study utilized a triangulation of interviews, surveys, and direct observation. The author conducted interviews of administrators and members of the living wage oversight boards in both counties and observed the monthly meetings held by each county’s oversight board from January 2006 to June 2007. These findings were buttressed with a national survey of senior staff in other living wage communities. The study utilized descriptive statistics, Chi Square, Cronbach’s Alpha, and Spearman’s Rank Correlation Coefficient (Spearman’s rho). Interviews indicated that administrators in Dade and Broward are seriously under-staffed and budgeted. Ambiguities in the enabling ordinances have lead to loopholes that undermine implementation and accountability for participating contractors. Survey results showed that policy ambiguity, organizational politics, and a lack of organizational capacity were significant negative factors in the implementation process while an organizational culture emphasizing consistent enforcement was a positive factor. Without the proper inputs, an organization hinders itself from meeting its outputs and outcomes. This study finds that Broward and Miami-Dade Counties do not provide the necessary administrative support to implement a living wage effectively – in stark contrast to the high hopes and strong political support behind their passage. For a living wage to succeed, it first needs an organizational culture committed to providing the necessary resources for implementation as well as transparent, consistent accountability mechanisms.

More than Metadata: Where the Rubber Meets the Road in DLS Migration

This panel presentation provided several use cases that detail the complexity of large-scale digital library system (DLS) migration from the perspective of three university libraries and a statewide academic library services consortium. Each described the methodologies developed at the beginning of their migration process, the unique challenges that arose along the way, how issues were managed, and the outcomes of their work. Florida Atlantic University, Florida International University, and the University of Central Florida are members of the state's academic library services consortium, the Florida Virtual Campus (FLVC). In 2011, the Digital Services Committee members began exploring alternatives to DigiTool, their shared FLVC hosted DLS. After completing a review of functional requirements and existing systems, the universities and FLVC began the implementation process of their chosen platforms. Migrations began in 2013 with limited sets of materials. As functionalities were enhanced to support additional categories of materials from the legacy system, migration paths were created for the remaining materials. Some of the challenges experienced with the institutional and statewide collaborative legacy collections were due to gradual changes in standards, technology, policies, and personnel. This was manifested in the quality of original digital files and metadata, as well as collection and record structures. Additionally, the complexities involved with multiple institutions collaborating and compromising throughout the migration process, as well as the move from a consortial support structure with a vendor solution to open source systems (both locally and consortially supported), presented their own sets of unique challenges. Following the presentation, the speakers discussed commonalities in their migration experience, including learning opportunities for future migrations.

The design, implementation and production process of creating a viable series of Latin shows in Hollywood, Florida

The purpose of this research was to design and implement a Series of Latin Shows to be featured at the Satine Restaurant located in The Diplomat Hotel in Hollywood, Florida. Three shows were created: "Electro Tango," "Bossa Nova Jazz," and "Piel Canela Night" to help generate interest for not only the Satine Restaurant but also for the surrounding area. The artistic concept included big bands, costumes, dancers and a DJ. A production book was created and included the most important aspects of the individual shows such as budgets, costumes, and ground plans, to assure the success of each event. Careful analysis was done for the demographic area and a marketing plan was designed and implemented. The research and practical application of similar shows in the industry determined that the production of these particular shows, although costly, have a qualifiable chance to succeed in this venue.

Development and implementation of a tool to assess the micro/macro elements in an organization

This study examines the congruency of planning between organizational structure and process, through an evaluation and planning model known as the Micro/Macro Dynamic Planning Grid. The model compares day-to-day planning within an organization to planning imposed by organizational administration and accrediting agencies. A survey instrument was developed to assess the micro and macro sociological analysis elements utilized by an organization.^ The Micro/Macro Dynamic Planning Grid consists of four quadrants. Each quadrant contains characteristics that reflect the interaction between the micro and macro elements of planning, objectives and goals within an organization. The Over Macro/Over Micro, Quadrant 1, contains attributes that reflect a tremendous amount of action and ongoing adjustments, typical of an organization undergoing significant changes in either leadership, program and/or structure. Over Macro/Under Micro, Quadrant 2, reflects planning characteristics found in large, bureaucratic systems with little regard given to the workings of their component parts. Under Macro/Under Micro, Quadrant 3, reflects the uncooperative, uncoordinated organization, one that contains a multiplicity of viewpoints, language, objectives and goals. Under Macro/Under Micro, Quadrant 4 represents the worst case scenario for any organization. The attributes of this quadrant are very reactive, chaotic, non-productive and redundant.^ There were three phases to the study: development of the initial instrument, pilot testing the initial instrument and item revision, and administration and assessment of the refined instrument. The survey instrument was found to be valid and reliable for the purposes and audiences herein described.^ In order to expand the applicability of the instrument to other organizational settings, the survey was administered to three professional colleges within a university.^ The first three specific research questions collectively answered, in the affirmative, the basic research question: Can the Micro/Macro Dynamic Planning Grid be applied to an organization through an organizational development tool? The first specific question: Can an instrument be constructed that applies the Micro/Macro Dynamic Planning Grid? The second specific research question: Is the constructed instrument valid and reliable? The third specific research question: Does an instrument that applies the Micro/Macro Dynamic Planning Grid assess congruency of micro and macro planning, goals and objectives within an organization? The fourth specific research question: What are the differences in the responses based on roles and responsibilities within an organization? involved statistical analysis of the response data and comparisons obtained with the demographic data. (Abstract shortened by UMI.) ^

A qualitative analysis of the lived experience of nursing staff developers in the process of changing to a new educational model

The purpose of this study was to document and critically analyze the lived experience of selected nursing staff developers in the process of moving toward a new model for hospital nursing education. Eleven respondents were drawn from a nation-wide population of about two hundred individuals involved in nursing staff development. These subjects were responsible for the implementation of the Performance Based Development System (PBDS) in their institutions.^ A purposive, criterion-based sampling technique was used with respondents being selected according to size of hospital, primary responsibility for orchestration of the change, influence over budgetary factors and managerial responsibility for PBDS. Data were gathered by the researcher through both in-person and telephone interviews. A semi-structured interview guide, designed by the researcher was used, and respondents were encouraged to amplify on their recollections as desired. Audiotapes were transcribed and resulting computer files were analyzed using the program "Martin". Answers to interview questions were compiled and reported across cases. The data was then reviewed a second time and interpreted for emerging themes and patterns.^ Two types of verification were used in the study. Internal verification was done through interview transcript review and feedback by respondents. External verification was done through review and feedback on data analysis by readers who were experienced in management of staff development departments.^ All respondents were female, so Gilligan's concept of the "ethic of care" was examined as a decision making strategy. Three levels of caring which influenced decision making were found. They were caring: (a) for the organization, (b) for the employee, and (c) for the patient. The four existentials of the lived experience, relationality, corporeality, temporality and spatiality were also examined to reveal the everydayness of making change. ^

Profile of planning: A study of a three-year project on the implementation of collaborative library media programs

The implementation of collaborative planning and teaching models in ten flexibly scheduled elementary and middle school library media centers was studied to determine which factors facilitated the collaborative planning process and to learn what occurs when library media specialists (LMSs) and classroom teachers (CTs) plan together. In this qualitative study, 61 principals, CTs, and LMSs were interviewed on a range of topics including the principal's role, school climate, the value of team planning, the importance of information literacy instruction, and the ideal learning environment. Other data sources were observations, videotapes of planning sessions, and documents. This three-year school reform effort was funded by the Library Power Project to improve library programs, to encourage collaborative planning, and to increase curricular integration of information literacy skills instruction. ^ The findings included a description of typical planning sessions and the identification of several major factors which impacted the success of collaborative planning: the individuals involved, school climate, time for planning, the organization of the school, the facility and collection, and training. Of these factors, the characteristics and actions of the people involved were most critical to the implementation of the innovation. The LMS was the pivotal player and, in the views of CTs, principals, and LMSs themselves, must be knowledgeable about curriculum, the library collection, and instructional design and delivery; must be open and welcoming to CTs and use good interpersonal skills; and must be committed to information literacy instruction and willing to act as a change agent. The support of the principal was vital; in schools with successful programs, the principal served as an advocate for collaborative planning and information literacy instruction, provided financial support for the library program including clerical staff, and arranged for LMSs and CTs to have time during the school day to plan together. ^ CTs involved in positive planning partnerships with LMSs were flexible, were open to change, used a variety of instructional materials, expected students to be actively involved in their own learning, and were willing to team teach with LMSs. Most CTs planning with LMSs made lesson plans in advance and preferred to plan with others. Also, most CTs in this study planned with grade level or departmental groups, which expedited the delivery of information literacy instruction and the effective use of planning time. ^ Implications of the findings of this research project were discussed for individual schools, for school districts, and for colleges and universities training LMSs, CTs, and administrators. Suggestions for additional research were also included. ^

A qualitative case study of teacher perceptions and concerns during the implementation of literacy folders in a select elementary school in Broward County, Florida

Classroom teachers are often required to implement new procedures or practices in response to local or federal education mandates. Attempts to implement innovations, often do not take into account the personal side of change; the perceptions, concerns and needs of those required to implement the innovation. One innovation that was required by the School Board of Broward County, Florida for all elementary classroom teachers was the implementation of Literacy Folders. ^ This study attempted to address the personal side of change by identifying teacher concerns during the implementation of Literacy Folders in a select elementary school in Broward County Florida. The Concerns Based Adoption model (CBAM) for change was used as the conceptual framework for this qualitative case study. ^ Sources of data for this study included participant interviews, observations and analysis of documents. Informal conversations with the participants and unscheduled classroom visits were also sources of data. Seven classroom teachers were interviewed using a predesigned interview guide developed based on the CBAM of change, specifically the Stages of Concern Dimension. Participant responses were coded into two categories, (a) recollections of past perceptions, and (b) present perceptions regarding the innovation. ^ Data analysis resulted in the emergence of one major theme and two subordinate themes. The themes were related to time and purpose of the innovation. The researcher also discovered that the participants exhibited responses typically representative of the CBAM for individuals who are in the process of adjusting to a new innovation. ^ Recommendations based on participant concerns are made for improving the implementation of the innovation. Recommendations for alternatives to the innovation and suggestions regarding areas for further research in the field of educational change are also made. ^

Parent involvement on school advisory councils: A process evaluation at the middle school level

Increasing parental involvement was made an important goal for all Florida schools in educational reform legislation in the 1990's. A forum for this input was established and became known as the School Advisory Council (SAC). To demonstrate the importance of process and inclusion, a south Florida school district and its local teacher's union agreed on the following five goals for SACs: (a) to foster an environment of professional collaboration among all stakeholders, (b) to assist in the preparation and evaluation of the school improvement plan, (c) to address all state and district goals, (d) to serve as the avenue for authentic and representative input from all stakeholders, and (e) to ensure the continued existence of the consensus-building process on all issues related to the school's instructional program. ^ The purpose of this study was to determine to what extent and in what ways the parent members of one south Florida middle school's SAC achieved the five district goals during its first three years of implementation. The primary participants were 16 parents who served as members of the SAC, while 16 non-parent members provided perspective on parent involvement as “outside sources.” Being qualitative by design, factors such as school climate, leadership styles, and the quality of parental input were described from data collected from four sources: parent interviews, a questionnaire of non-parents, researcher observations, and relevant documents. A cross-case analysis of all data informed a process evaluation that described the similarities and differences of intended and observed outcomes of parent involvement from each source using Stake's descriptive matrix model. A formative evaluation of the process compared the observed outcomes with standards set for successful SACs, such as the district's five goals. ^ The findings indicated that parents elected to the SACs did not meet the intended goals set by the state and district. The school leadership did not foster an environment of professional collaboration and authentic decision-making for parents and other stakeholders. The overall process did not include consensus-building, and there was little if any input by parents on school improvement and other important issues relating to the instructional program. Only two parents gave the SAC a successful rating for involving parents in the decision-making process. Although compliance was met in many of the procedural transactions of the SAC, the reactions of parents to their perceived role and influence often reflected feelings of powerlessness and frustration with a process that many thought lacked meaningfulness and productivity. Two conclusions made from this study are as follows: (a) that the role of the principal in the collaborative process is pivotal, and (b) that the normative-re-educative approach to change would be most appropriate for SACs. ^

A case study: Perceptions of the induction process of intern principals in Broward County Public Schools

The case study is a qualitative study of the perceptions of a purposeful sample of intern principal participants in Broward County Public School's 2001-2003 principal leadership induction program through survey, interview and document analysis of their experiences concerning their success or failure in achieving the position of principal. The study focused on constructs of professional and organizational socialization and instructional leadership that research suggests are vital and integrated components of the effective development of aspiring instructional leaders. ^ The findings revealed that purposeful mentoring, a variety of site placement, hands on practical experiences, in addition to the quality of experience measured by the number of years prior experience are positively reported to affect the degrees of success perceived by intern principals. The study validated the interrelatedness of the three constructs professional and organizational socialization and instructional leadership as components that are realized in the development process through formal and informal characteristics of socialization. The data gathered would be of benefit to principal leadership program designers to assist in their understanding of participants' successes and failures that influence individual needs based on their experience as perceived by this group. ^ Implications for further study are the need for better understanding of leadership development, continued reinforcement of best practices such as mentoring, site shadowing and coaching, clarification of the administrator's role, data analysis, curriculum implementation and student achievement. Organizations need to implement a common set of expectations, reasoning, attitudes, and understanding of purpose that guide behaviors. Recommendations are to design leadership induction programs to meet individual strengths and weaknesses not a one-size-fits-all program including a constructive and prescriptive two-way feedback system, select and assign mentors based on their expertise and candidate needs, varied site placements, develop skills to build collaborative relationships, and a standards based monitoring and assessment system to document program mastery and completion. ^