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First published January 28, 2003 as JAMIA PrePrint; doi:10.1197/jamia.M1285
Journal of the American Medical Informatics Association 2003;10(3):244-251
© 2003 American Medical Informatics Association

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Submitted on November 4, 2002
Accepted on December 28, 2002

Clinical team functioning and IT innovation: A study of the diffusion of a point-of-care online evidence system

A. Sophie Gosling PsychD1*, Johanna I. Westbrook PhD1, and Jeffrey Braithwaite PhD2

Affiliation of the authors: 1 Centre for Health Informatics, University of New South Wales, Sydney, Australia; 2 Centre for Clinical Governance Research, University of New South Wales, Sydney, Australia

* To whom correspondence should be addressed.

Objectives To investigate the association between clinical team functioning and diffusion (awareness, use and impact) of a 24 hour online evidence retrieval system. To examine the relationships between clinical team characteristics and the adoption of the online evidence system.

Design 18 clinical teams, comprising 180 clinicians from three Australian hospitals, were identified and studied. Teams were categorized as small (<= 15 members) or large (> 15).

Measurements Clinical team functioning was assessed using the Team Climate Inventory (TCI). Awareness, use and impact of an online evidence retrieval system were measured using a self-administered questionnaire. The relationships between TCI scores and awareness, use and impact were examined using t-tests and one-way ANOVAs. Chi square analyses were used to examine differences between small and large teams. Results were interpreted within a diffusion of innovations framework.

Results Clinical team functioning was not related to awareness or use of the online evidence retrieval system. However, clinical team functioning was significantly associated with the impact of online evidence in terms of reported experience of improved patient care following system use. Clinicians in small teams (<= 15 members) had higher levels of system awareness compared to large (> 15) teams.

Conclusion Team functioning had the greatest impact on the fourth stage of innovation diffusion, the effective use of online evidence for clinical care. This supports Rogers' diffusion of innovation theory, to the effect that different types of communication about an innovation are important at different stages in the diffusion process. Members of small teams were more aware of the system than members of large teams. Team functioning is amenable to improvement through interventions. The findings suggest that the role of team climate in the diffusion of information systems is a promising area for future research.




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