Complements or Substitutes? Culture–Technology Interactions in Healthcare

Abstract

The U.S. government recommends that hospitals adopt Computerized Provider Order Entry (CPOE) systems to improve the quality problems that plague U.S. hospitals. However, CPOE studies show mixed results. We hypothesize that CPOE effectiveness depends on the prevalence of patient safety culture within a hospital. Using organizational information processing theory, we describe how patient safety culture and CPOE enable healthcare organizations to better process information. Specifically, we posit that CPOE complements some aspects of patient safety culture and substitutes for others. Using ridge regression, we empirically test this proposition using data from 268 hospitals and multiple data sources. Results show that while CPOE complements the patient safety dimensions of handoffs and transitions, feedback and communication about error, and organizational learning, CPOE substitutes for the dimension of management support for safety, in the context of our dependent variable. As organizations work to implement new systems, this research can help decision-makers understand how culture impacts such initiatives and account for culture when anticipating effects.

Supply Chain Disruptions and Business Continuity: An Empirical Assessment

“…We found OIPT to be particularly useful in explaining the phenomenon studied here because of its ability to explain ways in which BCPs can improve firm performance by liming the “information gap,” or the gap between expected and information possessed by the firm (Galbraith, ; Daft & Lengel, ; Queenan et al., ). Depicting BCPs as a way to reduce the information gap is particularly helpful in explaining disruption management (i.e., crisis management in production settings, also referred to as response and recovery).…”

“…OIPT argues that firms perform better by reducing the gap between the information required to perform their tasks and the amount of information already possessed by the organization (Galbraith, ). We contend that BCP changes an organization's ability to process information to reduce the “information gap” and in turn, make better decisions and improve outcomes (Queenan et al., ).…”

“…According to OIPT, companies that reduce their need for information processing or increase the capacity to process information can improve their performance (Galbraith, 1974;Handley & Benton, 2013;Queenan et al, 2016). OIPT identifies three main concepts: information processing needs, information processing capability, and the fit between the two (Galbraith, 1974).…”

“…Although seminal work in SCT suggests that a flexible orientation is effective in the face of uncertain and volatile situations (Burns & Stalker, ), others find a procedural orientation to be effective in such settings (Chenhall, ; Sine, Mitsuhashi, & Kirsch, ). OIPT suggests that organizations need to match their information processing capabilities with expectations of their operating environment by reducing the gap between the necessary and the available information (Galbraith, ; Queenan, Kull, & Devaraj, ). As will be explained in upcoming sections, BCPs can play a pivotal role in reducing the information gap through several knowledge‐enhancing attributes that improve transforming and interpreting data and help with dissemination data across the organization (Daft & Lengel, ; Queenan et al., ).…”

“…OIPT suggests that organizations need to match their information processing capabilities with expectations of their operating environment by reducing the gap between the necessary and the available information (Galbraith, 1974;Queenan, Kull, & Devaraj, 2016). As will be explained in upcoming sections, BCPs can play a pivotal role in reducing the information gap through several knowledge-enhancing attributes that improve transforming and interpreting data and help with dissemination data across the organization (Daft & Lengel, 1986;Queenan et al, 2016).…”