Discrepancies between Expected and Actual Implementation: The Process Evaluation of PERS Integration in Nursing Homes

Abstract

Recent studies prove that when implementing new technology technology-driven and one-size-fits-all approaches are problematic. This study focuses on the process of implementing personal emergency response system (PERS) at nursing homes. The aim is to understand why the implementation of PERS has not met initial expectations. Multiple methods were used in two Swedish nursing homes, including document analysis, questionnaires (n = 42), participant observation (67 h), and individual interviews (n = 12). A logic model was used to ascertain the discrepancies that emerged between expected and actual implementation, and the domestication theory was used to discuss the underlying meanings of the discrepancies. The discrepancies primarily focused on staff competence, system readiness, work routines, and implementation duration. Corresponding reasons were largely relevant to management issues regarding training, the procurement systems, individual and collective responsibilities as well as invisible work. The uptake of technology in daily practice is far more nuanced than a technology implementation plan might imply. We point out the importance of preparing for implementation, adjusting to new practices, and leaving space and time for facilitating implementation. The findings will be of use to implementers, service providers, and organizational managers to evaluate various measures in the implementation process, enabling them to perform technology implementation faster and more efficiently.

Technology scripts in care practice: A case study of assistant nurses’ use of a social alarm system in Swedish nursing homes

“…Shifting the focus from technology scripts to care practice, there is a long tradition of research which reveals factors affecting the integration of technology into practice, and unanticipated consequences compared to expected outcomes. 14 – 16 However, the question of how technology-mediated care practices are being delivered as practical accomplishments for care provision has been largely unexamined. 17 , 18 A research gap still remains concerning the process through which technology is used in care practices, and healthcare professionals’ considerations of the objectives of care provision during the process.…”

A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: Formative Evaluation Study

“…We positioned this digital platform as an assistive technology to facilitate the care team in personalizing BPSD management. Studies from the perspectives of care research [ 28 , 29 ], anthropology [ 30 ], and gerontology [ 31 ] have pointed out that understanding the interplay between the technology and the context (eg, users) to which it is introduced early on could help in the integration of the technology for regular use in the future. Therefore, this study was conducted to explore the effects of the digital platform as an assistive technology on the facilitation of personalized BPSD management in the daily care practice in a nursing home for a longer period of time.…”

Development Work in Swedish Eldercare: Resources for Trustworthy, Integrated Managerial Work During the COVID-19 Pandemic

“…In fact, one central hindrance to the development and implementation of needed changes in healthcare is deficient practical operationalization of strategies (19)(20)(21) and a lack of vertical alignment within organizations (22). In eldercare, studies have reported challenges regarding vertical alignment due to insufficient resources and followup in the implementation process (20,23,24). To support organizational capability, development leaders (DLs) and change-supporting functions at different organizational levels can support the conversion of resources generated in development projects into improved practice at operational levels (25)(26)(27), i.e., trustworthy management.…”