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    <title language="eng">Understanding Antecedents of Nurses' and Physicians' Workaround Behavior Regarding Hospital Information Systems: Qualitative Interview Study</title>
    <parentTitle language="eng">Journal of Medical Internet Research</parentTitle>
    <identifier type="issn">1438-8871</identifier>
    <identifier type="doi">10.2196/51781</identifier>
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Workarounds are considered negatively when associated with risks and positively when seen as feedback and a source of innovation. Learning about the antecedents of workarounds allows for the establishment of control mechanisms, under the promise of enhanced patient safety.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec sec-type=\"objective\"&gt;\n            &lt;jats:title&gt;Objective&lt;\/jats:title&gt;\n            &lt;jats:p&gt;This study seeks to explore which antecedents shape nurses\u2019 and physicians\u2019 workaround behavior in the context of HISs, how they influence behavior and interrelate, and the intentions with which they are carried out.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec sec-type=\"methods\"&gt;\n            &lt;jats:title&gt;Methods&lt;\/jats:title&gt;\n            &lt;jats:p&gt;Using 26 qualitative interviews with nurses, physicians, and health information technicians from Germany and the United States and applying grounded theory analysis techniques, we identify antecedents of HIS-related workarounds and respective relations.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec sec-type=\"results\"&gt;\n            &lt;jats:title&gt;Results&lt;\/jats:title&gt;\n            &lt;jats:p&gt;From the interview transcripts, we derive 506 open codes which we cluster into 3 direct causes (organizational prerequisites, human factor, and system), and 4 influencing factors (regulations, sector funding, role of software providers, and role of ownership and management). While Influencing Factors constitute higher-level influences, they do not directly impact nurses' and physicians' behavior but rather depict the defaults that lead to conditions for Direct Causes of workarounds.&lt;\/jats:p&gt;\n          &lt;\/jats:sec&gt;\n          &lt;jats:sec sec-type=\"conclusions\"&gt;\n            &lt;jats:title&gt;Conclusions&lt;\/jats:title&gt;\n            &lt;jats:p&gt;This study provides an understanding of the antecedents of workarounds performed by medical personnel regarding HIS use, structures and categorizes them, and lays the foundation for an understanding of users\u2019 deviant behavior. Moreover, by revealing cause-effect relationships between the antecedents, we take on a behavioral perspective and provide a basis for developing effective strategies to prevent the need for workarounds. 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    <author>Eileen Doctor</author>
    <author>Jasmin Hennrich</author>
    <author>Torsten Eymann</author>
    <author>Christoph Buck</author>
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      <value>workaround</value>
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      <language>eng</language>
      <type>uncontrolled</type>
      <value>hospital information system</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>grounded theory</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>qualitative interview</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>time-critical routine</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>hospital</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>ward</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>accuracy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>innovation</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>antecedent</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>patient safety</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>nurse</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>physician</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>behavior</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>health information</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>medical personnel</value>
    </subject>
    <collection role="ddc" number="61">Medizin und Gesundheit</collection>
    <collection role="institutes" number="">Fakultät für Informatik</collection>
    <collection role="persons" number="buck">Buck, Christoph (Prof. Dr.)</collection>
    <collection role="DFG-Fachsystematik" number="205">Medizin</collection>
  </doc>
</export-example>
