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The rate of technological change within organizations has been fast-tracked by the recent global health crisis and shifting workplace dynamics. As many organizations decide how to best manage the implementation of new technologies, they must also consider the human response, which can facilitate the success of the overall implementation. Complementing the focus of this book (how is change perceived by recipients?), we focus on what is known about how employees respond to technological changes. In this review, we provide a retrospective account of the body of work on this topic. First, we review the types of technological changes that have been studied in relation to broader dimensions of organizational change. Second, we elaborate on theoretical perspectives that have been used, including comparing technology-specific models with broader theoretical approaches. Third, we summarize the antecedent-response relationships that have been examined. We hope that this bird’s-eye view of the field allows scholars to span disciplines and consider aspects related to the design and type of the technology, which have been largely treated as a setting, in future research.
AI harbours considerable potential to improve diagnosis and therapy, enhance access to healthcare, and promote population health. AI-enabled healthcare is increasingly seen as part of the solution needed to address the growing gap between the supply and demand of hospital care. AI is well placed to help us tackle new challenges, though these novel applications are likely to render technology implementation even more complex. Yet, many hospitals within the EU are unprepared for this change. Historically, hospitals have faced multiple challenges when implementing new technologies. This chapter discusses the importance of AI readiness and highlights the benefits and limitations of a new policy tool: an AI Readiness Index for Hospitals (AI-RIH). We conceptualise AI readiness from an organisational perspective and discuss the dual functionality of the AI-RIH. For hospital managers, it could serve as a benchmarking tool. For policy-makers, it can help create targeted technology policies and measure their effectiveness. This chapter also discusses the conceptual challenges of indices and illustrates why a hospital index might provide more policy insights than an aggregated or national index. Finally, we explain how AI readiness can strengthen hospitals’ role as innovators and support the development and deployment of AI.
Emergency department (ED) triage prioritizes patients based on urgency of care, and the Canadian Triage and Acuity Scale (CTAS) is the national standard. We describe the inter-rater agreement and manual overrides of nurses using a CTAS-compliant web-based triage tool (eTRIAGE) for 2 different intensities of staff training.
Methods:
This prospective study was conducted in an urban tertiary care ED. In phase 1, eTRIAGE was deployed after a 3-hour training course for 24 triage nurses who were asked to share this knowledge during regular triage shifts with colleagues who had not received training (n = 77). In phase 2, a targeted group of 8 triage nurses underwent further training with eTRIAGE. In each phase, patients were assessed first by the duty triage nurse and then by a blinded independent study nurse, both using eTRIAGE. Inter-rater agreement was calculated using kappa (weighted κ) statistics.
Results:
In phase 1, 569 patients were enrolled with 513 (90.2%) complete records; 577 patients were enrolled in phase 2 with 555 (96.2%) complete records. Inter-rater agreement during phase 1 was moderate (weighted κ = 0.55; 95% confidence interval [CI] 0.49–0.62); agreement improved in phase 2 (weighted κ = 0.65; 95% CI 0.60–0.70). Manual overrides of eTRIAGE scores were infrequent (approximately 10%) during both periods.
Conclusions:
Agreement between study nurses and duty triage nurses, both using eTRIAGE, was moderate to good, with a trend toward improvement with additional training. Triage overrides were infrequent. Continued attempts to refine the triage process and training appear warranted.
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