Can information technology help ward sisters become ward managers?

AIM: This paper describes an evaluation methodology that focuses on management decisions at the ward level in a hospital. BACKGROUND: Successive governments in the 1990s have provided considerable funds to introduce decision support systems for ward management, but few have been evaluated rigorously. This paper reviews the approaches to systems' evaluation that have been developed. METHODS: Measuring instruments were designed to define and measure management decisions and those organizational factors which affect decision making. The resulting difficulty index was validated in a before-and-after study of ward decision making. FINDINGS: Changes in decision making, after the implementation of a decision support system, were found to relate to the identified organizational factors. CONCLUSION: The evaluation methodology described in this paper showed that the potential benefits of a computerized management system would not be realized unless managers, doctors and nurses carried out an organizational review before implementation and then took joint ownership of the system.