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J Am Med Inform Assoc 7:116-124 doi:10.1136/jamia.2000.0070116
  • Cornerstones of Medical Informatics

Managing Change

Table 1

Reasons for Contemporary System Failures

Category Examples
Communication Ineffective outgoing communication
Ineffective listening
Failure to effectively prepare the staff for the new system
Culture Hostile culture within the information systems organization
Hostile culture toward the information systems area
No strategies to nurture or grow a new culture
Underestimation of complexity Missed deadlines and cost overruns
Lost credibility
Scope creep Failure to define and maintain original success criteria
Failure to renegotiate deadlines and resources if criteria do change
Organizational No clear vision for the change
Unintended consequences
Ineffective reporting structure
Staff turnover
Staff competency
Provision of a technical “fix” to a management problem
Lack of full support of “boss(es)”
Roles and responsibilities not clearly defined or understood by everyone
Several people vying to be “in charge”
Adequate resources not available from the beginning
Failure to benchmark existing practices
Inability to measure success
Technology System too technology oriented
Poor procurement
Lure of the leading (bleeding) edge
Inadequate testing
Training Inadequate or poor-quality training
Poor timing of training—too early or too late
Leadership issues Leader too emotionally committed
Leader's time over committed
Too much delegation without control
Failure to get ownership in the effort
Leader's political skills weak
“Lying” to get initial approval

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