In 2016, online travel sales increased 8%, resulting in profits increasing to over 565 billion U.S. dollars. Traditional travel agencies in brick-and-mortar storefronts are facing challenges related to competing with online travel agencies (OTAs), attracting new customers, and retaining existing customers. The purpose of this qualitative case study was to explore the e-commerce processes, business models, and strategies that leaders of traditional travel agencies use to compete with OTAs. The study sample consisted of 8 travel professionals from 3 small travel agencies located in the mid-Atlantic region of the United States. The conceptual framework for this study was Rogers's diffusion of innovation theory. Data for the study were derived from semistructured interviews, review of travel agency documents and websites, and review of interview transcripts. Data analysis and methodological triangulation included coding, organizing, interpreting, and summarizing data to identify themes. Four themes emerged: the effect of e-commerce on travel agents' performance, competing with online travel agencies, marketing strategies to attract and retain customers, and e-commerce processes used in travel agencies. Fifty percent of travel agents' business declined, and performance decreased because customers used OTAs or e-commerce websites to purchase vacations. Travel agents specialized in niche' travel destinations to compete with OTAs. Travel agents differentiated products and services to attract and retain customers. Leaders may use the findings to develop strategies, improve business processes, and profitability, thereby, increasing revenues, creating jobs, and providing income for families.

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio recordings with these managers were transcribed and analyzed along with interview notes and publicly available documents to identify themes regarding strategies used by managers to successfully upgrade to a compliant EHR system at an MHS. Three major themes emerged: hybrid implementation strategy, training strategy, and social pressure strategy. Results may be used to facilitate the adoption of information technology systems in any industry. Results may directly benefit other MHSs by facilitating successful EHR system transitions. Implications for social change include improved care coordination, reductions in duplicated medical procedures, and more timely and relevant tests for patients through the full use of EHRs.

Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and were supplemented with archival records from the organization's policies and legislated mandates. Participants' responses were coded into invariant constituents, single concepts, and ideas to develop theme clusters. Member checking was used to validate the transcribed data which was subsequently coded into 4 themes that included: access to information, quality of care, training, and reporting implications. Recommendations include increased effectiveness of training provided to health care leaders or the perceptions of the patients as stakeholders in EMR implementation. By using strategies that facilitate seamless movement of information within a digital health care infrastructure, business leaders could benefit from improved reimbursement for services. Implications for social change include progress and transformation in the way health care access is provided.

The electronic health record (EHR) is an important part of the effort to improve health care and reduce costs in the United States. Primary care providers, among the largest group of caregivers in the nation, often experience difficulty with implementation and utilization of EHRs. Efforts to enhance the provider's effectiveness in the use of the EHR should result in improved patient outcomes as well as decreasing the overall cost of health care. Guided by the diffusion of innovation theory, this project was initiated to develop a plan for improved usage of the EHR in a primary care setting. A survey and observations were used to better understand how the providers and staff were using the EHR. Observations and a survey of 11 participants were completed. The observations utilizing a mock patient revealed issues related to the usability of screen information, information availability, and user preference for documentation. The mock patient scenario took 25-35 minutes, on average, to complete. All participants stated they had stayed late to input information on actual clinic patients or to clarify their documentation. The same 11 participants completed the Primary Care Information Project (PCIP) Post-Electronic Health Record Implementation: Survey of Providers responses. Descriptive statistics were used to analyze the results. Most participants indicated that the screen font was difficult to read (72.7%), they had difficulty using the EHR (72.8%) and were not satisfied with its use (63.6%). The project recommendations include working with the vendor to improve information access and ongoing training. Improvements to the EHR should support social change by improving access to information at the point of care, enhancing quality treatment and improving patient care outcomes.

The cost of resolving user requests for IT assistance rises annually. Researchers have demonstrated that data warehouse analytic techniques can improve service, but they have not established the benefit of using global organizational data to reduce reported IT incidents. The purpose of this quantitative, quasi-experimental study was to examine the extent to which IT staff use of organizational knowledge generated from data warehouse analytical measures reduces the number of IT incidents over a 30-day period, as reported by global users of IT within an international pharmaceutical company headquartered in Germany. Organizational learning theory was used to approach the theorized relationship between organizational knowledge and user calls received. Archival data from an internal help desk ticketing system was the source of data, with access provided by the organization under study. The population for this study was all calls logged and linked to application systems registered in a configuration database, and the sample was the top 14 application systems with the highest call volume that were under the control of infrastructure management. Based on an analysis of the data using a split-plot ANOVA (SPANOVA) of Time 1, Time 2, treatment, and nontreatment data, there was a small reduction in calls in the number of reported IT incidents in the treatment group, though the reduction was not statistically significant. Implications for positive social change include reassigning employees to other tasks, rather than continuing efforts in this area, enabling employees to support alternative initiatives to drive the development of innovative therapies benefiting patients and improving employee satisfaction.

Small business owners in a range of industries continually adapt to take advantage of technological developments in accounting, marketing, and communication. The purpose of this multiple case study was to explore strategies that small business owners operating in the central region of North Carolina used to implement information and communication technology (ICT). Roger's diffusion of innovation theory grounded the study. Data collection included face-to-face semistructured interviews with 6 owners of small businesses who successfully implemented ICT, field notes from site observations, and reviews of participant websites. Interviews were transcribed and participants were engaged in member checking. Data were analyzed using Yin's 5-step process, methodological triangulation, and manual coding methods. Three themes emerged: applications, security awareness, and overcoming barriers. The study findings might be of use to owners of small businesses for improving business processes, customer satisfaction, and cost savings. This study might contribute to social change by increasing the sustainability of small businesses in the community, which could drive economic development and improve community relations. Potential implications for effecting positive social change include increasing the rate of small business owners' success in e-commerce and Internet technologies, and increasing the financial security for owners, employees, their families, and communities.

The effects of a technology disaster on an organization can include a prolonged disruption, loss of reputation, monetary damages, and the inability to remain in business. Although much is known about disaster recovery and business continuance, not much research has been produced on how businesses can leverage other technology frameworks to assist information technology disaster recovery. The problem was the lack of organizational knowledge to recover from computer crime interruptions given the maturity level of existing disaster recovery programs. The purpose of this Delphi study was to understand how disaster recovery controls and processes can be modified to improve response to a computer crime caused business interruption. The overarching research question in this study was to understand what factors emerge relative to the ability of disaster recovery programs to respond to disasters caused by computer crimes. The conceptual framework included a maturity model to look at how programs might be improved to respond to the computer crimes threat. Research data were collected from a 3 round Delphi study of 22 disaster recovery experts in the fields of disaster recovery and information security. Results from the Delphi encompass a consensus by the panel. Key findings included the need for planning for cyber security, aligning disaster recovery with cyber security, providing cyber security training for managers and staff, and applying lessons learned from experience. Implications for positive social change include the ability for organizations to return to an acceptable level of operation and continue their service benefiting employees, customers, and other stakeholders.

In natural and manmade disasters, inadequate strategies to recover from satellite communication (SATCOM) failures can affect the ability of humanitarian organizations to provide timely assistance to the affected populations. This single case study explored strategies used by network administrators (NAs) to recover from SATCOM failures in humanitarian operations. The study population were NAs in Asia, the Middle East, Central Africa, East Africa, and West Africa. Data were collected from semistructured interviews with 9 NAs and an analysis of network statistics for their locations. The resource-based view was used as the conceptual framework for the study. Using inductive analysis, 3 themes emerged from coding and triangulation: redundancy of equipment, knowledge transfer, and the use of spare parts to service the SATCOM infrastructure. The findings showed that the organization's use of knowledge, and collaboration among NAs and nontechnical staff improved the organization's ability to recover from SATCOM failures. The implication of this study for social change was the reduced cost of satellite services due to the efficient use of the bandwidth. These savings can be channeled into the purchase of vaccines, shelter, and the improvement in the quality of water and sanitation for displaced persons in humanitarian disasters, which improve the organization's delivery of humanitarian services to the affected populations in the disaster.

Bar Code Medication Administration (BCMA) is a technology-supported nursing tool that has become the standard of practice for medication administration. When used effectively and efficiently, this tool has the potential to reduce medication errors in acute care settings. In a pediatric unit at a major urban hospital in the northeast region of the United States, the absence of a BCMA nursing staff educational module affected the use of this safety tool leading to an increase of medication errors. The purpose of this DNP project was to develop a comprehensive educational module to promote BCMA in the pediatric unit of the hospital. Two theories were used to guide the translation of research into practice. Lewin's theory of planned change was used as a conceptual model to understand human behavior related to change management. Also employed was Benner's novice to expert theory to define the learning process. The research question for this project involved whether a staff education module of BCMA would optimize the medication administration process and prevent medication errors. The research design included an expert panel that used a 5-point Likert scale to evaluate the BCMA education module for clearness, effectiveness, relevance and utilization in practice. Subsequently, the effectiveness of the module was determined through a descriptive analysis. Findings that resulted from the analysis of the evidence revealed 80% percent felt the education module will increase BCMA compliance and all agreed the education module would help identify areas of needed improvement with the current process. The social change of this study will impact nurses to deliver medications safely with the use of BCMA resulting in improved patient outcomes and safe medication administration.

Logistics managers work to create practices that reduce technostress, which is associated with diminished productivity in supply chain management. The purpose of this multiple case study was to explore the mitigation strategies that logistics managers at distribution centers used to reduce technostress with their employees in the Los Angeles County, California area. The conceptual framework included in this study was the sociotechnical systems theory. Semistructured interviews were conducted with 6 logistics managers from large distribution centers who implemented mitigation strategies that demonstrably reduced technostress with their employees. Public documents and physical artifacts reviewed in this study included productivity assessment tools, information and communication technology system training materials, technostress mitigation instruments, and information from technological devices. Data were analyzed through a process of pattern matching, cross-case synthesis, and systematic text condensation. The findings included 6 themes: reliance on internal information technology experts; hiring temporary experts; maintaining communication and training; using time management skills and organizing priorities; identification and understanding of employee differences; and implementing well-being, fitness, and health programs. These findings could contribute to positive social change by providing logistics managers with strategies to reduce technostress, which could lead to improved employee well-being, better work conditions, and increased productivity for greater company profitability that could produce a more thriving and prosperous community.