Although there is a high risk of failure in the implementation of ICT projects (which appears to extend to health ICT projects), we continue to implement health information systems in order to deliver quality, cost-effective healthcare. The purpose of the research was to participate in and study the change management as a critical success factor in health ICT projects, and to examine people’s responses to change so as to develop understanding and theory that could be used in future change management programmes. The research was conducted within the context of a large infrastructure project that resulted from the emergence of a shared services organisation (from two participating District Health Boards in Auckland, New Zealand). Action research (AR) formed the basis of the methodology used, and provided the foundation for a change management programme: the AR intervention. Grounded theory (GT) was used for some of the data analysis, the generation of themes by means of constant comparison and the deeper examination of the change process using theoretical sampling. AR and GT together supported the development of theory regarding the change process associated with health ICT projects. Health ICT projects were revealed in the findings as exhibiting the properties of complex adaptive systems. This complexity highlighted the art of change management as a critical success factor for such projects. The fabric of change emerged as a composite of processes linked to project processes and organisational processes. The turning point in the change process from the before state to the after state is marked by a capability crisis which requires effective patterns of leadership, sensitive targeting of communication, effective learning, and management of increased workload and diminishing resources during the course of health ICT projects. A well managed capability crisis period as a component of change management can substantially contribute to health ICT project success.

This research examines the application of the ISO 9000 model for quality management in healthcare. Exploratory case study is made of three healthcare provider organisations: community health service; independent practitioner association; Maori health network. Three research models are developed to examine identified gaps and areas of interest in healthcare quality management literature. The first model relates to differences between generic standards and specification standards. The second model relates to the fit of healthcare service delivery systems and ISO 9000. The third model relates to exploration of the linkages and co-ordination of an integrated care delivery network. One proposition and two hypotheses are developed in relation to the models, and are closely associated with gaps in healthcare service quality knowledge. Strong support is found for the first hypothesis though not the second hypothesis, and there are also some unexpected results. There is strong support that the process of implementing the ISO 9000 model will enhance healthcare management performance, even though the outcomes are unpredictable. There are indications supporting the notion that implementation of the ISO 9000 model will increase effective linkages and co-ordination within integrated care delivery networks. The body of evidence accumulated during the study did not, however, permit a valid conclusion regarding the hypothesis. The findings of the study can be extended to other healthcare service areas and through interpretation and extrapolation they add value to healthcare service quality research in general. In particular, the findings of the three case studies in this research suggest that future models for healthcare service quality should include a comprehensive generic model for quality management of individual and integrated healthcare service organisations.

Whole document restricted, see Access Instructions file below for details of how to access the print copy. / Achieving and sustaining business-IT alignment in organisations continues to be a management challenge into the new millennium. As organisations strive toward this end, researchers are attempting to better understand the alignment phenomenon. Empirical research into business-IT alignment is dominated by studies examining the relationship between business strategy, information technology and performance. Investigations into the factors enabling or inhibiting alignment are emerging. This research has traditionally taken a behavioural perspective. There is evidence of little research that examines the issue through a cognitive lens. This thesis builds on and extends the study of business-IT alignment by investigating the cognition of the key stakeholders of the alignment process - business and IS executives. Drawing on Personal Construct Theory (Kelly, 1955), this study uses a cognitive mapping methodology known as the repertory grid technique to investigate two questions: i) is there a positive relationship between business-IT alignment and shared understanding between business and IS executives?; and ii) are there differences in the cognitive maps of business and IS executives in companies that report high business-IT alignment and those that report low business-IT alignment? Shared understanding is defined as cognition that is held in common between and that which is distributed amongst business and IS executives. It is portrayed in the form of a cognitive map for each company. The study proposes that business-IT alignment is directly related to the shared understanding between business and IS executives and that the cognitive maps of these executive groups are less diverse in companies that report a high level of alignment. Eighty business and IS executives from six companies were interviewed. Cognitive maps were elicited from the research participants from which diversity between cognitive maps of business and IS executives are measured. A collective cognitive map was produced to illustrate the quality of the shared understanding in each company. The state of business-IT alignment in each company was also measured. The results of the study suggest that there is a strong positive link between business-IT alignment and shared understanding between business and IS executives. As expected, companies with a high-level of business-IT alignment demonstrate high quality shared understanding between its business and IS executives as measured and portrayed by their collective cognitive maps. The investigation further finds significant diversity in the structure and content of the cognitive maps of these executive groups in companies reporting a low-level of alignment. This study concludes that shared understanding, between business and IS executives, is important to business-IT alignment. Reconciling the diversity in the cognitive maps of business and IS executives is a step toward achieving and sustaining alignment. Practical approaches to developing shared understanding are proposed. A methodology to aid organisations in assessing shared understanding between their business and IS executives is also outlined. Finally research on business-IT alignment continues to be a fruitful and important field of IS research. This study suggests that the most interesting issues are at the interface between cognition and behaviour. The process of business-IT alignment in organisations is characterised by the individuality and commonality in the cognition of key stakeholders, its influence on the behaviour of these members and hence the organisational action taken.

Although there is a high risk of failure in the implementation of ICT projects (which appears to extend to health ICT projects), we continue to implement health information systems in order to deliver quality, cost-effective healthcare. The purpose of the research was to participate in and study the change management as a critical success factor in health ICT projects, and to examine people’s responses to change so as to develop understanding and theory that could be used in future change management programmes. The research was conducted within the context of a large infrastructure project that resulted from the emergence of a shared services organisation (from two participating District Health Boards in Auckland, New Zealand). Action research (AR) formed the basis of the methodology used, and provided the foundation for a change management programme: the AR intervention. Grounded theory (GT) was used for some of the data analysis, the generation of themes by means of constant comparison and the deeper examination of the change process using theoretical sampling. AR and GT together supported the development of theory regarding the change process associated with health ICT projects. Health ICT projects were revealed in the findings as exhibiting the properties of complex adaptive systems. This complexity highlighted the art of change management as a critical success factor for such projects. The fabric of change emerged as a composite of processes linked to project processes and organisational processes. The turning point in the change process from the before state to the after state is marked by a capability crisis which requires effective patterns of leadership, sensitive targeting of communication, effective learning, and management of increased workload and diminishing resources during the course of health ICT projects. A well managed capability crisis period as a component of change management can substantially contribute to health ICT project success.

This research examines the application of the ISO 9000 model for quality management in healthcare. Exploratory case study is made of three healthcare provider organisations: community health service; independent practitioner association; Maori health network. Three research models are developed to examine identified gaps and areas of interest in healthcare quality management literature. The first model relates to differences between generic standards and specification standards. The second model relates to the fit of healthcare service delivery systems and ISO 9000. The third model relates to exploration of the linkages and co-ordination of an integrated care delivery network. One proposition and two hypotheses are developed in relation to the models, and are closely associated with gaps in healthcare service quality knowledge. Strong support is found for the first hypothesis though not the second hypothesis, and there are also some unexpected results. There is strong support that the process of implementing the ISO 9000 model will enhance healthcare management performance, even though the outcomes are unpredictable. There are indications supporting the notion that implementation of the ISO 9000 model will increase effective linkages and co-ordination within integrated care delivery networks. The body of evidence accumulated during the study did not, however, permit a valid conclusion regarding the hypothesis. The findings of the study can be extended to other healthcare service areas and through interpretation and extrapolation they add value to healthcare service quality research in general. In particular, the findings of the three case studies in this research suggest that future models for healthcare service quality should include a comprehensive generic model for quality management of individual and integrated healthcare service organisations.

Whole document restricted, see Access Instructions file below for details of how to access the print copy. / Achieving and sustaining business-IT alignment in organisations continues to be a management challenge into the new millennium. As organisations strive toward this end, researchers are attempting to better understand the alignment phenomenon. Empirical research into business-IT alignment is dominated by studies examining the relationship between business strategy, information technology and performance. Investigations into the factors enabling or inhibiting alignment are emerging. This research has traditionally taken a behavioural perspective. There is evidence of little research that examines the issue through a cognitive lens. This thesis builds on and extends the study of business-IT alignment by investigating the cognition of the key stakeholders of the alignment process - business and IS executives. Drawing on Personal Construct Theory (Kelly, 1955), this study uses a cognitive mapping methodology known as the repertory grid technique to investigate two questions: i) is there a positive relationship between business-IT alignment and shared understanding between business and IS executives?; and ii) are there differences in the cognitive maps of business and IS executives in companies that report high business-IT alignment and those that report low business-IT alignment? Shared understanding is defined as cognition that is held in common between and that which is distributed amongst business and IS executives. It is portrayed in the form of a cognitive map for each company. The study proposes that business-IT alignment is directly related to the shared understanding between business and IS executives and that the cognitive maps of these executive groups are less diverse in companies that report a high level of alignment. Eighty business and IS executives from six companies were interviewed. Cognitive maps were elicited from the research participants from which diversity between cognitive maps of business and IS executives are measured. A collective cognitive map was produced to illustrate the quality of the shared understanding in each company. The state of business-IT alignment in each company was also measured. The results of the study suggest that there is a strong positive link between business-IT alignment and shared understanding between business and IS executives. As expected, companies with a high-level of business-IT alignment demonstrate high quality shared understanding between its business and IS executives as measured and portrayed by their collective cognitive maps. The investigation further finds significant diversity in the structure and content of the cognitive maps of these executive groups in companies reporting a low-level of alignment. This study concludes that shared understanding, between business and IS executives, is important to business-IT alignment. Reconciling the diversity in the cognitive maps of business and IS executives is a step toward achieving and sustaining alignment. Practical approaches to developing shared understanding are proposed. A methodology to aid organisations in assessing shared understanding between their business and IS executives is also outlined. Finally research on business-IT alignment continues to be a fruitful and important field of IS research. This study suggests that the most interesting issues are at the interface between cognition and behaviour. The process of business-IT alignment in organisations is characterised by the individuality and commonality in the cognition of key stakeholders, its influence on the behaviour of these members and hence the organisational action taken.

Although there is a high risk of failure in the implementation of ICT projects (which appears to extend to health ICT projects), we continue to implement health information systems in order to deliver quality, cost-effective healthcare. The purpose of the research was to participate in and study the change management as a critical success factor in health ICT projects, and to examine people’s responses to change so as to develop understanding and theory that could be used in future change management programmes. The research was conducted within the context of a large infrastructure project that resulted from the emergence of a shared services organisation (from two participating District Health Boards in Auckland, New Zealand). Action research (AR) formed the basis of the methodology used, and provided the foundation for a change management programme: the AR intervention. Grounded theory (GT) was used for some of the data analysis, the generation of themes by means of constant comparison and the deeper examination of the change process using theoretical sampling. AR and GT together supported the development of theory regarding the change process associated with health ICT projects. Health ICT projects were revealed in the findings as exhibiting the properties of complex adaptive systems. This complexity highlighted the art of change management as a critical success factor for such projects. The fabric of change emerged as a composite of processes linked to project processes and organisational processes. The turning point in the change process from the before state to the after state is marked by a capability crisis which requires effective patterns of leadership, sensitive targeting of communication, effective learning, and management of increased workload and diminishing resources during the course of health ICT projects. A well managed capability crisis period as a component of change management can substantially contribute to health ICT project success.

Thesis (M.S.I.S.)--Baylor University, 2009. / Includes bibliographical references (p. 59-60).

Thesis (MScEng (Industrial Engineering))--University of Stellenbosch, 2009. / Thesis presented in partial fulfilment of the requirements for the degree of Master of Engineering Science at Stellenbosch University / ENGLISH ABSTRACT: Innovation capability is undoubtedly an essential attribute for organizations that wish to survive and grow in a modern economy. Innovation is however widely misunderstood and subsequently mismanaged. Common misconceptions include that innovation only consists of a single moment of inspiration, and that it is therefore dependent on a single person or department within the organization. In reality the Innovation Process has a distinct life cycle and involves a wide array of roleplayers. Effective innovation management is reliant on efficient cooperation between these role-players. This cooperation however extends beyond collaborative organizational structure, bilateral agreements and partnership contracts. Role-players in the Innovation Process form a Knowledge Supply Chain and should be connected in a way that promotes knowledge exchange between them. Several modern approaches to Knowledge Management are available, but few grasp the complexity of Innovation. A wide variety of knowledge sources and formats exist within a set of parties like those involved in Innovation. The preferred Knowledge Management strategy to accompany the Innovation Process should therefore take a holistic view on knowledge while embracing its dynamic nature. Knowledge Networks provide exactly this approach by encompassing a number of people and resources and the relationships between them. These actors within the network are allowed to capture, transfer and create knowledge for the purpose of creating value. This Knowledge Network is supported by a Knowledge Network Architecture consisting of a combination of organizational and information system tools. On an organizational front, the Knowledge Network Architecture is customized to reach across organizational boundaries, thereby creating the collaborative environment that is needed to support the Innovation Process. By allowing actors from different organizations to join the network, an Integrated Knowledge Network is formed. The Information and Communication Technology element of a Knowledge Network Architecture that suits the needs of the Innovation Process features an online Information System. This Information System employs a network model in its approach to the handling of content and supports all the knowledge transfer and creation processes within the Knowledge Network. Although such an Information System provides a single point of entry to the network’s knowledge base, it may be configured to allow access to individuals from multiple organizations. This functionality links it to the requirements of an Integrated Knowledge Network, thereby combining the elements of the Knowledge Network Architecture to form a solution framework instead of remaining modular tools. Fully supporting the Innovation Process within an Information System Architecture does however involve more than simply connecting role-players and facilitating knowledge management between them. Successful Innovation Management requires an understanding of the full Innovation Life Cycle, and ensuring that a comprehensive roadmap is followed to guide innovation projects that develop within the Integrated Knowledge Network. The required Information System should therefore facilitate an Integrated Knowledge Network, while providing support for the full life cycle of innovation projects that develop within the network. This study develops an architecture specification that functionally describes the aforementioned Information System. Using this architecture specification as a guideline, the Information System is subsequently designed and developed with the use of an online content management toolset and a showcase of the system’s functionality is provided. / AFRIKAANSE OPSOMMING: Innoveringsvermoë is ‘n kritiese eienskap vir organisasies wat poog om in ‘n moderne ekonomie te oorleef en te groei. Innovasie word egter gereeld misverstaan en gevolglik wanbestuur. Algemene wanopvattings sluit in dat Innovasie slegs ‘n oomblik van inspirasie behels en daarom slegs van individue of ‘n enkele departement binne die organisasie afhang. In realiteit word die Innovasieproses deur ‘n definitiewe lewenssikuls gekenmerk en neem ‘n wye verskeidenheid rolspelers daaraan deel. Effektiewe Innovasiebestuur maak tot ‘n groot mate op doeltreffende samewerking tussen bogenoemde rolspelers staat. Hierdie samewerking strek egter verder as kollaboratiewe organisasiestrukture, bilaterale ooreenkomste en gevestigde vennootskappe. Rolspelers in die Innovasieproses vorm ‘n Kennisvoorsieningsketting en moet verbind word op ‘n wyse wat die uitruil van kennis tussen hulle bevorder. Daar is verskeie moderne benaderings tot Kennisbestuur, maar weinig van hierdie strategieë spreek die volle kompleksiteit van Innovasie aan. ‘n Wye verskeidenheid kennisbronne en –formate bestaan tussen ‘n groep rolspelers soos dié wat in die Innovasieproses betrokke is. Die ideale Kennisbestuurstrategie om die Innovasieproses te vergesel moet daarom ‘n holistiese uitkyk op kennis bied en terselfdertyd die dinamiese aard daarvan in ag neem. Kennisnetwerke bied dié benadering deur ‘n aantal persone en hulpbronne, asook die verhoudinge tussen hulle, te omsluit. Hierdie spelers in die netwerk word toegelaat om kennis onderling vas te vang, oor te dra en te skep met die doel om waarde te genereer. Laasgenoemde Kennisnetwerk word ondersteun deur ‘n Kennisnetwerkargitektuur wat uit ‘n kombinasie van organisatoriese en inligtingstelselgereedskap bestaan. Op die organisatoriese front word die Kennisnetwerkargitektuur pasgemaak om oor organisasiegrense te strek. Die kollaboratiewe omgewing wat benodig word om die Innovasieproses te ondersteun, word hierdeur geskep. Deur spelers vanuit verskillende organisasies toe te laat om by die netwerk aan te sluit, word ‘n Geïntegreerde Kennisnetwerk gevorm. Die Inligting- en Kommunikasietegnologie onderafdeling van ‘n Kennisnetwerkargitektuur wat die Innovasieproses pas, sluit onder andere ‘n aanlyn Inligtingstelsel in. Hierdie Inligtingstelsel gebruik ‘n netwerkmodel in sy benadering tot inhoudsbestuur en behoort verder alle kennisoordrag en – skeppingsprosesse binne die Kennisnetwerk te ondersteun. Hoewel so ‘n Inligtingstelsel die ‘n enkele toegangspunt tot die netwerk se kennispoel bied, kan dit opgestel word om toegang aan indiwidue vanuit verskillende organisasies te verleen. Hierdie funksionaliteit koppel dit dus aan die behoeftes van ‘n Geïntegreerde Kennisnetwerk en verenig die verskillende onderafdelings van die Kennisnetwerkargitektuur. Die Kennisnetwerkargitektuur vorm gevolglik ‘n oplossingsraamwerk, eerder as ‘n modulêre gereedskapstel. Om die Innovasieproses volledig binne ‘n Inligtingstelsel te ondersteun verg egter meer as om die onderskeie rolspelers te verbind en kennisbestuur tussen hulle te fasiliteer. Suksesvolle Innovasiebestuur verg begrip vir die volle Innovasielewenssiklus en die gebruik van ‘n omvattende padkaart om innovasieprojekte (wat binne die Geïntegreerge Kennisnetwerk ontwikkel) te lei. Die verlangde Inligtingstelsel fasiliteer dus ‘n Geïntegreerde Kennisnetwerk en ondersteun terselfdertyd die volle lewenssiklus van innovasieprojekte wat uit die netwerk spruit. Hierdie studie ontwikkel ‘n argitektuurspesifikasie wat die bogenoemde Inligtingstelsel op ‘n funksionele vlak beskryf. Met hierdie argitektuurspesifikasie as riglyn, word die Inligtingstelsel met behulp van ‘n aanlyn inhoudsbestuurgereedskapstel ontwerp en ontwikkel. Ten slotte word die stelse se funksionaliteit gedemonstreer.

The technology revolution has transformed the way in which many organisations do their business. The resultant information systems have increased the decision making powers of executives, leading to increased effectiveness and ultimately to improved product delivery. The process of information systems development is, however, complex. Furthermore, it has a poor track record in terms of on-time and within-budget delivery, but more significantly in terms of low user acceptance frequently attributable to poor user requirements specification. Consequently, much attention has been given to the process of requirements elicitation, with both researchers and businessmen seeking new, innovative and effective methods. These methods usually involve large numbers of participants who are drawn from within the client and developer organisations. This is a financially costly characteristic of the requirements elicitation process. Besides information systems, the technology revolution has also brought sophisticated communication technologies into the marketplace. These communication technologies allow people to communicate with one another in a variety of different time and space scenarios. An important spin-off of this is the ability for people located in significantly different geographical locations to work collaboratively on a project. It is claimed that this approach to work has significant cost and productivity advantages. This study draws the requirements elicitation process into the realm of collaborative work. Important project management, communication, and collaborative working principles are examined in detail, and a model is developed which represents these issues as they pertain to the requirements elicitation process. An empirical study (conducted in South Africa) is performed in order to examine the principles of the model and the relationships between its constituent elements. A model of geographically distributed requirements elicitation (GDRE) is developed on the basis of the findings of this investigation. The model of GDRE is presented as a 3-phased approach to requirements elicitation, namely planning, implementation, and termination. Significantly, the model suggests the use of interviews, structured workshops, and prototyping as the chief requirements elicitation methods to be adopted in appropriate conditions. Although a detailed study of communications technology was not performed, this thesis suggests that each individual GDRE implementation requires a different mix of communication technologies to support its implementation.