Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Jacquie Fraser


Policy makers view electronic medical records as a way of increasing efficiency in the U.S. health care system. However, hospital administrators may not have the clinical background to choose a documentation system that helps the health care team safely increase efficiency. The purpose of this case study was to examine health care team members' attitudes and perceptions of quality of care and efficiency amid a documentation system change. The theory of change was the theoretical foundation for the study. The 6 research questions were designed to elicit information about what the health care team experienced when a documentation system changed and how the change affected health care workers' stress level, chance of medical errors, ability to deliver quality care, and attitudes about hospital efficiency. Semi-structured interviews were conducted with the 15 members of a health care team who volunteered from the group and met the inclusion criteria for the study (i.e., employed during the documentation system change). The participants represented all aspects of the health care team to create a bounded case. The interview responses were hand coded to find common themes among the participants. Most participants revealed that the implementation of the new system increased their efficiency and the quality of care they offered to patients. Participants felt that the training and implementation of the system was inadequate and not specific enough for their group. By providing health care administrators with more information about the health care teams' perceptions during a change in documentation systems, they may be able to improve implementation of a new system, creating more sustainable change with less negative impact.