MANAGING A CHANGE IN THE IMPLEMENTATION OF AN ELECTRONIC MEDICAL RECORD IN HOSPITALS: HEAD NURSES’ ROLE AS CHANGE LEADERS – A NARRATIVE LITERATURE REVIEW
MANAGING A CHANGE IN THE IMPLEMENTATION OF AN ELECTRONIC MEDICAL RECORD IN HOSPITALS: HEAD NURSES’ ROLE AS CHANGE LEADERS – A NARRATIVE LITERATURE REVIEW

Author(s): Malka Yakutilov
Subject(s): Politics / Political Sciences, Social Sciences
Published by: Editura Universităţii »Alexandru Ioan Cuza« din Iaşi
Keywords: Electronic Medical Record (EMR); head nurses; organizational change; implementation strategies; change management in nursing;
Summary/Abstract: The implementation of an electronic medical record (EMR) in hospitals constitutes a process of complex organizational change, integrating technological, procedural, and cultural aspects. Nursing staffs, particularly head nurses, are at the front of the process, being the largest professional group in the healthcare system and main users of clinical recording systems. Despite their centrality, many head nurses are required to lead the implementation process without any designated training or formal preparation for change management. This narrative review explores head nurses’ role in the promotion of EMR systems implementation, with a focus on management challenges and successful action methods. The review has identified recurrent barriers, including: staffs’ resistance to change, documentation overload, digital orientation gaps, lack of organizational support, and incompatibility between the system structure and existing work processes. Moreover, the review presents efficient implementation strategies, such as: preliminary involvement of the field, gradual and adapted training, continuous support, open communication, and local adjustment. The paper’s main conclusion is that head nurses should be acknowledged not only as clinical leaders, but also as strategic partners and organizational change agents. Hence, they should be offered structured training, practical management tools, and systemic support. Finally, the review recommends promoting future studies that examine the impact of advanced management training on the implementation quality and stability over time.

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