Identifying Success Factors in Construction Projects: A Case Study

Defining “project success” has been of interest for many years, and recent developments combine multiple measurable and psychosocial factors that add to this definition. There has also been research into success factors, but little research into the causal chains through which success emerges. Following the multi-dimensionality of “success,” this article shows how success factors combine in complex interactions; it describes factors contributing to project performance by a company working on two major construction programs and shows how to map and analyze paths from root causes to success criteria. The study also identifies some specific factors—some generic, some context-dependent—none of these is uncommon but here they come together synergistically.

A case study of an EMR system at a large hospital in India: challenges and strategies for successful adoption

This paper presents an ethnographically inspired interpretive case study of the Electronic Medical Record (EMR) system at Sankara Nethralaya hospital in India. It presents challenges related to the adoption of the system and methods and strategies that were utilized in order to overcome these challenges and help the system be adopted successfully. One of the more notable challenges at the hospital was a user base that included skeptical users, those lacking computing skills, and that had a history of rejecting designs. Despite these barriers the hospital was able to adopt the EMR system successfully. Notable issues related to the success of the system include the design strategy that was eventually used, and critical technical and social features of the system intended to support skeptical users and those lacking IT skills. The study contributes to overall understanding of the environment at large hospitals in developing countries as it relates to the adoption of EMR systems, and helps inform on methods that can be used to improve the adoption of EMR systems in similar contexts in both developed and developing countries.

Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method

CONTEXT

The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches.

METHODS

Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used "conflicting" findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation.

FINDINGS

Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR ("container" or "itinerary"); (2) the EPR user ("information-processer" or "member of socio-technical network"); (3) organizational context ("the setting within which the EPR is implemented" or "the EPR-in-use"); (4) clinical work ("decision making" or "situated practice"); (5) the process of change ("the logic of determinism" or "the logic of opposition"); (6) implementation success ("objectively defined" or "socially negotiated"); and (7) complexity and scale ("the bigger the better" or "small is beautiful").

CONCLUSIONS

The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.