Assessing hospital readiness for radio frequency identification device implementation in Iran: a conceptual model

Organizational factors entail features that have a direct relationship with implementation of the technology [25]. Organizational culture is a common and relatively stable pattern of values, beliefs, and essential ideologies in an organization. Making any changes in an organization is only possible through understanding its organizational culture [32]. Culture is the way through which duties are accomplished in an organization and is related to people’s behavior and viewpoint [33]. Culture should not be regarded as an aim, but as a means to an aim [34]. In information technology, culture has its own particular definition. To implement any kind of technology, cultural readiness is of particular importance [35]. Because it indirectly influences the successful implementation of information technology [36], organizational culture can be regarded as a mediator variable between cultural, organizational, and human factors in implementing RFID.

Accordingly, the first hypothesis (H1) is as follows:

There is a relationship between factors connected with organizational and cultural readiness.

In this era of knowledge and information, the human factor is one of the main influential elements and is regarded as a valuable property and asset in an organization. The human factor is the main resource for achieving an organization’s goals. Consequently, the factors influencing humans, such as culture, on different forms of technology have received attention. Culture is one of the most comprehensive, influential factors in empowering human resources and guaranteeing their success. It has an effective role in successful implementation of information technology in a particular organization [36]. Culture management should determine a list of appropriate behaviors and then suggest suitable human processes to develop these behaviors [37].

Thus, the second hypothesis (H2) is as follows:

There is a relationship between factors connected to human and cultural readiness.

Organizations exist in a dynamic and active environment and are under the influence of exogenous and endogenous factors [31]. Human resources constitute the main infrastructure in any organization. They are the major elements for the development of an organization or country [38]. If an organization provides necessary conditions to develop the skills and knowledge of its human resources, it can make progress. When human resources are knowledgeable and skillful, they can accumulate other resources for the organization to help the organization develop and achieve its goals [39]. Before developing a strategy for human-related resources, factors such as culture, organizational structure, and leadership style must be taken into consideration [37] because human factors considerably influence technology implementation [38]. As a result, the third hypothesis (H3) is as follows:

There is a relationship between factors connected with human and organizational readiness.

Of the 400 questionnaires distributed, 245 were returned to the researchers; a return rate of 61.3%. Based on the collected data, 202 of the participants (82.4%) were women. Some 119 respondents (48.6%) were aged between 25 and 35 and 75 participants (30.6%) had 5–10 years of work experience (Table 1).

We report descriptive statistics (i.e., central tendency and variance) for the 3 variables: human, cultural, and organizational readiness (Table 2). As the Table indicates, the mean for the 3 variables is relatively high.

A Kolmogorov–Smirnov test was conducted to test the normality of distribution (Table 3). All the obtained data had a normal distribution. Moreover, there was a significant positive correlation between the variables. Thus, as the exogenous variables increase, the endogenous variables increase (Table 4).

Table 5 shows the values of a parameters and the coefficients of exogenous variables. Based on the results, the constant values or the a of the 2 exogenous variables (namely cultural and human resource readiness) are significant (T > 2). The regression coefficient of cultural readiness based on organizational readiness is 0.33. The regression coefficient of human resource readiness based on organizational readiness is 0.14. When cultural readiness is considered as a mediator variable, the regression coefficient of human resource readiness based on organizational readiness increases by 0.44.

The predictive coefficient for cultural readiness of hospital staff for implementing RFID technology was significant (Table 6).

Considering the predictive model of human resource readiness for implementing technology and the fact that cultural readiness is influenced by organizational readiness for implementing RFID, it can be observed that 0.346 of the changes of a unit of score for the possibility of implementing RFID under the influence of these 2 variables. This value has a standard deviation of 0.374.

Organizational readiness had the highest mean (36.84) degree of readiness of the 3 variables. The organizational readiness of the hospitals for the implementation of RFID can play an important role in the successful implementation of this technology. Researchers in the area of information technology systems have emphasized that the secret to the success of this type of technology lies in managerial and organizational dimensions rather than technical and tactical ones [40].

Vanany and Shaharoun found that as organizational support plays a great role in the implementation of new technologies, at the start of the implementation of RFID systems the managers must promote organizational support through the initiation of discussions within the organization. In addition, a framework is needed to be utilized by managers to clearly introduce and explain RFID processes and promote investments and ensure the success of their projects [12]. Thus, organizational readiness will increase the chance of being successful in implementing RFID in the target hospitals.

The results of the present research further showed that a unit of increase in the organizational readiness would lead to 0.576 unit of increase in cultural readiness of the staff members of the hospitals. This finding supports the first hypothesis. However, based on the obtained means, cultural readiness was not as important as organizational readiness. As a result, hospitals should increase commitment to execute their own plans. This commitment will, in turn, raise the commitment of staff. This statement is consistent with the findings of Battani et al., which demonstrate that, for implementing RFID, health organizations should be aware of the reasons for its implementation and all levels of the organization should be committed to the plans [41]. Furthermore, hospitals can form a team to include operators in designing RFID, and by so doing, improve staff commitment and teamwork for implementing this technology.

Senior management plays a critical role in RFID implementation [42]. Through their appropriate behavior, managers can promote cultural principles [43], and as a result support the implementation of RFID.

Equally, some changes in duties and responsibilities must be made along with the implementation of the RFID [44] that will result in numerous changes in the working conditions of an organization. Gupta et al. concluded that managers must express their expectations and clarify the possible impact of the new systems on employees’ job descriptions and workload as this could encourage the staffs to use new technologies [45].

A study that was conducted at hospitals in Taiwan found that after the implementation of RFID, many changes were made in work processes, manual processes such as data entry, displaying the patient’s condition, integration and standardization of operational activities were eliminated, and the efficiency and effectiveness of business processes were increased [18]. Many hospital administrators in Malaysia believed that the implementation of RFID should not make substantial changes in the existing IT systems that they were using [12].

Fisher and Monahan concluded that RFID projects are associated with a reengineering of business processes [5]. Many people are involved in this process and in change management [13]. Fisher and Monahan also argued that prediction of workload increase, assessment of staff’s readiness, and involvement in clear negotiation with staff members will lead to staff support for the implementation of RFID and will enhance the chance of its success [5].

It is indisputable that the implementation of RFID technology will result in many changes in the working conditions of employees and organizations. In view of that, by forming executive teams, reengineering working processes, and adopting proper managerial behaviors to manage the processes correctly, hospitals can promote cultural factors such as flexibility among their staff. They can also overcome staff resistance and fear of losing their job as a result of implementing the new technology. They can further enhance a sense of freedom for staff.

Holding appropriate training courses will increase the understanding of staff of the usefulness of RFID, which, in turn, will increase their cooperation and minimize their concerns and resistance. Gupta et al. concluded that training staff along with other facilities such as hardware and software are among the important factors that have a positive effect on the successful implementation of information technology in organizations in countries such as India, which is a developing country. They also stated that organizations need to provide adequate training and support during the process of the implementation and application of information technology systems [45].

For hospitals in South-East Asia, a lack of information was identified as one of the main challenges and obstacles to the implementation of RFID. One study found employees had very little information about this technology; and as a result, they thought the implementation of this system is very difficult and problematic, and thus they resisted the new system. The study suggested that hospitals should train their staff about RFID so that they acquire the required skills and participate more in implementing the new system [12]. Our present results are consistent with these findings.

The present study found that the predictive coefficient of human resource readiness based on cultural readiness for accepting the new technology was significant. More precisely, a unit of increase in cultural readiness would result in a 0.601 unit of increase in human resource readiness. A unit of increase in the standard deviation of cultural readiness would lead to 0.671 unit of increase in the standard deviation of human resource readiness. These findings substantiate the second research hypothesis.

Improving the culture of team work and flexibility will positively influence organizational readiness, and will enhance people’s motivation and creativity to attain the necessary skills to work with RFID. The results of the present study are similar to those obtained by Szczepańska-Woszczyna who concluded that culture plays a major role in enhancing people’s motivation and forming their creative behavior within an organization. They indicated that positive cultural features provide the required conditions for creativity in an organization [46].

The results of the present study show that organizational readiness directly influences human resource readiness, substantiating the third research hypothesis. However, if cultural readiness is considered as a mediator variable, the burden of organizational and human readiness will fall on the cultural readiness, and the impact of organizational readiness on human resource readiness will be reduced, and is transferred to cultural readiness.

As shown in Figure 1, considering the cultural factors as mediators, the factor load of organizational and human readiness is added to the variable of culture; moreover, the effect of organizational factors on human factors loses its weight and its load is shifted to cultural factors. Organizational readiness has a more profound effect on human resource readiness by affecting cultural readiness. It is thus claimed that the support of managers and organizations can enhance the cooperation of staff and innovation in the implementation of RFID. Moreover, organizational culture can promote organizational behavior by stimulating and motivating the staff and guiding their behavior. A similar conclusion is reported by Abbasi et al. [47].

Figure 1

The results of the present study should be interpreted with caution because this study was performed just in one city; moreover, only 61.3% of the eligible study subjects have participated. Hence, caution should be used when generalizing the results to other hospitals. Nevertheless, some of the findings of this study are consistent with the findings of others. Further studies are needed to generalize the results to the entire nation.

The impact of organizational readiness for implementing RFID is high. Therefore, health information managers will need the support of organization’s managers in all the steps of designing and implementing an RFID system as with any other information technology system. Such managers will have complete commitment to the implementation of RFID. To implement RFID, managers should clearly explain their managerial goals, determine the workload of the organization, and plan the necessary steps. They should also pay attention to division of labor in operating and maintaining RFID. Furthermore, managers need to rely on the cooperation of staff in implementing this technology and emphasize group work. The model presented can be regarded as an applied model for managers and programmers in the health area to make decisions and policies for implementing RFID in hospitals within Iran and across developing countries. Equally, cultural factors have greater influence on human resources than any other external factor. Any change in an organization will have no effect unless its organizational culture is taken into consideration. Thus, the culture of an organization must receive attention as an auxiliary tool that facilitates the relationship between human resources and organizational strategies.

The organizational structure and human and cultural factors of the studied hospitals are generally ready for accepting RFID technology. The data analysis revealed that cultural factors play a significant role in implementing RFID projects in developing countries like Iran. Concentrating more on cultural factors will minimize the risk of failure in implementing RFID. As a result, hospitals should strengthen organizational factors and enhance the support of top rank managers’ support for implementing RFID. By so doing, they will promote cultural readiness, prepare human resources, and win the cooperation of the personnel in implementing such a technological project. Overlooking these factors and their significant effect on each other, even when the project has a strong technical base, may lead to a malfunction in the implementation of RFID and may ultimately lead to project failure.