Modelling the critical success factors for evidence-based healthcare practice at a South African public hospital

Abstract

This study aimed to investigate the critical success factors for the adoption of evidence-based healthcare practice at a Dr George Mukhari Academic hospital (DGMAH). The updated DeLone & McLean's updated information systems success model (D&M IS Success Model), the technological, organisational, and environmental (TOE) framework and the technological acceptance model (TAM) were used as the underpinning theories to develop the hybrid model. Structural equation modelling (SEM) was utilised to validate and test the proposed model. Data for the study were gathered using a self-administered questionnaire for medical healthcare professionals at DGMAH. The findings of the study show that the electronic health records (EHR) construct had a significant positive influence on information quality (IQ), knowledge quality (KQ) and diagnosis and treatment of diseases (DTD) in the final model, with values of (β =0.558, (p<0.05), (β=0.558, (p <0.05) and (β =0.558, (p <0.05), respectively. Similarly, the study's findings also revealed a significant and positive correlation between two constructs: the adoption of evidence-based healthcare practice (EBHP) (r=0.299; p<0.05) and better coordination of patient care (r=0.294; p<0.05). Better patient care coordination is positively and significantly correlated with EHR (r= 0.121, p<0.05), DTD (r=0.173, p0.05), IQ (r= 0.221, p<0.05) and KQ (r=0.181, p<0.05). The path analysis' findings demonstrated that the goodness of fit indices including the goodness of fit index (GFI) of 0.905, the comparative fit index (CFI) of 0.905 and the root mean square error of approximation (RMSEA) of 0.035 were all within the acceptable range of values. This study contributed to the development of a new framework that identified the critical success factors for EBHP at a public hospital in South Africa. The study's findings also make a considerable contribution to the body of knowledge in the fields of health informatics, particularly eHealth. Policymakers at the Department of Health as well as healthcare professionals who are sectional heads of different hospital departments may adopt the developed framework as a guideline on how to adopt and implement EBHP in public hospitals, as well as the critical success factors that need to be considered. Future research employing qualitative research methodologies should investigate additional factors that may have an impact on the adoption of EBHP.