McGonigle and Mastrian, (2022) discuss the Systems Development life cycle or SDLC. They cite various approaches to the SDLC, including The waterfall model, where the output from one stage flows into the next, RAD or rapid application development that uses a quickly developed prototype that can be tested by users, Object Oriented Systems Development or OOSD, which assigns commodities that exist in reality to objects within computer software. Per Gogou et al, (2002), the benefit of this is that the system can focus on the relationship of these objects to each other rather than be designed from a procedural standpoint. There is also DSDM or the Dynamic System Development Model, which per McGonigle and Mastrian, (2022) is useful when a new system must be developed quickly and may have to be adjusted to meet unforeseen needs as it is developed. There is also a method discussed called Agile, which emphasizes the way the work (that the system will be supporting) is done and the way the people doing the work perform together.
These different approaches have different names for their phases. However, per Dr. Kevin Johnson in Walden (2018) the four general phases of SDLC are Planning, Design, Implementation, and Evaluation/ Maintenance. This video also stresses the importance of nurse involvement in each phase for the success of the new system.
Planning
In the planning stage, Dr. Johnson (Walden, 2018) describes two critical steps. First, he states that the individuals involved in systems development must remember that the whole thing is a cycle, and steps may need to be revisited. Second, he states that we must define what we need the system to do. It is essential that there is nurse representation, especially in this stage, because nurses will be the ones using the system, and they need to have input on how the system should operate. McGonigle and Mastrian, (2022) discuss for example, working with stakeholders (in this case, the nurses) to ask what a system should have, must have, could have and would have, identifying the must have facets of a system as the ones necessary for its success.
Design
Per McGonigle and Mastrian, (2022) use of healthcare technology can save lives, but when it is implemented without regard to actual workflow, it can create more danger than safety. This is why a nurse needs to be involved in the design stage of the systems development life cycle. These writers state that workflow analysis is a key part of the design (or re-design) process and that workflow analysis is a key skill that a nurse informaticist should possess to be part of the team that looks at workflow during the design stage of the SDLC. . I can think of a time in my last agency when the project team spent months redesigning the system with little or no influence from the direct care staff, and the result was basically to move all our widgets around and give the calendar a new look. There were no processes added that could have enhanced our workflow, such as the ability to create a working client list for each nurse or to do batch processes like adding vitals for all clients on a list. If the nurse staff had any input into this planning stage, it could have given the project management team better direction and resulted in changes that were more meaningful to patient care. The new design, without input from staff, actually got in the way of care by offering no meaningful changes to actually help the workflow. It also required a few days of learning where the design team relocated the same old tools to just affect a different look.
Implementation
In Walden University (2018) Kevin Johnson speaks about the most significant challenge to implementation being acceptance of change among the end users of the system. To ensure buy-in, he speaks about the necessity of collecting input from staff, with the recognition that not all views on what is the best direction can be satisfied. So during implementation, there needs to be the recognition that not all system users will be happy with the new system (because even if they had input, their input might not have been utilized). Cho et al, (2021) discuss resistance to change during implementation and state that resistance may not be apparent because nurses may understand the implications to their career by overtly resisting the change. But there may be hidden resistance, which can be even more damaging to the process. These writers state that an important nurse role in the implementation change is to have nurses that are super users (that they refer to as nurse champions) who are well trained in the use of the EHR, and can demonstrate and also promote from within the benefit of the EHR to other staff. McGonigle and Mastrian, (2022) also discuss training as an important step of implementation. In this area, nurses need to participate to be trained. But another critical role for the nurse and nurse informaticist is to be able to train their cohorts. And in the case of a major change like the adoption of a new system, it is not just about educating people on use but leading them to embrace change. Tyler (2019) describes an important role of a nurse informaticist as being able to lead their cohorts through change. The nurse informaticist needs to be involved to get people to unfreeze and accept change, move through the process of change, and then embrace the new way of working. I was not here for the new implementation of EPIC at my present place of employment. However, the physician I work under told me of several Physicians, who were at the end of their careers, and quit due to the complexities of the new system. These were providers who may have delayed their retirement by a few years but got so frustrated learning to use EPIC that they left early. It is clearly important that there are cohorts who can help new users learn the system , not just for the success of the system, but also for employee engagement.
Maintenance/Evaluation
In the Maintenance and evaluation stage of the SDLC the new system needs to be evaluated to see if it is working and have the necessary changes applied (This goes back to Dr. Kevin Johnsons statement in Walden (2018) that the process is cyclic and constantly needs to be revisited and evaluated to ensure it is meeting the needs of the healthcare facility and its patients. Untalan et al, (2022), besides recommending the use of super users for direct staff training as part of implementation also support the importance of evaluation and maintenance of the system through some sort of metric like lean sigma six to see if the system is meeting its goals. In their case, they created an audit tool. They combined it with nursing huddles to discuss barriers and pathways to meet specified nursing issues until their system had 100% resolution of identified issues. This demonstrates the importance of nursing involvement in this phase. If the nurses are not able to meet their care goals with the use of the system, and if the system cannot be modified to let nurses meet their patient care goals then it is not going to be much help to the facilitys nurses or patients. In my old agency, we were at least asked for feedback after the changes. I did not see any immediate changes to the system after feedback was collected. But there was at least an avenue for quality improvement that was staff experience related.
Along the SDLC the involvement of nurses (the people who will be mostly utilizing the system for patient care ) will always be of the strongest importance. Input into what a system will be used for, how it can be designed to do the job, whether it is accepted, embraced, and learnable, and how it works for its users revolves around the nursing staff. It is especially up to the nurse informaticist to bridge the gap between the nursing staff and the IT professionals who will be coding and building the system.
References
Cho, Y., Kim, M., & Choi, M. (2021). Factors associated with nurses user resistance to
change of electronic health record systems. BMC Medical Informatics & Decision
Making, 21(1), 112.
Gogou, G., Mavromatis, A., Maglaveras, N., Engelbrecht, R., & Pappas, C. (2002).
DIABCARD CCMISA Portable and Scalable CPR for Diabetes Care. IEEE
Transactions on Biomedical Engineering, 49(12), 1412.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
Tyler, D. D. (2019). A Day in the Life of a Nurse Informaticist: Super Users. Journal of
Informatics Nursing, 4(1), 1820.
Untalan, E., Cardenas, P., & Jenkins, Z. (2022). From Old to New: Process of
Integrating PACU Phase 1 Documentation and Workflow from Old Electronic Health
Record (EHR) System to New Electronic Health Record (EHR) System. Journal of
PeriAnesthesia Nursing, 37(4), e9.
Walden University, LLC. (Producer). (2018). Managing Health Information
Technology [Video file]. Baltimore, MD: Author.
Walden University, LLC. (Producer). (2018). Systems Implementation [Video file
Baltimore, MD: Author.
The Systems Development Life Cycle (SDLC) is a model that shows the different phases in a project’s evolution. The SDLC is one of four main models used to manage software development projects, along with the Waterfall Model, Agile Model and Hybrid Model. As with all of these models, the SDLC aims to ensure that projects are completed on time and within budget.
The SDLC is a structured approach to developing software. It helps ensure that the software is developed in an efficient and effective manner, meets the requirements of the customer and user, and can be adapted to meet future changes.
The SDLC provides a framework for creating an integrated system from multiple components or modules, such as user interfaces, databases, network services etc., which are developed by different teams or organizations within a project team (i.e., functional groups).
The SDLC is a process for developing software. It’s a set of phases and activities that are performed in a defined order, with each phase building on the previous one. The SDLC provides a systematic approach to the development of software, and it can be used in any software development project.
The purpose of this article is to give you an overview of how the SDLC works so that you can understand how different phases fit together when developing your own applications or websites
The SDLC phases are:
SDLC Planning
SDLC planning is the first step in the SDLC. It helps you to define the project and its goals, objectives and scope.
The purpose of SDLC planning is to identify what needs to be done for your project, who will be responsible for it and when it will be completed.
Design and Development (D&D)
Design and development are the first two phases in the Systems Development Life Cycle. They are also referred to as “design” or “implementation,” depending on how you want to think about them. In a traditional SDLC, design is one step before coding because it creates an outline for how your system will work and what its features should be. The next step is coding–the actual programming language used for building software–followed by unit testing: testing each piece of code separately from other parts of your system so that errors don’t creep into any part of it before being integrated into your final product version.
Test and QA is the process of testing the software to ensure it meets the quality requirements. Test and QA is also known as Quality Assurance (QA). The SDLC covers all phases of software development lifecycle, including requirements gathering, design, coding and testing.
Test and QA activities help in making sure that your product or service meets customer expectations by providing them with proof that it works as expected. The objective of test cases are:
The DM&D phase is the last stage in the SDLC, and it involves putting your software into production for its intended use. This includes ongoing support and maintenance of the software as well as disposing of it when it’s no longer needed.
In this phase, you will also deploy any new features or updates to users at your organization.
The SDLC is an important part of the software development process. It’s a framework that helps to guide the development of software and ensure that it is delivered on time, within budget and with high quality.
The SDLC consists of five steps or phases: initiation, elaboration, construction, transition and closeout (the last two are sometimes combined into one phase). Each step follows from the previous one by building upon its lessons learned while moving toward achieving project goals in order to complete successfully as soon as possible.
In this blog post, we’ve covered the basics of Systems Development Life Cycle (SDLC). You should now know what an SDLC is and why it’s important for software development. You should also understand the phases of SDLC and how they relate back to each other. Finally, you should have some knowledge about D&D which is the phase where developers work on creating testable features for deployment into production environments such as machines or virtual machines
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