Implementing enterprise resource planning (ERP) systems requires significant organisational, as well as technical, changes. These will affect stakeholders with varying perspectives and interests in the system. This is particularly the case in health care, as a feature of this sector is that responsibility of services is shared between many autonomous units. In these and similar settings, it is essential to analyse stakeholders and to understand their expectations and attitudes towards the system. Such an understanding will help implementers to address stakeholder interests and to encourage acceptance. Therefore, the purpose of this paper is to develop a theoretically based model to analyse how stakeholder attitudes and behaviours in a hospital setting affect the outcome of ERP implementation. This model is applied in an empirical study of a project to introduce an ERP system in medium-sized hospital in The Netherlands. The study shows how the ERP implementation impacts the interests of stakeholders such as physicians and administrators, which caused tensions. The paper examines the reasons of these tensions. In doing so, it contributes to our understanding of ERP implementation in health care and any other similar sectors from a stakeholder perspective, and it may help implementers to manage this more effectively.Albert Boonstra (albert.boonstra@rug.nl) is an associate professor in the Faculty of Economics and Business at the University of Groningen, The Netherlands. He researches the management issues raised by advanced information technologies, especially in health care environments. He has published in ERP system implementation in a hospital 177 IntroductionMany hospitals are shifting towards greater integration in health care delivery by offering a more homogeneous range of health care products (Van Merode et al., 2004: 493) This shift is driven by the desire to control costs, the need for organisational procedures for patients and an increase in the accountability of hospital managers with respect to how a hospital operates. The shift towards integration can be facilitated by information systems (IS), such as enterprise resource planning (ERP) systems, which help managers organise their central planning and control (Paré and Sikotte, 2001). ERP systems are software applications that use single information architecture to integrate a range of business functions in order to acquire an overview of the business (Klaus, 2000). Starting from manufacturing and financial systems, ERP systems allow for the integration of inter-organisational supply chains Fowler and Gilfillan, 2003) and cover a multi-functional range of activities, such as logistics, human resources and finance. These functions are integrated in such a way that whenever data are entered into one of these functions, they become available to all related functions.This trend whereby ERPs are increasingly being used in hospitals corresponds with a more general development in the application of health care IS, as identified by Haux (2006). He suggested ...

PurposeThe purpose of this study is to examine the effects of colleague and supervisor support on work engagement, examining the mediating role of possibilities for professional development in a healthcare setting.Design/methodology/approachA cross-sectional survey design was used. A sample of 253 Colombian nurses from a private hospital completed a series of questionnaires.FindingsAccording to the results, support from both colleagues and supervisors influences the work engagement of healthcare personnel. This research provides evidence about how to encourage work engagement in nursing staff through an adequate environment characterized by support and opportunities for career advancement.Research limitations/implicationsIn this study, a cross-sectional design was used; therefore, the generalization is limited, and it is not possible to infer causality.Originality/valueProviding certain conditions can promote not only work engagement with its desirable effects, but it may also mitigate the burden of a complex environment such as healthcare.

The HRQOL scores of patients with HIV/AIDS receiving antiretroviral therapy were relatively high in Bogotá, Colombia, using the EuroQol questionnaire. The utility data could be useful, in combination with cost data, for future economic evaluations.

This study suggests that treatment characteristics regarding efficacy and prolongation of life are particularly important for patients in Colombia. Further investigation on how patients make trade-offs between these important characteristics and incorporating this information in clinical and policy decision-making would be needed to improve adherence with HIV/AIDS medication.

This study suggests that having multiple CMs significantly influences utility, and CMs have some impact on HRQOL measured using the EQ-VAS but this effect is at the border of significance. No significant impact was observed on costs.