Systems Analysis, Design, and Implementation
Process, people, and technology
Systems work fails more often from neglected workflow and change management than from bad software. Expect scenarios that describe a situation and ask what the informatics nurse should do next.
Life cycle. The systems development life cycle moves through planning, analysis, design, implementation, testing, and maintenance and evaluation. Waterfall is sequential and documentation-heavy; agile methods deliver increments with continuous user feedback. Requirements are functional (what the system must do) or nonfunctional (performance, security, usability). Gap analysis compares current state to desired state; workflow analysis maps who does what, when, and with which data before any screen is designed.
Testing. Unit tests check one component; integration tests check interfaces; system testing checks the whole build; user acceptance testing asks real users to confirm the system supports their work. Verification asks whether the product was built correctly to specification; validation asks whether the right product was built. Items swap these terms deliberately.
Go-live and conversion. Big-bang converts everything at once (highest risk), phased conversion moves by unit or module, pilot converts one area first, and parallel conversion runs old and new systems together (safest, most costly). Downtime procedures and manual backups must be written, tested, and drilled before go-live.
Change and training. Lewin's unfreeze-change-refreeze, Kotter's urgency-driven steps, and Rogers' diffusion curve from innovators through laggards explain adoption. Super-users and train-the-trainer models build local expertise; competency-based validation outperforms attendance-based training.
Rule of thumb: training cannot fix a design flaw. When users complain after go-live, sort the problem into process, people, or technology before choosing an intervention.