Table 5.

Macroergonomic Principles for Implementation (Karsh, 2004)

Implementation Design Principles	Reason for Importance
Top management commitment	Enables additional design principles.
Responsibility/accountability	Effective in promoting success because it shows the importance of the change and lets end users know who to go to with ideas or concerns
Structured program	Provides end users with a “road map” which can reduce uncertainty and promote feelings of control. Reduces many of the fears associated with new system: end users will know why the change is coming, what to expect, when to expect it, where to expect it to happen and who will be in charge.
Training	Targets self-efficacy, ease of use, and usefulness explicitly. Reduces uncertainty and fear and promotes control because users gain knowledge and skills.
Pilot testing	Involves users with the new system and creates a test bed to uncover and solve problems. Promotes an understanding of integration needs.
Communication	Early and clear communication about intentions begins to reduce uncertainty and promotes perceptions of procedural justice. Clear and open communication channels are needed between prospective end users, decision makers and technical support.
Feedback	Feedback on end user concerns and ideas must be provided quickly so that they know they are being taken seriously, e.g., staffing a help desk with knowledgeable staff at all times when people are engaged in using the new system.
Simulation	Use before, during, and after an implementation promotes predictions, self-efficacy, usefulness, intervention validation, ease of use and control while reducing the variety of fears that can exist.
End user participation	Enhances perceptions of justice, self-efficacy and control, reduces a variety of fears and uncertainty. May have both cognitive and motivational components.