By far, our most common experience in the health IT space is that clinical staff are disenfranchised from improving their IT because of the expense and difficulty of getting vendors to honestly and truthfully participate in a partnership of continuous process improvement. The older vendors have some legitimate excuse for avoiding software modifications because of the expense to them and the higher risk of making things worse due to the complexity of their software. That nevertheless leaves the clinicians frustrated with no way out of dead-end.
This is the exact reason for our architectural design where the system can be changed in real-time without the need for any programming. The staff can not only design their own system, but experiment with ways of changing it, and even revert when new ideas turn out not to be as smart as they thought they were. The bottom line is that the software has to support continuous process improvement.