Accepted for/Published in: JMIR Human Factors
Date Submitted: Aug 6, 2025
Date Accepted: Nov 12, 2025
Organisational Readiness for Change in the Era of Smart Hospital Wards: A Qualitative study of Healthcare Workers’ Insights
ABSTRACT
Background:
Technology is rapidly reshaping conventional hospital environments into smart spaces, enhancing care, improving clinical workflows, and reducing workload. However, successful implementation depends not only on the technology's effectiveness but also on organisational readiness for change.
Objective:
To identify key enablers and barriers to readiness for change for a smart hospital ward initiative.
Methods:
We conducted a qualitative study to gauge organisational readiness for change for a smart ward initiative. Using purposive sampling, we capture diverse views from clinicians, IT staff, operational support staff and the hospitals healthcare redesign group. Data were coded deductively under three key domains in Weiner’s theory of organisational readiness: change efficacy, change commitment and contextual factors. Sub-themes were derived inductively under each domain.
Results:
We interviewed nineteen participants, including clinicians and support staff. Seven sub-themes emerged: 1) Awareness and shared understanding of purpose, 2) resources and staff capability, 3) perceived valence and expectations, 4) appropriateness of concept and feasibility, 5) transparency and trust in management, 6) innovation culture, and 7) past experiences. Participants viewed the initiative as valuable and were motivated to change, citing that the institution's sandbox culture was a key enabler. However, key barriers exist, including unclear timelines, inconsistent training, limited resources, and a lack of infrastructure to support sandbox innovation. Concerns about the over-reliance on technology were also prominent, with staff wary of its impact on clinical judgment and system reliability.
Conclusions:
Enabling readiness for the smart ward initiative requires transparent communication of timelines and project awareness, particularly for ground staff, development of training frameworks and adequate prioritisation of innovation. Alleviating commonly reported technology concerns such as over-reliance, loss of human touch, and reliability will also be key to adoption and sustainability. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.