This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/84841
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
From Usability to User:ability – Barriers and Facilitators for the Implementation of Modifiable Off-the-shelf Technologies in a University Hospital: A Qualitative Multimethod Study
ABSTRACT
Background:
Hospitals are under increasing pressure to accelerate digital transformation. Modifiable off-the-shelf technologies (MOTs) combine standardized products with local adaptability, offering promising opportunities to accelerate digitalization. Yet, multiple barriers, facilitators, and organizational dynamics must be considered when implementing MOTs in complex hospital settings.
Objective:
This study aimed to identify barriers and facilitators in the implementation process of MOTs in hospitals and to explore how organizational dynamics, conceptualized as tensions and misfits, emerge throughout this process.
Methods:
This study was guided by a constructivist-interpretivist paradigm and followed an action research approach. A qualitative multi-method study was conducted incorporating observations, workshops, and focus groups with clinical and project management staff. Deductive-inductive qualitative content analysis was performed, following Kuckartz’s approach.
Results:
Twelve protocols from observations, workshops, and focus groups involving 129 participants across wards and departments were analyzed. Major MOT implementation barriers included product limitations, resource constraints, and structural challenges. Major MOT implementation facilitators included product alignment, orchestrated implementation processes, effective coordination and communication, and the presence of available individuals. Three central tensions in organizational dynamics emerged from the MOT barriers and facilitators: the generic systems colliding with local needs resulting in a limited relative advantage, the need for structured participation versus the organizational complexity of a large university hospital and the present individual enthusiasm constrained by limited resources for digitalization.
Conclusions:
Tensions in the context of MOT implementation reflect different organizational misfits that go beyond concrete barriers or facilitators and instead require systemic, agile organizational structures and processes. Ensuring relative advantage through IT integration and targeted learning; empowering user participation through communication and involvement; and enabling clinician engagement through resource allocation and systematic implementation can be crucial for overcoming barriers and tensions regarding the implementation of MOTs in complex healthcare settings. 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.