Abstract
BACKGROUND: Digital Coordination Centres (DCCs) represent an innovative approach in hospital settings, designed to enhance patient flow, operational efficiency, and real-time decision-making. While their potential is widely recognised, there is limited understanding of the factors influencing their implementation. This study evaluated the implementation of a DCC in a large Australian hospital, with a focus on identifying enablers, barriers, and strategies for improvement. METHODS: A process evaluation was conducted during Phase 1 of the DCC's implementation. Forty-two semi-structured interviews were undertaken with staff and stakeholders involved in, or affected by, the DCC. Thematic analysis was guided by the Consolidated Framework for Implementation Research (CFIR), to identify key influences on implementation and to identify strategies for ongoing improvement and future scalability. RESULTS: Key enablers included strong leadership, system adaptability, and improved communication across services. Barriers involved data accuracy, system integration, and initial staff resistance -particularly around role clarity and perceived surveillance, which participants suggested could be addressed through enhanced training, role refinement, and strengthened feedback mechanisms. The CFIR provided a useful lens for structuring analysis but required adaptation to address overlapping constructs and digital-specific barriers. CONCLUSIONS: This study offers practical insights into the implementation of a hospital-based DCC and demonstrates the value and challenges of using CFIR to evaluate complex digital health innovations. Findings highlight the importance of adaptable design, sustained leadership, continuous evaluation, and stakeholder-driven refinement. These insights can guide the successful implementation and scaling of digital coordination solutions in similarly complex healthcare environments.