Rajni Nair CHIA

Rajni Nair CHIA

Acting Nursing Director, Metro North Health

Healthcare leaders and managers are at the helm of workforce transformation, which is evolving and adapting to epidemiological, economical, environmental, and societal shifts, in addition to the digitalisation complexities. Digital health is certainly transforming healthcare delivery through enhancing efficiencies and patient experience. Nevertheless, studies show deceleration in digital implementation and initial resistance during early phases of digital disruption, with processes gaining efficiency and increased adoption rates1. Systematic review papers have identified key management and business application factors across multiple stakeholder dimensions, impacting existing structures, processes, managerial implications, and workforce practices2,3.

The rapid digitalisation has been challenging for a majority of the healthcare workforce that is untrained in digital healthcare and attempts to address capability gaps have been predominantly reactive in nature4. This situation extends to managers navigating their own digital learning experiences and balancing the imperative to deliver digital outcomes whilst ensuring uninterrupted service delivery by a workforce already burdened with clinical priorities, expectations, and varying levels of digital literacy. Studies have shown a greater need for research on the management implications of digitalisation across various stakeholders for a holistic view of digital health transformation5.

The hybrid workforce
A distinctive healthcare workforce emerging within this paradigm is the Hospital in the Home (HITH) care model. This well-established model provides acute patient care in the comfort of their homes instead of hospital setting. Hospital-level care, assessment, and clinical management are provided by a highly skilled multidisciplinary team. Communication, monitoring, telehealth, and point of care diagnostics are pivotal in achieving clinical outcomes in HITH6.

With digitalisation within hospital settings gaining pace, a parallel shift is also being witnessed within the HITH paradigm. HITH faces a unique challenge in digitalisation, where hospital-level care is provided by a hybrid workforce that is constantly on the move. HITH leadership must prepare their teams by addressing specific challenges related to this care model, from building digital knowledge and skills to logistical complexities within a highly mobile workforce.

Kick starting the digital journey of a hybrid healthcare workforce.

The influence of digital transformation presents both opportunities and complexities, requiring health managers to transition teams between existing cultures, practices and future ones7. Whilst the ‘superuser’ model is the traditional method, managers should ensure a broad representation of superusers across disciplines within the multidisciplinary team. This fosters variety and variations in outputs and a feeling of inclusiveness. The purposeful injection of a digital framework within known quality improvement activities lays the groundwork for robust discussions and familiarisation with digital terms. Managers can encourage clinicians to attend courses focused on digital health activities, support secondments in professional development of skills, and demystify digital transformation perceptions.

Effective, continual, and transparent dissemination of information within the team is vital. As the existing workforce navigates through the ‘Plan, Do, Act and Study’ cycle, innovative recruitment practices can usher in a digitally affiliated workforce that is empathetic and capable of supporting the existing workforce in its journey. A tried and tested mechanism to introduce concepts and enable the workforce to remain in the learning sphere is microlearning tools and breaking content into easy to digest bites that facilitate gentle upskilling. Managers can, therefore, enable conversations that focus on recognising gaps and addressing opportunities.

As one of the largest HITH services in Queensland embarks on its journey towards digitalisation, the strategies implemented for the inpatient hybrid health workforce show great promise. Many of the approaches are transferable and take into account logistical challenges in HITH, such as, patient distribution, network availability, and portability of equipment. These ‘small steps’, lays the foundation for a giant leap towards developing a work culture primed to be part of digital healthcare.


  1. Sullivan C, Wong I, Adams E, Fahim M, Fraser J, Ranatunga G, et al. Moving faster than the COVID-19 pandemic: the rapid, digital transformation of a public health system. Appl Clin Inform. 2021 Mar 1;12(2):229–36.
  2. Kraus S, Schiavone F, Pluzhnikova A, Invernizzi AC. Digital transformation in healthcare: analyzing the current state-of-research. J Bus Res. 2021 Feb 1; 123:557-67.
  3. Habran E, Saulpic O, Zarlowski P. Digitalisation in healthcare: an analysis of projects proposed by practitioners. British Journal of Health Care Management. 2018 Mar 2;24(3):150–5.
  4. Woods L, Janssen A, Robertson S, Morgan C, Butler-Henderson K, Burton-Jones A, et al. The typing is on the wall: Australia’s healthcare future needs a digitally capable workforce. Australian Health Review. 2023 Sep 25;47(5):553–8.
  5. Stoumpos AI, Kitsios F, Talias MA. Digital transformation in healthcare: technology acceptance and its applications. Int J Environ Res Public Health. 2023 Feb 1;20(4).
  6. Patel HY, West DJ. Hospital at home: an evolving model for comprehensive healthcare. Global Journal on Quality and Safety in Healthcare. 2021 Nov 1;4(4):141-6.
  7. Figueroa CA, Harrison R, Chauhan A, Meyer L. Priorities and challenges for health leadership and workforce management globally: a rapid review. Vol. 19, BMC Health Services Research. 2019.