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Abstract
Introduction This protocol outlines a mixed methods study evaluating a new Digital Coordination Centre (DCC) at the Royal Melbourne Hospital (RMH), Melbourne, Australia. While coordination centres show potential for impact, evidence on effective implementation in the Australian context remains scarce. This study aims to address this gap.
Methods and analysis The evaluation involves a two-stage approach: a process evaluation to clarify DCC design and identify implementation factors, and an initial outcome evaluation to assess short and medium term outcomes. A developmental approach will support continuous improvement, and implementation science theories applied to unpack change processes. Data sources will include interviews, project documentation and observations, with qualitative and quantitative analyses targeting metrics like emergency department boarding and length of stay.
Ethics and dissemination This study has been approved by the RMH Human Research Ethics Committee (QA2023089). Findings will be shared through peer-reviewed publications and conference presentations.
Introduction
Healthcare providers recognise the need to improve patient access and flow, so patients get the right care, at the right time and in the right place.1 2 Increasingly, digital command or coordination centres are being adopted to improve information flow and situational awareness in several different industries.1
In a healthcare setting, command centres have been defined as the colocation of interdisciplinary workgroups, such as bed management and environmental services, that use real-time data to integrate and manage multiple processes related to patient flow.1 However, there is currently limited research evaluating the implementation of digital command centres and their impact on patient flow in healthcare.
In Australia, like in many parts of the world, there is currently high demand for the healthcare system. Contributing factors include unpredictable COVID-19 waves, staffing shortages and difficulties accessing primary care services.3 4 As service demand continues to increase, the Royal Melbourne Hospital (RMH) has committed to implementing a digital coordination centre (DCC) focused on improving patient access and flow to optimise the use of existing resources and provide better patient care.
The RMH DCC will be implemented across three phases. Phase 1, the focus for this evaluation protocol, addresses patient flow and involves colocation of resources and services, including access and bed management, elective surgery scheduling, nursing allocations, the patient flow coordination team, facilities management and transport coordination along with medical and administrative support. Newly developed digital tools and real-time dashboards will support the daily operations of the DCC (see online supplemental file 1 for an explanation of the digital tools and dashboards).
To understand factors associated with successful implementation of Phase 1, the Centre for Digital Transformation of Health (CDTH) at the University of Melbourne in partnership with the RMH is conducting a design, process and initial outcomes evaluation. The objectives and questions are listed in table 1.
Evaluation objectives and key evaluation questions
Phase 2 will be informed by the results of Phase 1 and concentrate on optimising clinical pathways and reducing preventable complications. Phase 3 extends the hospital’s reach through virtual health and community services. Each phase will be progressively evaluated to support continuous improvement.
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