Bridging Strategy and Local Reality: First-Line Managers' Experiences in Leading Large-Scale Implementation

Area of Science:

• Digital Health
• Healthcare Management
• Health Informatics

Background:

• eHealth implementation is complex, requiring organizational readiness, change management, and professional involvement.
• Leadership is crucial for digital transformation, but managers often lack necessary guidance.
• This study focuses on Swedish primary care middle managers implementing a digital service system (1177 Direct).

Purpose of the Study:

• Examine middle managers' experiences with digital transformation in primary care.
• Identify best practices, barriers, and enablers for successful eHealth adoption.
• Inform strategies to enhance leadership capacity in digital healthcare implementations.

Main Methods:

• Conducted semi-structured interviews with 26 primary care middle managers.
• Interviews occurred two weeks prior to the digital service system launch.
• Data analyzed using conventional content analysis.

Main Results:

• Managers navigated their leadership role in top-down change, developing tailored implementation strategies.
• Key preconditions for leadership included fostering staff support and readiness.
• Managers adapted the innovation and implementation to local contexts.

Conclusions:

• Middle managers play a pivotal role in preparing for and leading eHealth implementation.
• Effective leadership involves supporting staff, managing uncertainty, and using local strategies.
• Clear communication, contextual adaptation, and feedback are vital for sustainable digital transformation.