Design and Methodological Development of a Digital Clinical Safety Training Program Informed by a National Framework:...

The rapid digitalization of health care services has introduced new safety risks related to patient confidentiality, the reliability of digital tools, and their integration into clinical workflows. While digital health adoption is emphasized in national and international policy, guidance on embedding digital clinical safety (DCS) principles in large organizations is limited. The Health New Zealand - Te Whatu Ora (Health NZ) Data and Digital team has developed the first DCS Framework for New Zealand, but mechanisms to support its organizational adoption have not yet been established. This article describes the methodological design of a DCS training program and identifies preimplementation considerations for integrating DCS principles into organizational practice.

A qualitative exploratory study was conducted within Health NZ using purposive sampling and semistructured interviews with seven stakeholders involved in digital health, clinical informatics, and organizational learning. A structured options assessment was undertaken prior to the interviews to compare potential organizational approaches for implementing DCS capability. Stakeholder feedback on these options, together with interview findings, informed an integrated assessment of program feasibility and design.

Findings from the stakeholder interviews indicated that there is limited shared understanding of DCS across clinical and digital teams, strong support for DCS training that is accessible and relevant to everyday practice, and variable compliance with current mandatory training offered at Health NZ. The options assessment identified a comprehensive, modular training program as the most suitable option for embedding DCS principles within Health NZ policies and practices.

This study presents a structured methodology informed by the DCS Framework for designing DCS training within a national health system. Findings highlight that training can serve as a key mechanism for organizational change, promoting shared understanding, engagement, and consistent adoption of safe digital practices. This approach provides transferable insights into embedding DCS practices within a complex health system to support safe, resilient, and equitable digital health care delivery.