Bridging data availability and data use: A qualitative study on frontline managers' perspectives on data-driven...

Hospitals increasingly invest in health information systems and aim to embed data-driven decision making in daily operations. Yet empirical evidence on how frontline managers experience this transition at the departmental level remains limited. This study examines the current state, perceived opportunities, and challenges of data-driven decision making in Flemish hospital departments.

Semi-structured interviews were conducted with 28 medical department heads and head nurses across nine Flemish hospitals and eight department types. Data were analysed using thematic analysis following Braun and Clarke, supported by Atlas.ti, and interpreted through the technology-organisation-environment (TOE) framework. Reporting follows the COREQ guidelines.

Data are used across departments for operational planning, capacity management, quality monitoring, patient flow, and financial oversight, though routine use remains uneven. Respondents identified strategic and financial opportunities, opportunities for operational coordination and workflow optimisation, and opportunities for predictive, outcome-oriented and patient-centred care. Five interrelated challenges constrain progress: fragmented infrastructure and limited system integration, data quality and reliability concerns, time and resource constraints, organisational and cultural resistance, and regulatory and financial barriers. Manual registration increases the workload associated with collecting and using data and lowers data quality, which reduces trust and data use, while dependence on central services limits local access and support.

Technological, organisational and environmental constraints reinforce each other, with individual factors playing a key role within the organisation, and many arise at the boundary between departments and central services. Strengthening data-driven decision making therefore requires lighter registration, reliable data, local data capacity and governance support that reaches the departmental level, rather than additional systems alone.