Table 2.

Summary of key enablers and barriers by organizational readiness domains (change efficacy, change commitment, and contextual factors) and the 6 subthemes.

			Enabler		Barrier
Change commitment
	Perceived valence and feasibility	Value perceived Alignment on value across departments Perceived as appropriate for general medicine wards		Slow roll-out Limited integration Failure to meet expected needs Overreliance on technology Reliability questioned Alarm fatigue or desensitization
	Transparency and trust in management	Trust in management Active stakeholder engagement Minimal expectations for high involvement		Minimal ground-nurse engagement Fear of failure or perception that innovation is not a priority Cultural norms impacting openness
Change efficacy
	Shared understanding and readiness to act	Good awareness of the initiative Facilitation of interactions between teams		Inconsistent communication Misalignments on purpose
	Resources, training, and staff capability	Ground-up training initiatives Troubleshooting support		Delayed training or unclear responsibility for training Insufficient staff or time to engage with new technology Need for external funding
Contextual factors
	Innovation culture	Sandbox culture Keeping up to date with technology developments Raising staff awareness of technology		Complexity of the “sandbox” approach in the clinical setting
	Past experiences	Prior positive experience with technology		Prior negative experience with technology