Change management - digitalisation of labor room: A mixed-methods study to assess the level of acceptance of 'Arc Partograph' application to go paperless in labor rooms.

Abstract

Introduction: Delivery-related complications significantly contribute to maternal, fetal, and neonatal mortality, particularly in low-resource settings like India. Effective labor monitoring, exemplified by the WHO-endorsed partograph, is crucial but often underutilized due to various challenges. The transition to digital partographs offers potential benefits but faces obstacles that need to be addressed, especially regarding healthcare workers' acceptance and readiness for such changes.

Materials and methods: This explanatory sequential mixed-methods study was conducted at a public tertiary hospital in Nagpur, India, over two months in 2024. After demonstrating the 'arcPartograph' application, a web-based tool for digital labor monitoring, 60 obstetricians participated in a quantitative survey, followed by a focused group discussion (FGD) with a subset of participants. Data were analyzed using both statistical methods and manual content analysis.

Results: Among the 75 obstetricians contacted, 60 (80 %) participated, with 91.7 % (n = 55) expressing readiness to transition from paper-based to digital partographs, and 93.3 % (n = 56) willing to use the 'arcPartograph' application. Participants showed strong readiness for digital adoption (mean score 16.2) and positive perceptions (mean score 16.1), though global change acceptance was relatively low (mean score 27.0). No significant associations were found between socio-demographic factors and willingness to adopt digital tools. The FGD revealed diverse perceptions, identifying both facilitators and barriers to digital change management.

Conclusion: The study highlights a strong readiness among obstetricians to embrace digital partographs, underscoring the need for targeted strategies to address technical and logistical challenges for successful implementation in low-resource settings.