{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:39:36Z","timestamp":1791574776970,"version":"4.3.4"},"reference-count":124,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002001","name":"Health and Social Care Delivery Research (HSDR) Programme","doi-asserted-by":"publisher","award":["NIHR129483"],"award-info":[{"award-number":["NIHR129483"]}],"id":[{"id":"10.13039\/501100002001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Soc Care Deliv Res"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title>\n<jats:p>Hospital \u2018command centres\u2019 use digital technologies to collect, analyse and present real-time information that may improve patient flow and patient safety. Bradford Royal Infirmary has trialled this approach and presents an opportunity to evaluate effectiveness to inform future adoption in the United Kingdom.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-2\"><jats:title>Objective<\/jats:title>\n<jats:p>To evaluate the impact of the Bradford Command Centre on patient care and organisational processes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-3\"><jats:title>Design<\/jats:title>\n<jats:p>A comparative mixed-methods study. Operational data from a study and control site were collected and analysed. The intervention was observed, and staff at both sites were interviewed. Analysis was grounded in a literature review and the results were synthesised to form conclusions about the intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-4\"><jats:title>Setting<\/jats:title>\n<jats:p>The study site was Bradford Royal Infirmary, a large teaching hospital in the city of Bradford, United Kingdom. The control site was Huddersfield Royal Infirmary in the nearby city of Huddersfield.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-5\"><jats:title>Participants<\/jats:title>\n<jats:p>Thirty-six staff members were interviewed and\/or observed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-6\"><jats:title>Intervention<\/jats:title>\n<jats:p>The implementation of a digitally enabled hospital command centre.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-7\"><jats:title>Main outcome measures<\/jats:title>\n<jats:p>Qualitative perspectives on hospital management. Quantitative metrics on patient flow, patient safety, data quality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-8\"><jats:title>Data sources<\/jats:title>\n<jats:p>Anonymised electronic health record data. Ethnographic observations including interviews with hospital staff. Cross-industry review including relevant literature and expert panel interviews.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-9\"><jats:title>Results<\/jats:title>\n<jats:p>The Command Centre was implemented successfully and has improved staff confidence of better operational control. Unintended consequences included tensions between localised and centralised decision-making and variable confidence in the quality of data available. The Command Centre supported the hospital through the COVID-19 pandemic, but the direct impact of the Command Centre was difficult to measure as the pandemic forced all hospitals, including the study and control sites, to innovate rapidly. Late in the study we learnt that the control site had visited the study site and replicated some aspects of the command centre themselves; we were unable to explore this in detail. There was no significant difference between pre- and post-intervention periods for the quantitative outcome measures and no conclusive impact on patient flow and data quality. Staff and patients supported the command-centre approaches but patients expressed concern that individual needs might get lost to \u2018the system\u2019.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-10\"><jats:title>Conclusions<\/jats:title>\n<jats:p>Qualitative evidence suggests the Command Centre implementation was successful, but it proved challenging to link quantitative evidence to specific technology interventions. Staff were positive about the benefits and emphasised that these came from the way they adapted to and used the new technology rather than the technology per se.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-11\"><jats:title>Limitations<\/jats:title>\n<jats:p>The COVID-19 pandemic disrupted care patterns and forced rapid innovation which reduced our ability to compare study and control sites and data before, during and after the intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-12\"><jats:title>Future work<\/jats:title>\n<jats:p>We plan to follow developments at Bradford and in command centres in the National Health Service in order to share learning. Our mixed-methods approach should be of interest to future studies attempting similar evaluation of complex digitally enabled whole-system changes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-13\"><jats:title>Study registration<\/jats:title>\n<jats:p>The study is registered as IRAS No.: 285933.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-14\"><jats:title>Funding<\/jats:title>\n<jats:p>This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129483) and is published in full in <jats:italic>Health and Social Care Delivery Research<\/jats:italic>; Vol. 12, No. 41. See the NIHR Funding and Awards website for further award information.<\/jats:p>\n<\/jats:sec>","DOI":"10.3310\/tatm3277","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T14:11:15Z","timestamp":1730556675000},"page":"1-108","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Implementing an artificial intelligence command centre in the NHS: a mixed-methods study"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3998-541X","authenticated-orcid":true,"given":"Owen Ashby","family":"Johnson","sequence":"first","affiliation":[{"name":"School of Computing, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2673-6839","authenticated-orcid":true,"given":"Carolyn","family":"McCrorie","sequence":"additional","affiliation":[{"name":"School of Human and Health Sciences, University of Huddersfield, 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