Design and methodological development of a digital clinical safety training programme informed by a national framework: a New Zealand case study

Background: The rapid digitalisation of healthcare 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 emphasised in national and international policy, guidance on embedding Digital Clinical Safety (DCS) principles in large organisations is limited. The Health New Zealand – Te Whatu Ora (Health NZ) Data and Digital team have developed the first DCS Framework for New Zealand, but mechanisms to support its organisational adoption have not yet been established. This article describes the methodological design of a DCS training programme and identifies pre-implementation considerations for integrating DCS principles into organisational practice. Methods: A qualitative exploratory study was conducted within Health NZ using purposive sampling and semi-structured interviews with seven stakeholders involved in digital health, clinical informatics, and organisational learning. A structured options assessment was undertaken prior to the interviews to compare potential organisational approaches for implementing DCS capability. Stakeholder feedback on these options, together with interview findings, informed an integrated assessment of programme feasibility and design. Results: 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 programme as the most suitable option for embedding DCS principles within Health NZ policies and practices. Conclusion: 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 organisational 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 healthcare delivery. Keywords: digital clinical safety; patient safety; digital health education; workforce training; digital transformation