If the Organisation Isn’t Ready, Nothing Sticks

Hubert van Dalen
Jul 15
3 min read

Updated: Jul 15

"Personally, I think this is the most influential reason why most smart care projects falter."

In earlier articles we’ve examined the condition, the technology, the value proposition, and the adopters. All of these are important—but none will succeed unless the organisation itself is structured and resourced to support sustainable change.

That brings us to the fifth, and probably the most critical, influence on sustainable tech adoption in aged and healthcare: The Organisation.

This domain considers the leadership, culture, capability, and operating model of the provider organisation, and whether it is ready to take on, scale, and sustain the changes that come with implementing new technology.

Domain 5: The Organisation

This domain explores five key factors:

5A. Capacity to innovate – Does leadership champion innovation?
5B. Readiness for change – Are systems and people aligned for rollout?
5C. Nature of adoption – How many departments and business metrics are involved?
5D. Extent of change – Does this technology require significant operational shifts?
5E. Work needed to sustain – Is ongoing work acknowledged and resourced?

Many smart care implementations start strong—only to stall when competing priorities, legacy systems, or unclear accountability dilute the effort.

What the NARI Framework Covers Well

The NARI Implementation Framework for Enabling Technology-Supported Aged Care at Home²does a good job of identifying organisational enablers such as:

Leadership commitment
Organisational culture and readiness
Training and staff involvement

These are important and well-grounded in practice, especially for in-home aged care settings.

What the NARI Framework Does Not Cover (Organisation Gaps)

It doesn’t address conflicting priorities or change fatigue. Many aged care providers are under pressure—financially, operationally, and culturally. The framework assumes a willingness to change, but does not address how to manage change fatigue or align competing initiatives.
No governance or accountability model is provided. Who owns technology adoption? Who tracks usage, risk, and outcomes? It does not offer a structure for technology governance, mature control objectives (like in the IT governance framework CobIT), or cross-role accountability.
There’s no guidance on cross-functional alignment. New technology often spans clinical, operations, and IT. The NARI framework doesn’t provide strategies for cross-functional coordination or issue resolution.
Workforce planning is overlooked. Successful implementation requires time, training, and task redesign. It omits workload analysis, resource planning, or digital upskilling frameworks.
No model for post-pilot transition. The framework focuses on the implementation phase, but does not address how to transition pilots into core business or how to prepare for scale. Many well intended pilots die gracefully when the sponsor leaves.

Real-World Example: The Vanishing Pilot

A provider pilots an AI-based triage tool that improves care planning accuracy. It receives positive feedback from users. But when the pilot ends, there’s no one responsible for ongoing rollout, no system to support training, and no integration into daily workflows.

Twelve months later, the technology—and the learning—have vanished.

The problem wasn’t the tech. It was the lack of organisational muscle to carry it forward.

Take away: Structure Determines Traction

Adoption isn’t a technical or user issue alone—it’s an organisational one.

If your operating model doesn’t support technology integration, no amount of enthusiasm will overcome friction, fatigue, or drift.

Providers must build the governance, leadership, cross-functional roles, and resource models to sustain change—not just start it.

Next Steps: Check Your Organisation Readiness Before You Roll

Ask:

Do we have clear ownership and governance for digital transformation?
Are we aligning IT, clinical, and operational leaders?
Have we budgeted time, training, and support to make change stick?
Are we preparing to scale—beyond the pilot?

In Article 6, we’ll look outward—at Domain 6: The Wider System—to understand how regulation, policy, and funding models can help or hinder smart care adoption.

Let’s keep building the foundation for care technology that works—and lasts.

Article 5/7: Hubert van Dalen, Managing Director of eHomeCare, where he advises on the strategies and governance of smart care technologies across the health, aged care, and disability sectors.