Resisting or transforming? Workforce readiness for digital shift in healthcare workflows

Purpose This study examines the effect of digital literacy on operational efficiency, with technology acceptance and readiness for digital transformation as mediating variables. It also investigates the moderating role of workload pressure and resistance to change in the relationship between digital literacy and readiness for digital transformation, to better understand the factors influencing successful digital transformation in organizations. Design/methodology/approach A quantitative research design with a cross-sectional survey was adopted. Data were collected from 105 frontline professionals working in a tertiary-care hospital and research centre in South Karnataka, India, representing a fast-digitizing yet resource-constrained healthcare sector. Six constructs were measured using a structured questionnaire, and Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to test reliability, structural relationships, mediation and moderation effects. Findings The results show that digital literacy significantly enhances technology acceptance and readiness for digital transformation, which in turn improves operational efficiency. Technology acceptance mediates the relationship between digital literacy and readiness. However, workload pressure and resistance to change did not significantly moderate the relationship, indicating that the positive effect of digital literacy on readiness remains stable even under high workload and resistance conditions in the hospital setting. Research limitations/implications The findings guide hospital administrators and policymakers on the importance of digital training, inclusive leadership and change management to support staff readiness and improve hospital efficiency during digital transitions. Practical implications The findings highlight the need for structured digital training and effective change-management practices to improve efficiency and performance in hospitals. Originality/value The study extends the Technology Acceptance Model by linking digital literacy and technology acceptance to operational performance and provides empirical evidence on workforce readiness in an emerging tertiary healthcare context.