Developing a Change Readiness Survey for Health Technology Implementation.

Addressing the challenges of health technology implementation, this study aims to develop a survey that assesses staff readiness for change in clinical settings. The survey items were refined from 67 to 38 through a narrative literature review, expert focus groups, and cognitive interviews. The survey suggests an approach that prioritizes the user's needs in identifying barriers and facilitators to the adoption of health technology in order to ensure successful implementation by proactively addressing potential obstacles.

Organizational structure, agility, and public value-driven innovation performance in the UAE public services.

Existing public sector management literature requires an empirical examination of the relationship between change readiness, organizational agility, and public value-driven innovation performance. Moreover, how organizational structure moderates these relationships in the public sector context is still being determined. This study aims to address this gap by collecting data from 421 top management respondents working in public services in the United Arab Emirates. The hypotheses are tested using a structural equation model. The study's findings confirm that change readiness positively influences organizational agility and reveals the positive effects of organizational agility on public value-driven innovation performance in public service organizations. Additionally, this study highlights that change readiness directly affects public value-driven innovation performance. Simultaneously, organizational structure (formalization and centralization) affects the relationships between change readiness and public value-driven innovation performance, and organizational agility and public value-driven innovation performance. Finally, this study shows that organizational structure (centralized and formalized) impacts the relationship between change readiness and organizational agility. This study contributes substantially to the existing knowledge on the relationships between change readiness, organizational agility, organizational structure, and public value-driven innovation performance.

The assessment of readiness to change among head managers of primary healthcare centers in Makkah, KSA.

Background: KSA is currently undergoing significant changes in its healthcare system, with a particular emphasis on enhancing the role of primary healthcare centers (PHCs) to elevate patient experience and overall healthcare quality. At the forefront of this transformation are head managers in PHCs, who play a crucial role in implementing these changes effectively. The readiness of these managers is paramount to the successful execution of the envisioned transformation and the subsequent improvement of patient experience. Objective: This study aims to assess the readiness to change among head managers of primary healthcare centers in Makkah, KSA. Methodology: Cross-sectional study utilized the ADKAR model questionnaire, consisting of 22 Likert scale questions, to assess PHCs head managers' awareness, desire, knowledge, ability, reinforcement, and overall change readiness. Results: The study found a significant association between higher educational levels and increased awareness (ß = 0.214, p = 0.030), along with greater desire (ß = 0.207, p = 0.029) among primary healthcare (PHC) managers. Additionally, a positive association was found between age (≥41 years) and knowledge among PHC managers (ß = 0.138, p = 0.030). However, managers with 11 or more years of experience showed a negative association with change readiness (ß = -0.112, p = 0.001). Conclusion: The ADKAR model outlines five dimensions that are useful for identifying the readiness and willingness of head managers in PHCs in Makkah cluster to undergo change. Assessing change readiness is crucial for organizational transformation, with head managers playing a significant role. Factors such as age, education, and experience influence managers' readiness for change in primary healthcare centers (PHCs) in Makkah.

Participatory ergonomics: What works for whom and why? A realist review.

Participatory workplace interventions to improve workforce musculoskeletal health are infrequently analysed regarding why they work, for whom or under what circumstances. This review sought to identify intervention strategies which achieved genuine worker participation. In total, 3388 articles on participatory ergonomic (PE) interventions were screened; 23 were suitable to analyse within a realist framework identifying contexts, mechanisms of change, and outcomes. The interventions which succeeded in achieving worker participation were characterised by one or more of these contexts: workers' needs as a core starting point; a positive implementation climate; clear distribution of roles and responsibilities; allocation of sufficient resources; and managerial commitment to and involvement in occupational safety and health. Interventions that were organised and delivered in this way generated relevance, meaning, confidence, ownership and trust for the workers in an interrelated and multi-directional manner. With such information, PE interventions may be carried out more effectively and sustainably in the future.Practitioner summary: This review focuses on the question: which mechanisms support genuine worker participation, in what context and with which necessary resources, to reduce musculoskeletal disorders. Results emphasise the importance of starting with workers' needs, making the implementation climate egalitarian, clarifying the roles and responsibilities of all involved, and providing sufficient resources.Abbreviations: PE: participatory ergonomic(s); WMSD: Work-related musculoskeletal disorders; EU: European Union; MSD: Muskuloskeletal disorders; OSH: Occupational health and safety; C: context; M: mechanism; O: outcome; CMOCs: CMO configurations; NPT: Normalization process theory; OECD: The Organisation for Economic Co-operation and Development: EU-OSHA: European Occupational Safety and Health Agency.

Leading medical laboratory professionals toward change readiness: a correlational study.

BACKGROUND: To remain effective in the dynamic health care landscape, the laboratory must embrace the continuous improvement mindset to support a culture of change, and leadership must facilitate the change process, mitigating perceived barriers of change readiness in followers. METHODS: This quantitative study was designed to determine whether there is an association between leadership style (Multifactor Leadership Questionnaire [MLQ]) and change readiness (3-component model [TCM] commitment to change/Employee Commitment Survey, and whether leadership style predicts change readiness. Laboratory professionals (n = 718) were recruited through national societies to complete a combined MLQ-TCM survey instrument. Multivariate analysis of variance, Pearson correlations, and multiple regression analyses were performed. RESULTS: A significant correlation between leadership style and change readiness (transformational leadership [TL] and affective commitment to change, r(716) = .12, P = .002; passive-avoidant behavior and continuance commitment to change, r(716) = .25, P < .001) and between leadership style and leadership outcomes (TL and effectiveness, r(716) = .90, P < .001) was identified. Transformational leadership was a significant predictor of change readiness (ß = .17, P < .05). CONCLUSION: It is recommended that laboratory leaders use transformational leadership or situational leadership to improve followers' affective commitment to change and reduce followers' continuance commitment to change, thus improving commitment to continuous improvement. Leaders should also limit passive-avoidant behavior.

Unravelling the relationship between perceived values-congruence with organizational change readiness: A moderated mediation model.

Recent studies have demonstrated that organizations often fail to execute organizational changes effectively due to a lack of their employees' organizational change readiness (OCR). However, the absence of employees' OCR is rooted in whether their values align with their organizations. The research aims to clarify when and why employees' perceived values-congruence with their organizations, supervisors, and workgroups (PVC-O, PVC-S, and PVC-G) helps stimulate their organizational change readiness (OCR). Specifically, it Integrates the self-categorization theory and social information processing theory and proposes a moderated mediation model to investigate the roles of perceived insider status (PIS) and the quality of change communication (QCC). This study gathered a valid sample of 252 employees from six Chinese companies at three different time points, and performed the structural equation modeling and multiple regression to test the proposed research model. The results demonstrate that PVC-O, PVC-S, and PVC-G are all positively related to employees' PIS, which further promotes their readiness for organizational change. Additionally, QCC strengthens not only the positive effect of employees' PVC-O and PVC-G (except for PVC-S) on PIS but also the indirect effects of PIS. This study offers valuable implications for practitioners implementing their organizational change practices in China. Moreover, this study can contribute to the organizational change literature by uncovering the underlying mechanism between perceived values-congruence and employees' OCR in the light of the person-environment interaction.

Hospital organizational change: The importance of teamwork culture, communication, and change readiness.

Background: Hospital organizational change can be a challenging time, especially when staff do not feel informed and ready for the change to come. A supportive workplace culture can mitigate the negative effects allowing for a smooth transition during hospital organizational change. In this paper, we test an exploratory path model by which teamwork culture influences staff attitudes in feeling informed and ready for change, and which are ultimately related to reduced staff burnout. We also examined different types of change communication, identifying the channels that were perceived as most useful for communicating organizational change. Methods: In 2019, a cross-sectional online and paper-based survey of all staff (clinical and non-clinical) was conducted at a hospital undergoing major organizational change in Sydney, Australia. The survey included items regarding teamwork culture, communication (feeling informed, communication channels), change readiness (appropriateness, change efficacy), and burnout. With a sample size of 153 (62% clinical staff), regression and path analyses were used to examine relationships between variables. Results: The total effects between teamwork culture and burnout was significant [ß (Total) = -0.37, p < 0.001) and explained through a serial mediation. This relationship was found to be mediated by three factors (feeling informed, appropriateness of change and change efficacy) in a full mediation. Further, change readiness (appropriateness of change and change efficacy) mediated the relationship between feeling informed and burnout. The most useful channels of change communication included face-to-face informal communication, emails, and a newsletter specifically about the change. Conclusion: Overall, the results supported the predicted hypotheses and were consistent with past research. In the context of large hospital change, staff with a positive teamwork culture who feel informed are more likely to feel change-ready, heightening the chances of successful organizational change and potentially reducing staff burnout. Understanding the pathways on how culture and communication related to burnout during organizational change provides an explanatory pathway that can be used to heighten the chances of a smooth change transition with minimal disruption to staff and patient care.

Implementing a new emergency department: a qualitative study of health professionals' change responses and perceptions.

BACKGROUND: The aim of the study is two-fold. It explores how managers and key employees at the Emergency Department (ED) and specialist departments in a university hospital in the Capital Region of Denmark respond to the planned change to a new ED, and how they perceive the change involved in the implementation of the new ED. The study investigates what happens when health professionals are confronted with implementation of policy that changes their organization and everyday work lives. Few studies provide in-depth investigations of health professionals' reactions to the implementation of new EDs, and particularly how they influence the implementation of a nationwide organizational change framed within a political strategy. METHODS: The study used semi-structured individual interviews with 51 health professionals involved in implementation activities related to an organizational change of establishing a new ED with new patient pathways for acutely ill patients. The data was deductively analyzed using Leon Coetsee's theoretical framework of change responses, but the analysis also allowed for a more inductive reading of the material. RESULTS: Fourteen types of responses to establishing a new ED were identified and mapped onto six of the seven overall change responses in Coetsee's framework. The participants perceived the change as particularly three changes. Firstly, they wished to create the best possible acute patient pathway in relation to their specialty. Whether the planned new ED would redeem this was disputed. Secondly, participants perceived the change as relocation to a new building, which both posed potentials and worries. Thirdly, both hopeful and frustrated statements were given about the newly established medical specialty of emergency medicine (EM), which was connected to the success of the new ED. CONCLUSIONS: The study showcases how implementation processes within health care are not straightforward and that it is not only the content of the implementation that determines the success of the implementation and its outcomes but also how these are perceived by managers and employees responsible for the process and their context. In this way, managers must recognize that it cannot be pre-determined how implementation will proceed, which necessitates fluid implementation plans and demands implementation managements skills.

Achieving change readiness for health service innovations.

Continual innovation to address emerging population needs necessitates health service ongoing redesign and transformation worldwide. Recent examples include service transformations in response to Covid-19, many of which were led and managed by nurses. Ensuring change readiness is central to delivering these transformative changes yet has been identified as a central challenge impacting nurse leaders and managers. Recent evidence indicates that affective commitment to change among healthcare staff may be an important contributor to gaining support for change implementation but understudied in healthcare. A cross-sectional survey study was used to examine the association between affective commitment to change and change readiness among 30 healthcare staff across four projects in one state-wide health system in Australia. Our findings indicate that affective commitment to change; healthcare worker's emotional and personal perception of the value of the proposed change is independently associated with individual and collective change readiness. Given that achieving change readiness is a central goal of change management strategies, this pilot work provides valuable insight to inform the change management practices of nurse leaders and managers.

Is Gaining Affective Commitment the Missing Strategy for Successful Change Management in Healthcare?

Despite the requirement for continual change and development, change failure is omnipresent in health care, ranging from small technical errors within new systems, processes or technologies, through to breakdowns and large-scale disaster. Despite decades of research investment, consultancy and initiatives, creating a healthcare context that promotes clinician engagement with change remains elusive, with limited demonstrated progress. Affective commitment to change refers to commitment that is driven by a desire to support change based on its perceived benefits or value, as opposed to commitment that is based on a sense of obligation or the minimization of costs. Recent evidence from health-care contexts indicates that affective commitment to change drives change readiness more so than the individual's self-efficacy for dealing with the change. Considering evidence regarding the effect of affective commitment to change on individual and collective change readiness among health-care staff, we may need to reorient our current strategies for managing change. We explore the opportunities to enhance affective commitment to change and, in turn, change readiness through adopting values-based approaches to designing and executing change proposals with clinicians and service users.

The Emergence of Employees' Change Readiness for Energy-Conservation Behavior During Guided Group Discussions.

Studies of energy conservation efforts to reduce CO2 emissions in the residential sector are abundant; however similar efforts in organizations have not received as much attention as they deserve. In this study, we focus on methods for increasing employees' readiness to change their behaviors in favor of energy conservation, specifically examining the use of guided group discussions (GGDs). We use observational research methods to examine the micro-level of behavioral dynamics and understand the emergence of change readiness. We describe how facilitators ("change agents") can conduct GGDs and foster employees' change readiness using the established communication approach of Motivational Interviewing (MI). We also explore how employees can increase each other's change readiness regarding energy conservation behavior. Based on our sample of eight videotaped GGDs (5430 behavioral events), interaction analysis reveals that solution-focused communication elicits change readiness in employees, whereas problem-focused communication prompts resistance to change. We further show that employees can motivate their co-workers to express "green" intentions: when employees verbalized statements in favor of energy saving, this increased other employees' change readiness, while verbalized statements against energy saving had the opposite effect. This demonstrates that GGD participants are active individuals who can spark behavior change in their co-workers. Finally, based on our findings we propose several communication guidelines for working with groups and discuss the importance of solution-focused energy management practices to facilitate change readiness for energy saving in the workplace.

Organizational context and the learning and change readiness climate for implementing an evidence-based shared decision-making aid in US rheumatology clinics.

PURPOSE: The purpose of this study was to examine the organizational context that may support learning and change readiness climates that previous research has found to be conducive to implementing evidence-based interventions. DESIGN/METHODOLOGY/APPROACH: An exploratory, mixed method evaluation that included 15 rheumatology clinics throughout the United States was performed. Quantitative data were collected using a web-based survey completed by 135 clinic members. Qualitative data were collected via semi-structured interviews with 88 clinic members. FINDINGS: In general, clinics reported strong, positive learning and change readiness climates. More complex organizations (e.g. multispecialty, academic medical centers) with rational/hierarchical cultures and members with longer tenure were associated with less supportive learning and change readiness climates. The authors' findings highlight opportunities for organizational leaders and evidence-based intervention sponsors to focus their attention and allocate resources to settings that may be most susceptible to implementation challenges. ORIGINALITY/VALUE: First, the authors address a deficit in previous research by describing both the level and strength of the learning and change readiness climates for implementing an evidence-based shared decision-making aid (SDMA) and examine how these vary as a function of the organizational context. Second, the study examines a broader set of factors to assess the organizational context (e.g. organizational culture, organizational structure, ownership) than previous research, which may be especially salient for shaping the climate in smaller specialty clinics like those we study. Third, the authors utilize a mixed methods analysis to provide greater insights into questions of how and why organizational factors such as size and structure may influence the learning and change readiness climate.

Faith Communities' Improvements in Readiness to Engage in Addictions Resilience and Recovery Support Programming.

Spirituality and religion are well-documented components of prevention, treatment and recovery of substance use disorders. Faith communities are in a distinct position to support recovery and resilience regarding substance use disorders-not only in times of crisis, but every day. We conducted an exploratory study of congregational (i.e., organizational) "levers" that can drive change readiness in implementing recovery and resilience programming for substance use disorders within faith communities. Findings point to enhanced effectiveness post-intervention and the importance of developing awareness of resources to help with someone who has an alcohol or other drug problem.

A systematic scoping review of change management practices used for telemedicine service implementations.

BACKGROUND: Telemedicine improves access to health care services enabling remote care diagnosis and treatment of patients at a distance. However, the implementation of telemedicine services often pose challenges stemming from the lack of attention to change management (CM). Health care practitioners and researchers agree that successful telemedicine services require significant organizational and practice change. Despite recognizing the importance of the "people-side" of implementation, research on what constitutes best practice CM strategies for telemedicine implementations remains fragmented, offering little cohesive insight into the specific practices involved in the change process. We conducted a systematic scoping review of the literature to examine what and how CM practices have been applied to telemedicine service implementation, spanning a variety of health care areas and countries. METHODS: Three bibliographic databases (CINAHL, PubMed, and ISI Web of Science) and four specialist telehealth journals were searched. To keep the review manageable and relevant to contemporary telemedicine technologies and contexts, the search was limited to articles published from 2008 to 2019. Forty-eight articles were selected for inclusion. RESULTS: From the 48 articles, 16 CM practices were identified relating to either strategic or operational aspects of telemedicine implementations. We identify the key CM practices that are recognized in the broader CM literature as essential for successful and sustained change but are not commonly reported in telemedicine implementation studies. We draw on the CM literature to provide a comprehensive process-based, researched-informed, organizing framework to guide future telemedicine service implementations and research. CONCLUSIONS: Our findings suggest that the slow rate of adoption of telemedicine may be due to a piecemeal approach to the change process, and a lack of understanding of how to plan, manage and reinforce change when implementing telemedicine services.

Successful implementation of a Fracture Liaison Service through effective change management: a qualitative study.

We assessed the context in which a hip Fracture Liaison Service was implemented. We conducted semi-structured interviews with 21 key informants at two time points to understand organizational readiness, facilitators, and barriers to change. We identified strategies important to successful implementation, particularly in the context of change fatigue. PURPOSE: Fracture Liaison Service (FLS) is effective for secondary fracture prevention. Two hospital sites implemented FLS for hip fracture patients, 50 + years, in Alberta, Canada. We assessed organizational readiness, facilitators, and barriers to change to better understand the context in which the FLS was implemented to inform its potential spread provincially. METHODS: We recruited individuals involved in FLS implementation at provincial and site levels to participate in telephone interviews at baseline and 16 months post-implementation. Interviews were transcribed and analyzed using thematic content analysis. In addition, site-level participants were invited to complete the Organizational Readiness to Implement Change tool at baseline. RESULTS: We conducted 33 semi-structured interviews (20 at baseline; 13 at post-implementation) with 21 key informants. Participants included managers (24%), FLS physicians/clinical nurses (19%), operational/leadership roles (19%), physicians/surgeons (14%), pharmacists (10%), nurse practitioners (10%), and social work (5%). Seventeen site-level participants completed the ORIC tool at baseline; all participants scored high (71%) or neutral (29%). We found that the use of several strategies, including demonstrating value, providing resources, and selecting appropriate sites, were important to implementation, particularly in the context of change fatigue. Participants perceived the FLS as acceptable and there was evidence of facilitated learning rather than simply monitoring implementation as intended. CONCLUSIONS: An effective change management approach neutralized change fatigue. This approach, if maintained, bodes well for the potential spread of the FLS provincially if proven effective and cost effective. Change readiness assessment tools could be used strategically to inform the spread of the FLS to early adopter sites.

Exploring Personality and Readiness to Change in Patients With Substance Use Disorders With and Without ADHD.

Objective: To explore personality and readiness to change among substance use disorders (SUD) patients with and without ADHD. Method: SUD + ADHD versus SUD - ADHD patients consecutively entering treatment between 2010 and 2012 were compared concerning personality (Temperament and Character Inventory) and readiness to change (Stages of Change Readiness and Treatment Eagerness Scale). Results: Among 103 SUD patients (76 men, age M = 43.3, SD = 11.1), 16 (15.5%) were diagnosed with ADHD. SUD + ADHD patients reported significantly elevated eagerness to effort (p = .008) compared with SUD - ADHD patients, who reported significantly elevated fear of uncertainty (p < .000). SUD + ADHD patients reported higher ambition (p = .025), self-forgetfulness (p = .029), and lower recognition (p = .022). They were younger (p = .019) and showed more often amphetamine addiction (p = .022) compared with SUD - ADHD patients. Conclusion: The distinct characteristics found in SUD + ADHD and SUD - ADHD patients underline the need for differentiated treatment interventions.

How To Get Your Clinical Teaching Team Ready For Curriculum Change: A Practical Guide.

Our health care system is constantly adapting to change at an increasingly rapid pace. Unavoidably, this also applies to the field of medical education. As a result, clinical teaching teams face the challenging task of successfully implementing the proposed changes in daily practice. It goes without saying that implementing change takes time and that you need to be patient. However, a successful change process needs more than that. Change models or strategies could offer a helping hand. The questionnaire Specialty training's Organizational Readiness for curriculum Change (STORC) is a tool aiming to do just that. With a focus on readiness for change, this questionnaire tries to support implementation efforts in PGME. Additionally, since change is a team effort, it focusses on clinical teaching teams particularly. In this paper, we offer a practical guide for clinical teaching teams on how to deal with any concerns or hurdles detected in any of the core elements of readiness for change, in order to smoothen and support the educational change processes these teams are confronted with.

When and How Does Psychological Voice Climate Influence Individual Change Readiness? The Mediating Role of Normative Commitment and the Moderating Role of Work Engagement.

This research explores the linking mechanisms and conditional processes underlying the relationship between psychological voice climate and individual change readiness. In accordance with the social identity theory, we argued that normative commitment would mediate the relationship between psychological voice climate and individual change readiness; furthermore, work engagement would moderate the proposed indirect effect. Two-wave survey data were collected from 187 full-time employees in a government-owned institute of research and development and were adopted for moderated mediation analysis. The results showed that normative commitment mediates the relationship between psychological voice climate and individual change readiness. Furthermore, work engagement strengthens the effect of psychological voice climate on individual change readiness in an indirect manner via normative commitment. Based on the findings, the theoretical implications and practical suggestions were discussed.

Competing Values Framework: A useful tool to define the predominant culture in a maternity setting in Australia.

OBJECTIVE: To identify the predominant culture of an organisation which could then assess readiness for change. DESIGN: An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool. SETTING: The Maternity Unit in one Australian metropolitan tertiary referral hospital. SUBJECTS: All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded. MAIN OUTCOME MEASURE: The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy. RESULTS: The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change. CONCLUSION: There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change.

Assessing Change Readiness and Treatment Eagerness among Psychoactive Substance Users in Northern Nigeria.

Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. This study therefore provided psychometric properties of one of such measuring scales: Stage of Change Readiness and Treatment Eagerness Scale version 8 (SOCRATES-8) and the accompanying change in resilience among Nigerians using psychoactive substances. Participants were 111 psychoactive substance dependent users in three treatment centers in Northern Nigeria. All respondents filled sociodemographic questionnaire, SOCRATES-8 and 14-item Resilience Scale. The study found overall motivation for change among participants to be medium on the three subscales of SOCRATES-8: ambivalence (median=14.00; range=7-20); recognition (median=31.00; range=7-35); and taking steps (median=35.00; range=12-40). More than half (61.3%) scored moderately on resilience. The Internal reliability of SOCRATES-8's subscales fell into acceptable range (ambivalence=0.54; recognition=0.87; taking steps=0.84). Pearson correlation coefficients of subscales with resilience are positive and in moderate range except for ambivalence with very low coefficient. Hierarchical cluster analysis based on participants' resilience characteristics yields five distinct profiles corresponding to five stages of motivational change. ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment outcome.