RESUMEN
BACKGROUND: Organizational readiness for change measures were reviewed to develop an assessment tool for guiding implementation of an occupational safety and health program based on Total Worker Health (TWH) principles. Considerable conceptual ambiguity in the theoretical and empirical peer-reviewed literature was revealed. OBJECTIVE: Develop and validate an assessment tool that organizations can use to prepare for implementation of a participatory TWH program. METHODS: Inclusion criteria identified 29 relevant publications. Analysis revealed eight key organizational characteristics and predictors of successful organizational change. A conceptual framework was created that subject matter experts used to generate prospective survey items. Items were revised after pretesting with 10 cognitive interviews with upper-level management and pilot-tested in five healthcare organizations. Reliability of the domain subscales were tested based on Cronbach's α. RESULTS: The Organizational Readiness Tool (ORT) showed adequate psychometric properties and specificity in these eight domains: 1) Current safety/health/well-being programs; 2) Current organizational approaches to safety/health/well-being; 3) Resources available for safety/health/well-being; 4) Resources and readiness for change initiatives to improve safety/health/well-being; 5) Resources and readiness for use of teams in programmatic initiatives; 6) Teamwork; 7) Resources and readiness for employee participation; and 8) Management communication about safety/health/well-being. Acceptable ranges of internal consistency statistics for the domain subscales were observed. CONCLUSIONS: A conceptual model of organizational readiness for change guided development of the Organizational Readiness Tool (ORT), a survey instrument designed to provide actionable guidance for implementing a participatory TWH program. Initial internal consistency was demonstrated following administration at multiple organizations prior to implementation of a participatory Total Worker Health® program.