Are Healthcare Organizations Ready for Change? Comment on "Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT"

Abstract

Worldwide most health systems are facing a series of common challenges characterized by the increasing burden of chronic diseases and multimorbidity, and the accelerated pace of biomedical and technological innovations, on the other side. There is a growing recognition that many changes are needed at the macro, meso and micro management levels to tackle these challenges. Therefore, knowing if healthcare organizations are ready for change is a key issue, as high organizational readiness for change (ORC) has been positively related with higher organizational effort and staff motivation for overcoming barriers and setbacks in change endeavours. In practice, readiness for change is not commonly measured and there is a need of adequate metrics for it. In this commentary, a new tool for measuring readiness change is reviewed, the OR4KT. It has been developed based on a solid theoretical background and with the involvement of experts and potential users in the design and it has been tested and validated in three languages and in different organizational settings. Although its generalizability needs to be further tested, it seems to be a promising and useful tool to diagnose if organizations are ready to implement evidence-informed changes. A broader recognition of the key role that the science of implementation can play in the success of much needed transformations in healthcare provides a good opportunity for the dissemination of the OR4KT.

Assessing Organizational Readiness to Change through a Framework Applied to Hospitals

“…Employee readiness for change was positively related to constructive leadership, and negatively related to both passive and active destructive leadership LEAD (Masood & Afsar, 2017 ) transformational leadership through psychological empowerment, knowledge sharing, and intrinsic motivation fosters nurse's innovative work behavior LEAD (Mazur et al, 2019 ) willingness of executive employees to actively support and participate in the change management process LEAD (Morin et al, 2016 ) relations among latent constructs reflecting change-related beliefs (necessity, legitimacy, support) and psychological reactions (psychological empowerment, affective commitment to change). Our findings suggest that psychological empowerment and affective commitment to change represent largely orthogonal reactions, that psychological empowerment is influenced more by beliefs regarding support, whereas affective commitment to change is shaped more by beliefs concerning necessity and legitimacy LEAD (Mrayyan, 2020 ) Successful leaders support employees' creative ideas, focus on the timing of the change, and provide training on change management LEAD (Nelson-Brantley & Ford, 2017 ) attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance LEAD (Nuno-Solinis, 2018 ) staff motivation LEAD (Nuno-Solinis, 2018 ) higher organizational effort LEAD (Oygarden & Mikkelsen, 2020 ) strategic translations may foster readiness for change LEAD (Proctor et al, 2019 ) implementation climate, participants reported the greatest increases in educational support and recognition for using EBP (evidence-based practices) LEAD (Puchalski Ritchie & Straus, …”

A mixed methods study to develop a tool to assess institutional readiness to conduct knowledge translation activities in low-income and middle-income countries

“…16 Indeed, some institutions are becoming increasingly aware of the importance of organisational readiness and the need to implement processes that motivate and enhance change to facilitate the conduct of KT activities or address barriers to conducting KT activities. 17 18 Such processes could be motivated by increased demand from policy makers for evidence-based data or funders offering new opportunities that prioritise or require KT activities. Whereas specific KT activities (eg, systematic review, establishing a community of practice) may vary in different academic institutions given differences in their priority health issue focus, policy cycle and resources, the similarities in the structure, function and objectives of academic institutions provide a conceptual basis for assessing their readiness to conduct different KT activities across different settings.…”

Meeting the Challenge of the "Know-Do" Gap Comment on "CIHR Health System Impact Fellows: Reflections on ‘Driving Change’ Within the Health System"

“…Using best evidence is important in getting the policy right but unless there is also evidence of a readiness to change and the essential components of a receptive context for that change are in place, then the chances are that the ‘know-do’ gap to which Sim et al refer, and which is the trigger for the HSI Fellowship, will remain or even widen. 11,12…”