Assessing Health Care Organizations’ Ability to Implement Screening, Brief Intervention, and Referral to Treatment

Bohman, Thomas M.; Kulkarni, Shanti; Waters, Vicki; Spence, Richard T.; Murphy-Smith, Michele; McQueen, Katherine

doi:10.1097/adm.0b013e3181800ae5

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…Compatibility of the intervention could be with the organization broadly, leadership, a workgroup or team, or the respondent's beliefs or job. Items in the tension for change sub-construct took the form of needs assessments (e.g., "my unit needs guidance in developing services to address alcohol and drug behaviors presented by our patients" [21]), or descriptions of pressures for changes. The final 19 items in implementation climate were in the subconstructs of relative priority (n = 7), organizational incentives and rewards (n = 6), goals and feedback (n = 4), and other (n = 2).…”

Section: Implementation Climatementioning

confidence: 99%

Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments

Miake-Lye

Delevan

Ganz

et al. 2020

BMC Health Serv Res

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Background: Organizational readiness assessments have a history of being developed as important support tools for successful implementation. However, it remains unclear how best to operationalize readiness across varied projects or settings. We conducted a synthesis and content analysis of published readiness instruments to compare how investigators have operationalized the concept of organizational readiness for change. Methods:We identified readiness assessments using a systematic review and update search. We mapped individual assessment items to the Consolidated Framework for Implementation Research (CFIR), which identifies five domains affecting implementation (outer setting, inner setting, intervention characteristics, characteristics of individuals, and implementation process) and multiple constructs within each domain. Results: Of 1370 survey items, 897 (68%) mapped to the CFIR domain of inner setting, most commonly related to constructs of readiness for implementation (n = 220); networks and communication (n = 207); implementation climate (n = 204); structural characteristics (n = 139); and culture (n = 93). Two hundred forty-two items (18%) mapped to characteristics of individuals (mainly other personal attributes [n = 157] and self-efficacy [n = 52]); 80 (6%) mapped to outer setting; 51 (4%) mapped to implementation process; 40 (3%) mapped to intervention characteristics; and 60 (4%) did not map to CFIR constructs. Instruments were typically tailored to specific interventions or contexts.Discussion: Available readiness instruments predominantly focus on contextual factors within the organization and characteristics of individuals, but the specificity of most assessment items suggests a need to tailor items to the specific scenario in which an assessment is fielded. Readiness assessments must bridge the gap between measuring a theoretical construct and factors of importance to a particular implementation.

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Section: Implementation Climatementioning

confidence: 99%

Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments

Miake-Lye

Delevan

Ganz

et al. 2020

BMC Health Serv Res

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“…None of these studies examined whether organizational readiness to change is related to actual future implementation of new practices. Two additional recent studies assessed the ability of an organizational readiness to change measure to predict organization-level outcomes [ 11 , 12 ]; one retrospectively assessed non-adoption of a new technology [ 11 ], and the other offered a qualitative description of the relationship between organizational readiness to change and implementation outcomes [ 12 ]. In healthcare, with its current heavy focus on interventions designed to implement evidence-based practices, what is sorely needed is a measure that demonstrates a correlation to actual uptake of new practices following such interventions.…”

Section: Introductionmentioning

confidence: 99%

The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

Hagedorn

Heideman

2010

Implementation Sci

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BackgroundThe Organizational Readiness to Change Assessment (ORCA) is a measure of organizational readiness for implementing practice change in healthcare settings that is organized based on the core elements and sub-elements of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. General support for the reliability and factor structure of the ORCA has been reported. However, no published study has examined the utility of the ORCA in a clinical setting. The purpose of the current study was to examine the relationship between baseline ORCA scores and implementation of hepatitis prevention services in substance use disorders (SUD) clinics.MethodsNine clinic teams from Veterans Health Administration SUD clinics across the United States participated in a six-month training program to promote evidence-based practices for hepatitis prevention. A representative from each team completed the ORCA evidence and context subscales at baseline.ResultsEight of nine clinics reported implementation of at least one new hepatitis prevention practice after completing the six-month training program. Clinic teams were categorized by level of implementation-high (n = 4) versus low (n = 5)-based on how many hepatitis prevention practices were integrated into their clinics after completing the training program. High implementation teams had significantly higher scores on the patient experience and leadership culture subscales of the ORCA compared to low implementation teams. While not reaching significance in this small sample, high implementation clinics also had higher scores on the research, clinical experience, staff culture, leadership behavior, and measurement subscales as compared to low implementation clinics.ConclusionsThe results of this study suggest that the ORCA was able to measure differences in organizational factors at baseline between clinics that reported high and low implementation of practice recommendations at follow-up. This supports the use of the ORCA to describe factors related to implementing practice recommendations in clinical settings. Future research utilizing larger sample sizes will be essential to support these preliminary findings.

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“…Additionally, without the support of the "collaborative", implementation of SBIRT in our health center would have been challenging." -Implementing Site An initial site-based readiness assessment [13] captured organizational context, including any existing plan for screening implementation, confidentiality protocols, EMR, current QI practices, organizational communication practices, and existing services to accommodate referrals, and informed site-specific implementation plans. Length, scope of content, and timing of on-site trainings were customized through collaborative content development, allowing for adaptation based on each site's level of expertise and access to other resources.…”

Section: Technical Assistance and Trainingmentioning

confidence: 99%

Lessons Learned from Implementing Screening, Brief Intervention, and Referral to Treatment for Youth and Young Adults in Primary Care Settings

Lr¹,

Bradley²,

Ar³

et al. 2018

IPCC

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Screening, Brief Intervention, and Referral to Treatment (S·BI·RT) in pediatric practices normalizes conversationsbetween youth and healthcare providers about alcohol and other substance use, and supports guidance about healthybehaviors. S·BI·RT also identifies youth ages 12-22 whose current use of addictive substances places them at risk fordeveloping substance use disorders, prompting provider brief intervention and referral for further assessment ortreatment before a substance use disorder develops. From May 2014 to June 2017, S·BI·RT was implemented as astandard of care in 23 pediatric practices in three cohorts across 10 organizations in New Hampshire —includingacademic medical centers and FQHCs—serving over 74,000 youth. This case study focuses on strategies associatedwith operationalizing S·BI·RT, specifically training and technical assistance related to clinical workflow, for youth andyoung adults.

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Assessing Health Care Organizations’ Ability to Implement Screening, Brief Intervention, and Referral to Treatment

Cited by 10 publications

References 15 publications

Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments

Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments

The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

Lessons Learned from Implementing Screening, Brief Intervention, and Referral to Treatment for Youth and Young Adults in Primary Care Settings

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