Assessing organizational readiness for change
TL;DR: Results indicate the ORC can contribute to the study of organizational change and technology transfer by identifying functional barriers involved and has acceptable psychometric properties.
About: This article is published in Journal of Substance Abuse Treatment.The article was published on 2002-06-01. It has received 817 citations till now. The article focuses on the topics: Organizational performance & Organizational learning.
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TL;DR: The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories.
Abstract: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.
8,080 citations
01 Jan 2005
TL;DR: The authors call for applied research to better understand service delivery processes and contextual factors to improve the efficiency and effectiveness of program implementation at local state and national levels.
Abstract: In the past few years several major reports highlighted the gap between our knowledge of effective treatments and services currently being received by consumers. These reports agree that we know much about interventions that are effective but make little use of them to help achieve important behavioral health outcomes for children families and adults nationally. This theme is repeated in reports by the Surgeon General (United States Department of Health and Human Services 1999; 2001) the National Institute of Mental Health [NIMH] National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment (2001) Bernfeld Farrington & Leschied (2001) Institute of Medicine (2001) and the Presidents New Freedom Commission on Mental Health (2003). The authors call for applied research to better understand service delivery processes and contextual factors to improve the efficiency and effectiveness of program implementation at local state and national levels. Our understanding of how to develop and evaluate evidence-based intervention programs has been furthered by on-going efforts to research and refine programs and practices to define "evidence bases" and to designate and catalogue "evidence-based programs or practices". However the factors involved in successful implementation of these programs are not as well understood. Current views of implementation are based on the scholarly foundations prepared by Pressman & Wildavskys (1973) study of policy implementation Havelock & Havelocks (1973) classic curriculum for training change agents and Rogers (1983; 1995) series of analyses of factors influencing decisions to choose a given innovation. These foundations were tested and further informed by the experience base generated by pioneering attempts to implement Fairweather Lodges and National Follow-Through education models among others. Petersilia (1990) concluded that "The ideas embodied in innovative social programs are not self-executing." Instead what is needed is an "implementation perspective on innovation--an approach that views postadoption events as crucial and focuses on the actions of those who convert it into practice as the key to success or failure". (excerpt)
3,603 citations
TL;DR: A multi-level, four phase model of the implementation process, derived from extant literature, is proposed and applied to public sector services and highlights features of the model likely to be particularly important in each phase, while considering the outer and inner contexts of public sector service systems.
Abstract: Implementation science is a quickly growing discipline. Lessons learned from business and medical settings are being applied but it is unclear how well they translate to settings with different historical origins and customs (e.g., public mental health, social service, alcohol/drug sectors). The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to public sector services. We highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of public sector service systems.
2,004 citations
Cites background from "Assessing organizational readiness ..."
...Studies of organizational readiness to change identify both structural (e.g., availability of computer resources) and process (e.g., cohesion, pressure for change) variables that may be related to adoption of EBPs (Lehman et al. 2002)....
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...pressure for change) variables that may be related to adoption of EBPs (Lehman et al. 2002)....
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TL;DR: The theory treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so, best suited for examining organizational changes where collective behavior change is necessary to effectively implement the change and for the change to produce anticipated benefits.
Abstract: Change management experts have emphasized the importance of establishing organizational readiness for change and recommended various strategies for creating it. Although the advice seems reasonable, the scientific basis for it is limited. Unlike individual readiness for change, organizational readiness for change has not been subject to extensive theoretical development or empirical study. In this article, I conceptually define organizational readiness for change and develop a theory of its determinants and outcomes. I focus on the organizational level of analysis because many promising approaches to improving healthcare delivery entail collective behavior change in the form of systems redesign--that is, multiple, simultaneous changes in staffing, work flow, decision making, communication, and reward systems. Organizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational members value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior. The result is more effective implementation. The theory described in this article treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so. This way of thinking about organizational readiness is best suited for examining organizational changes where collective behavior change is necessary in order to effectively implement the change and, in some instances, for the change to produce anticipated benefits. Testing the theory would require further measurement development and careful sampling decisions. The theory offers a means of reconciling the structural and psychological views of organizational readiness found in the literature. Further, the theory suggests the possibility that the strategies that change management experts recommend are equifinal. That is, there is no 'one best way' to increase organizational readiness for change.
1,453 citations
Cites background from "Assessing organizational readiness ..."
...Change valence is a parsimonious construct that brings some theoretical coherence to the numerous and disparate drivers of readiness that change management experts and scholars have discussed [11,13,22,28,44-46]....
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...Others describe organizational readiness for change in more structural terms, emphasizing the organization's financial, material, human, and informational resources [26-34]....
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TL;DR: Attitudes toward adoption of EBPs can be reliably measured and vary in relation to individual differences and service context and EBP implementation plans should include consideration of mental health service provider attitudes as a potential aid to improve the process and effectiveness of dissemination efforts.
Abstract: Mental health provider attitudes toward organizational change have not been well studied. Dissemination and implementation of evidence-based practices (EBPs) into real-world settings represent organizational change that may be limited or facilitated by provider attitudes toward adoption of new treatments, interventions, and practices. A brief measure of mental health provider attitudes toward adoption of EBPs was developed and attitudes were examined in relation to a set of provider individual difference and organizational characteristics. Methods: Participants were 322 public sector clinical service workers from 51 programs providing mental health services to children and adolescents and their families. Results: Four dimensions of attitudes toward adoption of EBPs were identified: (1) intuitive Appeal of EBP, (2) likelihood of adopting EBP given Requirements to do so, (3) Openness to new practices, and (4) perceived Divergence of usual practice with research-based/academically developed interventions. Provider attitudes varied by education level, level of experience, and organizational context. Conclusions: Attitudes toward adoption of EBPs can be reliably measured and vary in relation to individual differences and service context. EBP implementation plans should include consideration of mental health service provider attitudes as a potential aid to improve the process and effectiveness of dissemination efforts.
1,063 citations
Cites background from "Assessing organizational readiness ..."
...For example, Lehman, Greener, and Simpson (2002) examined staff attributes in regard to organizational change in substance abuse treatment settings....
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...For example, Lehman, Greener, and Simpson (2002) examined staff attributes in regard to organizational change in substance abuse treatment settings....
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References
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TL;DR: In this paper, a general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test, therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test.
Abstract: A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should be so divided before using the formula. The index
$$\bar r_{ij} $$
, derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches. Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial group-factor clusters within a subtest. Scalability is not a requisite.
37,235 citations
"Assessing organizational readiness ..." refers methods in this paper
...Consistent with these recommendations and related methodological work (Muthén, 1991; Raudenbush, Rowan, & Kang, 1991), we computed separate coefficient alpha reliabilities (Cronbach, 1951) for staff and programs....
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TL;DR: An up-to-date handbook on conceptual and methodological issues relevant to the study of industrial and organizational behavior is presented in this paper, which covers substantive issues at both the individual and organizational level in both theoretical and practical terms.
Abstract: An up-to-date handbook on conceptual and methodological issues relevant to the study of industrial and organizational behavior. Chapters contributed by leading experts from the academic and business communities cover substantive issues at both the individual and organizational level, in both theoretical and practical terms.
7,809 citations
TL;DR: In this article, the authors suggest that implementation effectiveness is a function of the strength of an organization's climate for the implementation of an innovation and the fit of that innovation to targeted users' values.
Abstract: Implementation is the process of gaining targeted organizational members' appropriate and committed use of an innovation. Our model suggests that implementation effectiveness—the consistency and quality of targeted organizational members' use of an innovation—is a function of (a) the strength of an organization's climate for the implementation of that innovation and (b) the fit of that innovation to targeted users' values. The model specifies a range of implementation outcomes (including resistance, avoidance, compliance, and commitment); highlights the equifinality of an organization's climate for implementation; describes within- and between-organizational differences in innovation-values fit; and suggests new topics and strategies for implementation research.
2,006 citations
"Assessing organizational readiness ..." refers background in this paper
...For example, Klein and colleagues ( Klein & Sorra, 1996; Klein, Conn, & Sorra, 2001) describe a model in which financial resource availability, management support, and staff attributes are key elements in determining implementation effectiveness....
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TL;DR: In this paper, the authors present a typology of readiness programs for large-scale organizational change, and a large multinational corporation's efforts to create readiness for large scale change are described.
Abstract: The purpose of this article is to clarify the readiness for change concept and examine how change agents can influence employee readiness for organizational change. The article contributes to an improved understanding of change dynamics in four important ways. First, readiness for change is distinguished from resistance to change. Readiness is described in terms of the organizational members' beliefs, attitudes, and intentions. Second, a model is offered that describes the influence strategies as well as the importance of change agent credibility and interpersonal and social dynamics in the readiness creation process. Third, by combining urgency of, and employee readiness for, needed changes, a typology of readiness programs is offered. Fourth, a large multinational corporation's efforts to create readiness for large-scale change are described to provide a cogent illustration of the various readiness interventions described in the model.
1,780 citations
"Assessing organizational readiness ..." refers background in this paper
...Judgments are made about the value of these innovations, and sometimes pressures for change are involved as well ( Armenakis, Harris, & Mossholder, 1993; Backer, 1995; Hage & Aiken, 1966; Pond, Armenakis, & Green, 1984)....
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TL;DR: In this article, structural and attitudinal aspects of professionalization and the organizational settings in which many professional occupations exist are analyzed, and it is suggested that the presence of professionals in an organization affects the structure of the organization, while at the same time, the organizational structure can affect professionalization process.
Abstract: Analysis of structural and attitudinal aspects of professionalization, and of the organizational settings in which many professional occupations exist, suggests that there is generally an inverse relationship between professionalization and bureaucratization, although there is considerable variation within the relationship. The data further suggest that the structural and attitudinal aspects of professionalization do not necessarily vary together. The organizations in which professionals work also differ in their degrees of bureaucratization. It is suggested that the presence of professionals in an organization affects the structure of the organization, while at the same time, the organizational structure can affect the professionalization process.
1,192 citations
"Assessing organizational readiness ..." refers background in this paper
..., 1999), professionalism (Bartol, 1979; Hall, 1968), and behavioral change models (Fishbein, 1995) converge on similar dimensions of attitude and functioning that influence organizational change....
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