Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, CB # 7411, Chapel Hill, NC, USA.
Implement Sci. 2014 Jan 10;9:7. doi: 10.1186/1748-5908-9-7.
BACKGROUND: Organizational readiness for change in healthcare settings is an important factor in successful implementation of new policies, programs, and practices. However, research on the topic is hindered by the absence of a brief, reliable, and valid measure. Until such a measure is developed, we cannot advance scientific knowledge about readiness or provide evidence-based guidance to organizational leaders about how to increase readiness. This article presents results of a psychometric assessment of a new measure called Organizational Readiness for Implementing Change (ORIC), which we developed based on Weiner's theory of organizational readiness for change. METHODS: We conducted four studies to assess the psychometric properties of ORIC. In study one, we assessed the content adequacy of the new measure using quantitative methods. In study two, we examined the measure's factor structure and reliability in a laboratory simulation. In study three, we assessed the reliability and validity of an organization-level measure of readiness based on aggregated individual-level data from study two. In study four, we conducted a small field study utilizing the same analytic methods as in study three. RESULTS: Content adequacy assessment indicated that the items developed to measure change commitment and change efficacy reflected the theoretical content of these two facets of organizational readiness and distinguished the facets from hypothesized determinants of readiness. Exploratory and confirmatory factor analysis in the lab and field studies revealed two correlated factors, as expected, with good model fit and high item loadings. Reliability analysis in the lab and field studies showed high inter-item consistency for the resulting individual-level scales for change commitment and change efficacy. Inter-rater reliability and inter-rater agreement statistics supported the aggregation of individual level readiness perceptions to the organizational level of analysis. CONCLUSIONS: This article provides evidence in support of the ORIC measure. We believe this measure will enable testing of theories about determinants and consequences of organizational readiness and, ultimately, assist healthcare leaders to reduce the number of health organization change efforts that do not achieve desired benefits. Although ORIC shows promise, further assessment is needed to test for convergent, discriminant, and predictive validity.
背景:医疗机构的组织变革准备度是成功实施新政策、项目和实践的重要因素。然而,由于缺乏简洁、可靠和有效的衡量标准,该主题的研究受到了阻碍。在开发出这样的衡量标准之前,我们无法推进有关准备度的科学知识,也无法为组织领导者提供关于如何提高准备度的循证指导。本文介绍了一种新的衡量标准,即组织变革实施准备度(ORIC)的心理测量评估结果,该标准是基于 Weiner 的组织变革准备度理论开发的。
方法:我们进行了四项研究,以评估 ORIC 的心理测量特性。在研究一,我们使用定量方法评估新测量的内容充分性。在研究二,我们在实验室模拟中检验了该测量的因素结构和可靠性。在研究三,我们基于研究二中的聚合个体数据评估了基于组织层面的准备度的可靠性和有效性。在研究四,我们利用与研究三相同的分析方法进行了一项小型实地研究。
结果:内容充分性评估表明,为衡量变革承诺和变革效能而开发的项目反映了组织准备度这两个方面的理论内容,并将这两个方面与准备度的假设决定因素区分开来。实验室和实地研究的探索性和验证性因素分析揭示了两个相关因素,这与预期相符,并且具有良好的模型拟合度和高项目负荷。实验室和实地研究的可靠性分析显示,变革承诺和变革效能的个体水平尺度的项目内一致性很高。评分者间信度和评分者间一致性统计数据支持将个体层面的准备度感知聚合到组织层面的分析中。
结论:本文提供了支持 ORIC 测量的证据。我们相信,该测量将能够检验有关组织准备度决定因素和后果的理论,并最终帮助医疗保健领导者减少未能实现预期收益的医疗组织变革努力的数量。尽管 ORIC 显示出了前景,但还需要进一步评估以检验其收敛性、区分度和预测性有效性。
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