Department of Psychology, Linnaeus University, Sweden; Department of Psychology, Lund University, Sweden; Department of Psychology, Halmstad University, Sweden.
Department of Psychology, Linnaeus University, Sweden; Department of Psychology, Lund University, Sweden; Department of Psychology, Halmstad University, Sweden.
J Subst Abuse Treat. 2018 Jan;84:9-16. doi: 10.1016/j.jsat.2017.10.004. Epub 2017 Oct 13.
Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare.
The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013.
The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis.
Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes.
A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α=0.67 to α=0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α=0.64), institutional resources (α=0.52), staff attributes (α=0.76), and organizational climate (α=0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n=614), Profile 2 (n=934), and Profile 1 (n=246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile.
In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users.
组织氛围和相关因素与结果相关，因此对医疗保健组织至关重要。组织变革准备度（ORC）是本研究中用于评估组织因素对实施成功影响的问卷。受访者受雇于瑞典社会福利和精神药物/滥用治疗服务的 203 个瑞典市中的一个。他们参加了由瑞典地方当局和地区协会（SALAR）组织的全国实施项目，该项目由瑞典国家卫生和福利委员会委托。
（a）根据 2011 年收集的数据，确定具有不同 ORC 特征的员工类别（群集）；（b）调查在 2011 年和 2013 年预测使用评估工具、治疗方法和协作活动的 ORC 特征。
评估研究采用自然主义设计，连续评估登记结果。通过各自医疗单位的官方电子邮件地址联系参与者，并由其主管鼓励他们自愿参加。
使用 SPSS 版本 23 获得描述性统计数据。使用 Mplus 7.3 进行潜在剖面分析（LPA），使用稳健最大似然估计器（MLR），根据 18 个 ORC 指标确定亚组（群集）。
共有 2402 名员工对调查做出了回应，其中 1794 名（74.7%）完成了 ORC 评分。描述性分析表明，受访者是一个同质的员工群体，其中女性（72.0%）占多数。18 个 ORC 指标的 Cronbach's alpha 范围为α=0.67 至α=0.78。主成分分析产生了一个四因素解决方案，解释了总 ORC 分数的 62%。这些因素是：动机准备（α=0.64）、机构资源（α=0.52）、员工属性（α=0.76）和组织氛围（α=0.74）。对四个因素及其三个不同特征的 LPA 分析提供了最佳的数据拟合：特征 3（n=614）、特征 2（n=934）和特征 1（n=246）。具有最有利的 ORC 评分（特征 3）的受访者在 2011 年和 2013 年比特征 1（最不成功的特征）的受访者使用了更多的工具和更多的治疗方法，并且具有更好的协作网络。
在一个大型的社会工作和医疗保健专业人员样本中，反映更高机构资源、员工属性和组织氛围以及更低变革动机准备度的 ORC 评分与瑞典物质使用者护理和治疗良好实践指南的成功实施相关。作为一个构建，低动机准备度可能表明对现状的满意。由于 ORC 被证明是将基于证据的指南成功传播到常规和专业医疗保健中的指标，因此它可用于针对个别员工或服务进行干预，并提高物质使用者治疗指南的传播和遵守。
