Seed Global Health, Boston, MA, USA.
Boston College Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
BMC Health Serv Res. 2024 Aug 21;24(1):961. doi: 10.1186/s12913-024-11435-9.
Sierra Leone has one of the world's highest maternal and infant mortality rates and suffers from a shortage of well-trained health professionals, including midwives. Prior to engaging in systematic interventions, it is critical to measure organizational readiness to gauge members' psychological and behavioral preparedness to implement change. We aimed to measure the organizational readiness for implementing change and compare results among midwives and administrative leaders at two schools of midwifery in Sierra Leone prior to the rollout of a midwifery preceptor program.
The Organizational Readiness for Implementing Change (ORIC) survey is a validated 12-item questionnaire designed to assess two domains of organizational readiness for change: change commitment (motivation) and change efficacy (capacity). All survey items begin with the same prompt and a five-item Likert scale response, with seven questions about change commitment and five about change efficacy. Data collection occurred in two schools of midwifery in Sierra Leone during two day-long meetings with stakeholders. Statistical analysis was conducted using descriptive statistics and Wilcoxon rank-sum test to compare independent samples: School 1 versus School 2 (site), midwife versus other roles (role).
Participants included 42 respondents (mean age 41 years, 95% female). Surveys were distributed evenly between the two sites. Occupations included midwifery faculty (n = 8), administrators (n = 5), clinicians (n = 25), and clinical educators (n = 4). Domain 1 (change commitment) had a mean score of 4.72 (SD 0.47) while Domain 2 (change efficacy) had a mean score of 4.53 (SD 0.54) out of a total potential score of five. There were no statistically significant differences between site responses for Domain 1 (p = 0.5479) and Domain 2 (p = 0.1026) nor role responses for Domain 1 (p = 0.0627) and Domain 2 (p = 0.2520).
Stakeholders had very high overall readiness for change across all ORIC questions for both change commitment and change efficacy. Mean scores for change commitment were slightly higher which is not surprising given the low-resourced settings stakeholders work in while training students. High mean scores across sites and roles is encouraging as this novel preceptor program is currently being rolled out.
塞拉利昂是世界上孕产妇和婴儿死亡率最高的国家之一，同时面临着合格卫生专业人员短缺的问题，包括助产士。在进行系统干预之前，衡量组织对变革的准备程度对于评估成员实施变革的心理和行为准备至关重要。我们旨在衡量实施变革的组织准备程度，并在塞拉利昂的两所助产学校推出助产导师计划之前，比较助产士和行政领导之间的结果。
实施变革的组织准备度（ORIC）调查是一个经过验证的 12 项问卷，旨在评估组织变革准备度的两个领域：变革承诺（动机）和变革效能（能力）。所有调查项目都以相同的提示和五分制李克特量表响应开头，有七个关于变革承诺的问题和五个关于变革效能的问题。数据收集在塞拉利昂的两所助产学校进行，为期两天的利益相关者会议。使用描述性统计和 Wilcoxon 秩和检验进行统计分析，以比较独立样本：学校 1 与学校 2（地点）、助产士与其他角色（角色）。
参与者包括 42 名受访者（平均年龄 41 岁，95%女性）。调查在两个地点均匀分布。职业包括助产士教师（n=8）、管理人员（n=5）、临床医生（n=25）和临床教育家（n=4）。领域 1（变革承诺）的平均得分为 4.72（SD 0.47），而领域 2（变革效能）的平均得分为 4.53（SD 0.54），总分为五分。在领域 1（p=0.5479）和领域 2（p=0.1026）的地点反应以及领域 1（p=0.0627）和领域 2（p=0.2520）的角色反应方面，没有统计学上的显著差异。
利益相关者对所有 ORIC 问题的变革准备程度都非常高，包括变革承诺和变革效能。变革承诺的平均得分略高，这并不奇怪，因为利益相关者在培训学生时所处的资源匮乏环境。各地点和角色的高平均得分令人鼓舞，因为目前正在推出这种新的导师计划。
