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医疗机构为实施脓毒症幸存者从医院到家庭的过渡护理协议而进行变革的准备情况。

Organizational readiness for change towards implementing a sepsis survivor hospital to home transition-in-care protocol.

作者信息

Sang Elaine, Quinn Ryan, Stawnychy Michael A, Song Jiyoun, Hirschman Karen B, You Sang Bin, Pitcher Katherine S, Hodgson Nancy A, Garren Patrik, O'Connor Melissa, Oh Sungho, Bowles Kathryn H

机构信息

NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States.

Leonard Davis Institute of Health Economics, The Wharton School, University of Pennsylvania, Philadelphia, PA, United States.

出版信息

Front Health Serv. 2024 Sep 6;4:1436375. doi: 10.3389/frhs.2024.1436375. eCollection 2024.

Abstract

BACKGROUND

Organizational readiness for change, defined as the collective preparedness of organization members to enact changes, remains understudied in implementing sepsis survivor transition-in-care protocols. Effective implementation relies on collaboration between hospital and post-acute care informants, including those who are leaders and staff. Therefore, our cross-sectional study compared organizational readiness for change among hospital and post-acute care informants.

METHODS

We invited informants from 16 hospitals and five affiliated HHC agencies involved in implementing a sepsis survivor transition-in-care protocol to complete a pre-implementation survey, where organizational readiness for change was measured via the Organizational Readiness to Implement Change (ORIC) scale (range 12-60). We also collected their demographic and job area information. Mann-Whitney -tests and linear regressions, adjusting for leadership status, were used to compare organizational readiness of change between hospital and post-acute care informants.

RESULTS

Eighty-four informants, 51 from hospitals and 33 from post-acute care, completed the survey. Hospital and post-acute care informants had a median ORIC score of 52 and 57 respectively. Post-acute care informants had a mean 4.39-unit higher ORIC score compared to hospital informants (= 0.03).

CONCLUSIONS

Post-acute care informants had higher organizational readiness of change than hospital informants, potentially attributed to differences in health policies, expertise, organizational structure, and priorities. These findings and potential inferences may inform sepsis survivor transition-in-care protocol implementation. Future research should confirm, expand, and examine underlying factors related to these findings with a larger and more diverse sample. Additional studies may assess the predictive validity of ORIC towards implementation success.

摘要

背景

组织变革准备度被定义为组织成员实施变革的集体准备情况,在实施脓毒症幸存者护理过渡方案方面仍未得到充分研究。有效的实施依赖于医院和急性后护理机构(包括领导者和工作人员)之间的协作。因此,我们的横断面研究比较了医院和急性后护理机构人员的组织变革准备度。

方法

我们邀请了参与实施脓毒症幸存者护理过渡方案的16家医院和5家附属HHC机构的人员完成一项实施前调查,通过组织变革准备度(ORIC)量表(范围为12 - 60)来衡量组织变革准备度。我们还收集了他们的人口统计学和工作领域信息。使用曼 - 惠特尼检验和线性回归,并对领导地位进行调整,以比较医院和急性后护理机构人员之间的组织变革准备度。

结果

84名人员完成了调查,其中51名来自医院,33名来自急性后护理机构。医院和急性后护理机构人员的ORIC中位数分别为52分和57分。与医院人员相比,急性后护理机构人员的ORIC平均分高4.39分(P = 0.03)。

结论

急性后护理机构人员比医院人员具有更高的组织变革准备度,这可能归因于卫生政策、专业知识、组织结构和优先事项的差异。这些发现和潜在推论可能为脓毒症幸存者护理过渡方案的实施提供参考。未来的研究应以更大、更多样化的样本证实、扩展并研究与这些发现相关的潜在因素。其他研究可评估ORIC对实施成功的预测效度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/343a/11412944/2553ad6643c8/frhs-04-1436375-g001.jpg

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