Hefetz Tmira, Drach-Zahavy Anat
Health Care Manage Rev. 2025;50(3):250-260. doi: 10.1097/HMR.0000000000000443. Epub 2025 May 9.
According to organizational mindfulness (OM) theory, teams must constantly anticipate and recover from unforeseen events by avoiding oversimplified explanations, being attuned to operational details, maintaining commitment to resilience, engaging in preoccupation with failure, and prioritizing expertise in problem solving. Despite its merits, the assimilation of OM theory into health care systems remains challenging, as fundamental practices and procedures within these systems often conflict with the core principles of OM, leading to an implementation gap.
We begin by emphasizing why health care professionals, particularly nurses, are not yet ready for and even resistant to OM. Although OM is intensely patient focused and enables nurses to practice in alignment with the ideals of nursing, they may be reluctant to embrace it due to the burden it places on them without adequate resources.
We argue that readiness for change (RFC) theory offers valuable insights into addressing this challenge by identifying and mitigating barriers to change. We combine research on OM with the RFC model to conceptualize how to systematically integrate OM into health care settings.
Conceptually integrating RFC and OM frameworks can aid in narrowing the OM theory-implementation gap. To advance the field further, OM scholars should focus on better operationalizing OM principles, designing interventions to implement OM, and assessing their effectiveness with longitudinal designs and identify contextual boundary conditions for OM effective implementation. Moreover, we describe how leaders can support OM and RFC while managing resource constraints and supporting overwhelmed health care workers.
We distill our analysis into the 6-Step Road Map, suggesting evidence-based strategies for health care policymakers, administrators, and managers aiming to implement OM.
根据组织正念（OM）理论，团队必须通过避免过度简化的解释、关注运营细节、保持恢复力的承诺、专注于失败以及在解决问题时优先考虑专业知识，不断预测并从意外事件中恢复过来。尽管OM理论有其优点，但将其融入医疗保健系统仍然具有挑战性，因为这些系统中的基本做法和程序往往与OM的核心原则相冲突，导致实施差距。
我们首先强调为什么医疗保健专业人员，尤其是护士，尚未准备好甚至抵制OM。尽管OM高度以患者为中心，使护士能够按照护理理想进行实践，但由于在没有足够资源的情况下给他们带来的负担，他们可能不愿意接受它。
我们认为，变革准备度（RFC）理论通过识别和减轻变革障碍，为应对这一挑战提供了有价值的见解。我们将对OM的研究与RFC模型相结合，以概念化如何将OM系统地整合到医疗保健环境中。
从概念上整合RFC和OM框架有助于缩小OM理论与实施之间的差距。为了进一步推动该领域的发展，OM学者应专注于更好地将OM原则付诸实践、设计实施OM的干预措施，并通过纵向设计评估其有效性，同时确定OM有效实施的背景边界条件。此外，我们描述了领导者在管理资源限制和支持不堪重负的医护人员的同时，如何支持OM和RFC。
我们将分析提炼为六步路线图，为旨在实施OM的医疗保健政策制定者、管理人员和经理提出基于证据的策略。
