Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations

BackgroundTo address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation.MethodsA multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability.ResultsNine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78 %) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44 %) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool .ConclusionsReady, Set, Change! decision support tool is an implementation support that is designed to facilitate the routine incorporation of a readiness assessment as an early step in implementation. Use of this tool in practice may offer time and resource-saving implications for implementation.

[1]  S. Michie,et al.  The behaviour change wheel: A new method for characterising and designing behaviour change interventions , 2011, Implementation science : IS.

[2]  D. Hunter,et al.  Qualitative Research: Consensus methods for medical and health services research , 1995 .

[3]  D. Cicchetti.  Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology. , 1994 .

[4]  D. Bouckenooghe.  The role of organizational politics, contextual resources, and formal communication on change recipients' commitment to change: A multilevel study , 2012 .

[5]  S. Straus,et al.  Learning in practice The case for knowledge translation : shortening the journey from evidence to effect , 2003 .

[6]  Bryan J. Weiner,et al.  Are You Ready? How Health Professionals Can Comprehensively Conceptualize Readiness for Change , 2010, Journal of General Internal Medicine.

[7]  S. Straus,et al.  Lost in knowledge translation: Time for a map? , 2006, The Journal of continuing education in the health professions.

[8]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[9]  S. Straus,et al.  The development of an online decision support tool for organizational readiness for change , 2014, Implementation Science.

[10]  Susan Michie,et al.  Demystifying theory and its use in improvement , 2015, BMJ quality & safety.

[11]  Bryan J Weiner,et al.  Conceptualization and measurement of organizational readiness for change: a review of the literature in health services research and other fields. , 2008, Medical care research and review : MCRR.

[12]  M. Gagnon,et al.  Organizational readiness for knowledge translation in chronic care: a review of theoretical components , 2013, Implementation Science.

[13]  L. Sinclair,et al.  Evaluating organizational readiness for change: a preliminary mixed-model assessment of an interprofessional rehabilitation hospital. , 2006, Healthcare quarterly.

[14]  Barbara Cherry,et al.  Assessing organizational readiness for electronic health record adoption in long-term care facilities. , 2011, Journal of gerontological nursing.

[15]  Rita Snyder-Halpern.  Development and pilot testing of an Organizational Information Technology/Systems Innovation Readiness Scale (OITIRS) , 2002, AMIA.

[16]  Bryan J. Weiner,et al.  Review: Conceptualization and Measurement of Organizational Readiness for Change , 2008, Medical care research and review : MCRR.

[17]  J. Grimshaw,et al.  Knowledge translation of research findings , 2012, Implementation Science.

[18]  J. Lowery,et al.  Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science , 2009, Implementation science : IS.

[19]  B. Swaine,et al.  Assessment of organizational readiness for e-health in a rehabilitation centre , 2012, Disability and rehabilitation.

[20]  Wei Wang,et al.  Predicting Program Start-Up Using the Stages of Implementation Measure , 2012, Administration and Policy in Mental Health and Mental Health Services Research.

[21]  Karen A. Blase,et al.  Implementation Research: A Synthesis of the , 2005 .

[22]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[23]  Jennifer Leeman,et al.  What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review , 2015, Implementation Science.

[24]  N. Jimmieson,et al.  The Impact of Organizational Culture and Reshaping Capabilities on Change Implementation Success: The Mediating Role of Readiness for Change , 2005 .

[25]  Achilles A. Armenakis,et al.  Readiness for Organizational Change , 2007 .

[26]  G. Christiaens,et al.  Leading change , 2018, Leadership Transitions in Universities.

[27]  Albert Gatt,et al.  American Medical Informatics Association Annual Symposium Proceedings , 2008 .

[28]  S. Straus,et al.  Knowledge translation in health care : moving from evidence to practice , 2009 .

[29]  Vimla L. Patel,et al.  Usability testing in medical informatics: cognitive approaches to evaluation of information systems and user interfaces , 1997, AMIA.

[30]  Michael A. West,et al.  Team Climate Inventory , 2016 .

[31]  S. Flocke,et al.  Measuring Practice Capacity for Change: A Tool for Guiding Quality Improvement in Primary Care Settings , 2009, Quality management in health care.

[32]  P. Vargha,et al.  A critical discussion of intraclass correlation coefficients. , 1997, Statistics in medicine.

[33]  James T. Miller,et al.  An Empirical Evaluation of the System Usability Scale , 2008, Int. J. Hum. Comput. Interact..

[34]  D. Simpson,et al.  Assessing organizational readiness for change. , 2002, Journal of substance abuse treatment.

[35]  Iain Chalmers,et al.  How to increase value and reduce waste when research priorities are set , 2014, The Lancet.

[36]  Monika Kastner,et al.  Usability evaluation of a clinical decision support tool for osteoporosis disease management , 2010, Implementation science : IS.

[37]  Sharon E. Straus,et al.  Knowledge Translation in Health Care , 2009 .

[38]  J. Grimshaw,et al.  A Systematic Review of Instruments to Assess Organizational Readiness for Knowledge Translation in Health Care , 2014, PloS one.

[39]  S. Harris,et al.  Creating Readiness for Organizational Change , 1993 .

[40]  Karen A. Blase,et al.  Implementation research: A synthesis of the literature (No. 231). University of South Florida, Louis de la Parte Florida Mental Health Implementation Research Network. , 2012 .

[41]  C. Helfrich,et al.  Implementation Science Organizational Readiness to Change Assessment (orca): Development of an Instrument Based on the Promoting Action on Research in Health Services (parihs) Framework , 2022 .

[42]  Margret Amatayakul,et al.  EHR? Assess readiness first. , 2005, Healthcare financial management : journal of the Healthcare Financial Management Association.

[43]  P A Jennett,et al.  Preparing for success: readiness models for rural telehealth. , 2005, Journal of postgraduate medicine.

[44]  Alan Bryman,et al.  Analyzing Qualitative Data , 1994 .

[45]  L. Eby,et al.  Perceptions of Organizational Readiness for Change: Factors Related to Employees' Reactions to the Implementation of Team-Based Selling , 2000 .