# Presentation: 485424

## Measuring organizational readiness for change: an ongoing journey

**Bryan J. Weiner, Ph.D.**
**Shoou-Yih Daniel Lee, Ph.D.**
**Department of Health Policy and Management**
**Gillings School of Global Public Health**
**University of North Carolina at Chapel Hill**

## How did we define readiness?

- A two-dimensional construct reflecting organizational members’ _collective commitment_ and _collective efficacy_ to implement an organizational change
- Collective commitment refers to organizational members’ _shared resolve_ to pursue courses of action that will lead to successful change implementation
- Collective efficacy refers to organizational members’ _shared belief_ in their conjoint capabilities to organize and execute the courses of action required to implement change successfully
- Key features:
- Capture both motivation and capability
- Reference collective (organizational) versus individual readiness for change
- Treat readiness as perceptual versus structural construct
- Focus construct on implementation rather than on adoption

## What did we want in our measure?

- Keep measure “pure” (exclude potential determinants)
- Balance generic versus specific item content (make it reusable)
- Give measure a specific change referent (differentiate from culture)
- Make measure group-referenced (focus on collective readiness)
- Develop something short and simple (8-10 items maximum)

## What was our overall approach?

- Keep measure “pure” of potential determinants
- Develop a conceptual model of organizational readiness for change
- Work deductively rather than inductively to develop item pool
- Balance generic versus specific item content
- Develop a broad item pool to capture many aspects of efficacy
- Keep item wording general and put specifics in parentheses
- Give measure a specific change referent
- Use instructions to direct people’s attention to specific change
- Provide written synopsis of specific change
- Make measure group-referenced
- Use instructions to direct people’s attention to reference group
- Use item wording to direct people’s attention to collectivity
- Develop something short and simple
- Create item bank to permit tailoring

## What was our conceptual model?

- _Organizational Readiness to Change_
-  Change commitment
-  Change efficacy

- _Resource Availability_
-  Human resources
-  Financial resources
-  Material resources

- _Task Requirements_
-  Knowledge of task demands
-  Knowledge of resource demands
-  Knowledge of time/effort demands

- _Situational Factors_
-  Competing demands
-  Time availability
-  Timing

- _Change Valence_
-  Perceived need for change
-  Relative advantage of change
-  Appropriateness of change

- _Implementation Effectiveness_
-  Consistency of use
-  Quality of use

## How did we proceed?

- Develop item pool from readiness/change management literature
- Conduct content adequacy test to check item-construct alignment
- Revise item wording/pool based on content adequacy test
- Conduct pilot test to check presumed factor structure and reliability
- ....Develop R21 proposal to move beyond pilot stage....
- But then.....along came the “HTN Improve” study

## How did we measure change commitment?

- Provide written description of program (with bulleted summary)
- Define “implementation group” and “user group”
- Measure perceived change commitment of implementation group:
- 1. Not at all		2. A little		3. Fairly		4. Very		5. DK
- How _committed_ is the implementation group to implementing this program?
- How _motivated_ is the implementation group to implement this program?
- How _willing_ is the implementation group to implement this program?
- How much does the implementation group _want_ to implement this program?
- Repeat in order to measure change commitment of user group

## How did we measure change efficacy?

- Measure perceived change efficacy of implementation group
- 1. Not at all	2. A little		3. Fairly		4. Very		5. DK
- How confident are you that the implementation group can:
- Effectively use the resources that are currently available to implement this program?
- Encourage clinicians to try using this program (e.g., refer patients)?
- Effectively coordinate the efforts of those involved in implementing this program?
- Support clinicians as they adjust their clinical practice in response to this program?
- Effectively solve problems that might arise in implementing this program?

## Where are we going?

- Innovator

- Broker

- Producer

- Director

- Coordinator

- Monitor

- Mentor

- Facilitator

- Source: Quinn, RE. (1988) Beyond Rational Management. San Francisco: Jossey-Bass.

- Internal Process

- Human Relations

- Open Systems

- Rational Goal

## What are some sample items?

- 1. Not at all	2. A little		3. Fairly		4. Very		5. DK
- How confident are you that the implementation group can:
- Develop an effective strategy or plan for implementing this change? (director)
- Keep the momentum going in implementing this change? (producer)
- Hold people accountable for implementing this change (monitor)
- Coordinate tasks so that implementation goes smoothly? (coordinator)
- Support people as they adjust to this change? (mentor)
- Get people involved and invested in implementing this change? (facilitator)
- Improvise when problems arise implementing this change? (innovator)
- Manage the politics of implementing this change? (broker)
- Working on developing 2-3 items per change management role/task

## Want more information?

- Bryan Weiner, Ph.D.
- Department of Health Policy and Management
- Gillings School of Global Public Health
- University of North Carolina at Chapel Hill
- _[Bryan_Weiner@unc.edu](mailto:Bryan_Weiner@unc.edu)_
- 919-966-7375