# Presentation: 729495

## Defining and measuring organizational readiness for change

**Bryan J. Weiner, Ph.D.**
**Halle Amick, BFA**
**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**

## What was our objective?

- Organizational readiness for change (ORC) is viewed as critical precursor to successful implementation
- Disconnected research activity across investigators and fields has resulted in a proliferation of terms, definitions, and measures
- _Question_:  how has organizational readiness for change (ORC) been defined and measured in health services research and other fields?
- _Aims_:
- Comprehensive review of growing but scattered body of work
- Critical assessment of conceptual and methodological issues

## What did we do?

- Searched peer-reviewed literature using six bibliographic databases
- Generated search term list with help of health science librarian
- Search parameters:  English only, January 1990-July 2007
- Inclusion/exclusion criteria:
- Focus on organizational change
- Eliminated articles focused on social, economic, or political change
- Eliminated articles that focus on individual-level change in health behavior or clinical practice
- Article had to emphasize or mention ORC
- Accepted synonyms:  commitment to change, willingness to change, acceptance and attitudes toward change, reactions to change, and readiness to take action
- Excluded resistance to change (regarded as different construct)
- Title, abstract, and full-text review done independently by 2 authors

## Combined

**Combined**
**(No Duplicates)**
- 1,469 Articles

**Retained after**
**Title Review**
- 628 Articles

**Retained after **
**Abstract Review**
- 115 Articles

**Retained after **
**Article Review **
- 106 Articles

**Reasons for Discarding at **
_**Title Review (N =841)**_
- Non-English:  21
- Non-Peer-Reviewed: 145
- Political/Economic/Social Change: 144
- Physical/Biological/Clinical Change: 230
- Organizational Change, but not readiness: 167
- Miscellaneous: 134*

**Reasons for Discarding at**
_**Abstract Review (N=513)**_
- Political/Economic/Social Change:   80
- Organizational Change, but not readiness:   321
- Miscellaneous:  112*

**Reasons for Discarding at**_**        Article Review (N=9)**_
- Organizational change, but not readiness: 8
- Student readiness for organizational change: 1

- * Extraneous articles included those unrelated to the subject of organizational readiness for change. The relatively unstructured nature of the literature on readiness generated many irrelevant “hits” in bibliographic databases. Examples available from authors.

## What did we find?

- Little consistency in terminology or conceptualization of ORC
- Is ORC a psychological or structural concept?
- Is ORC an individual-level or collective construct?
- Does ORC refer to a general state of affairs or to a specific change?
- Does ORC apply to adoption or to implementation?
- Limited evidence of reliability or validity for available instruments
- 43 instruments used in empirical research, having close-ended formats
- Only seven have been systematically assessed for reliability and validity
- Two instruments are specific to information technology implementation
- One instrument has serious construct validity issues
- One instrument has unstable psychometric properties
- Three instruments look promising, but measure ORC at individual level of analysis
- Very few studies of consequences of ORC

## What does it mean?

- Clarify the conceptual meaning of ORC:
- View ORC as a 2-dimensional construct:  motivation and capability
- Differentiate ORC from individual readiness for organizational change
- Regard ORC as a perceptual rather than structural construct
- View ORC as having a specific change referent
- Focus ORC construct on implementation rather than on adoption
- Address measurement issues:
- Give ORC measure specific change referent (direct people’s attention)
- Strike balance in generic versus specific item content (no easy task)
- Keep ORC measure “pure” (exclude ORC determinants from measure)
- Make ORC measure group-referenced (focus on collective readiness)
- Issues of timing, sampling, statistical aggregation remain challenging

## Want more information?

- Weiner BJ, Amick H, Lee S-Y. Conceptualization and measurement of organizational readiness for change: a review of the literature in health services research and other fields. Med Care Res Rev 2008 Aug;65(4):379-436.
- 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