Abstract
BackgroundOrganizational change initiatives in health care frequently achieve only partial implementation success. Understanding an organizational readiness for change (ORC) may be a way to develop more effective and efficient change strategies. Denmark, like many countries, has begun a major system-wide structural reform which involves considerable changes in service delivery. Due to the lack of a validated Danish instrument, we aimed to translate and validate a Danish version of the Organizational Readiness for Implementing Change (ORIC) questionnaire. It measures if organizational members are confident in their collective commitment towards and ability (efficacy) to implement organizational change. ORIC is concise, grounded in theory, and designed, but not yet validated among employees in a real hospital setting.MethodsThe 12-item ORIC instrument was translated into Danish and back-translated to English. Employees (N = 284) at a hospital department facing a major organizational change in the Central Denmark Region completed the questionnaire. Face and content validity was ascertained. Exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were used to assess construct validity. Reliability was assessed with Cronbach’s alpha. Item response theory (Rasch analysis) was used to determine item and person reliability.ResultsResponse rate was 72%. A two factor (commitment and efficacy), 11-item scale, of the Danish language ORIC was shown to be valid (CFI = .95, RMSEA = .067, and CMNI/DF = 2.32) and reliable (Cronbach’s alpha 0.88) in a health care setting. Item response analysis confirmed acceptable person and item separation reliability.ConclusionsOur version of ORIC showed acceptable validity and reliability as an instrument for measuring readiness for implementing organizational change in a Danish-speaking health care population. For health care managers interested in evaluating their organizations and tailor change strategies, ORIC’s brevity and theoretical underpinnings could make it an appealing and feasible tool to develop more successful change efforts.
Highlights
Organizational change initiatives in health care frequently achieve only partial implementation success
Participants and procedures This study was conducted at the Department of Obstetrics and Gynecology (OB/GYN) at Aarhus University Hospital (AUH)
The efficacy requirements were addressed through an improvement process that led to the implementation of changes at the level of care pathways for individual medical conditions and at the organizational level
Summary
Organizational change initiatives in health care frequently achieve only partial implementation success. Due to the lack of a validated Danish instrument, we aimed to translate and validate a Danish version of the Organizational Readiness for Implementing Change (ORIC) questionnaire. It measures if organizational members are confident in their collective commitment towards and ability (efficacy) to implement organizational change. Change efficacy refers to organization members’ shared belief in their “collective capabilities to organize and execute the courses of action involved in change implementation” [8] It reflects the amount of knowledge available about what to do and how to do it, i.e., it is a function of members’ cognitive appraisal of three factors of implementation capability: the resources (including time) available, task demands, and the situation the organization faces [4, 9]. The ability to measure how an organization’s members perceive these two constructs may, be used by health care leaders to develop more effective and efficient change strategies [4]
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