Abstract
BackgroundHealth-care organizations need to be ready prior to implement evidence-based interventions. In this study, we sought to achieve consensus on a framework to assess the readiness of health-care organizations to implement evidence-based interventions in the context of chronic care.MethodsWe conducted a web-based modified Delphi study between March and May 2013. We contacted 76 potentially eligible international experts working in the fields of organizational readiness (OR), knowledge translation (KT), and chronic care to comment upon the 76 elements resulting from our proposed conceptual map. This conceptual map was based on a systematic review of the existing frameworks of Organizational Readiness for Change (ORC) in health-care. We developed a conceptual map that proposed a set of core concepts and their associated 17 dimensions and 59 sub-dimensions. Experts rated their agreement concerning the applicability and importance of ORC elements on a 5-point Likert scale, where 1 indicates total disagreement and 5 indicates total agreement. Two rounds were needed to get a consensus from the experts. Consensus was a priori defined as strong (≥75%) or moderate (60-74%). Simple descriptive statistics was used.ResultsIn total, 14 participants completed the first round and 10 completed the two rounds. Panel members reached consensus on the applicability and importance of 6 out of 17 dimensions and 28 out of 59 sub-dimensions to assess OR for KT in the context of chronic care. A strong level of consensus (≥75%) was attained on the Organizational contextual factors, Leadership/participation, Organizational support, and Motivation dimensions. The Organizational climate for change and Change content dimensions reached a moderate consensus (60-74%). Experts also reached consensus on 28 out of 59 sub-dimensions to assess OR for KT. Twenty-one sub-dimensions reached a strong consensus (≥75%) and seven a moderate consensus (60-74%).ConclusionThis study results provided the most important and applicable dimensions and sub-dimensions for assessing OR-KT in the context of chronic care. They can be used to guide the design of an assessment tool to improve knowledge translation in the field of chronic care.
Highlights
Health-care organizations need to be ready prior to implement evidence-based interventions
Consistent with the considerable body of literature that suggests that organizational contextual factors influence readiness [7], our findings showed that this dimension is considered key in the assessment of organizational readiness (OR) for knowledge translation (KT)
Change content and the change context are central dimensions of many instruments developed to assess Organizational readiness for change (ORC) [7]. Consistent with this literature, our study showed that the panel members consented on content of change dimension to consider in the assessment of OR for KT in the context of chronic care
Summary
Health-care organizations need to be ready prior to implement evidence-based interventions. We sought to achieve consensus on a framework to assess the readiness of health-care organizations to implement evidence-based interventions in the context of chronic care. Health-care organizations need sufficient high levels of readiness prior to implement evidence-based interventions [1,2]. Organizational readiness for change (ORC) in health-care settings is needed to assess an organization’s readiness to implement change in health-care in. We reviewed and synthesized the existing evidence on conceptual models/frameworks of ORC as the basis for the development of a comprehensive framework of organizational readiness (OR) for knowledge translation (KT) in the context of chronic care (CC) [6].
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