Abstract
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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0262-y) contains supplementary material, which is available to authorized users.
Highlights
To 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
Phase two: Mapping items to a conceptual framework Study investigators and research experts in organizational readiness for change were identified from existing professional networks using purposive sampling, and invited to participate in a mapping exercise to categorize the individual items of included readiness assessment measures according to key readiness constructs from an existing framework [16]
The goal of Ready, Set, Change! decision support tool is to provide a rigorously developed implementation support to be used in practice during the planning stages of implementation
Summary
To 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. To maximize the return on investments made in implementation initiatives and to ensure significant and sustainable impacts, healthcare organizations must rollout interventions that are known to be effective, using evidence-based and contextualized implementation processes [1,2,3,4,5]. Implementation is a complex process often resulting in unsuccessful attempts to adopt interventions. When initiatives are implemented, they often result in little to no meaningful practice change [9]. Contextual factors that surround a particular implementation effort can act to promote or hinder the implementation of evidence-based interventions [10]
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