52 research outputs found
Predicting implementation from organizational readiness for change: a study protocol
<p>Abstract</p> <p>Background</p> <p>There is widespread interest in measuring organizational readiness to implement evidence-based practices in clinical care. However, there are a number of challenges to validating organizational measures, including inferential bias arising from the halo effect and method bias - two threats to validity that, while well-documented by organizational scholars, are often ignored in health services research. We describe a protocol to comprehensively assess the psychometric properties of a previously developed survey, the Organizational Readiness to Change Assessment.</p> <p>Objectives</p> <p>Our objective is to conduct a comprehensive assessment of the psychometric properties of the Organizational Readiness to Change Assessment incorporating methods specifically to address threats from halo effect and method bias.</p> <p>Methods and Design</p> <p>We will conduct three sets of analyses using longitudinal, secondary data from four partner projects, each testing interventions to improve the implementation of an evidence-based clinical practice. Partner projects field the Organizational Readiness to Change Assessment at baseline (n = 208 respondents; 53 facilities), and prospectively assesses the degree to which the evidence-based practice is implemented. We will conduct predictive and concurrent validities using hierarchical linear modeling and multivariate regression, respectively. For predictive validity, the outcome is the change from baseline to follow-up in the use of the evidence-based practice. We will use intra-class correlations derived from hierarchical linear models to assess inter-rater reliability. Two partner projects will also field measures of job satisfaction for convergent and discriminant validity analyses, and will field Organizational Readiness to Change Assessment measures at follow-up for concurrent validity (n = 158 respondents; 33 facilities). Convergent and discriminant validities will test associations between organizational readiness and different aspects of job satisfaction: satisfaction with leadership, which should be highly correlated with readiness, versus satisfaction with salary, which should be less correlated with readiness. Content validity will be assessed using an expert panel and modified Delphi technique.</p> <p>Discussion</p> <p>We propose a comprehensive protocol for validating a survey instrument for assessing organizational readiness to change that specifically addresses key threats of bias related to halo effect, method bias and questions of construct validity that often go unexplored in research using measures of organizational constructs.</p
Quality collaboratives: lessons from research.
Quality improvement collaboratives are increasingly
being used in many countries to achieve rapid
improvements in health care. However, there is little
independent evidence that they are more cost effective
than other methods, and little knowledge about how
they could be made more effective. A number of
systematic evaluations are being performed by
researchers in North America, the UK, and Sweden.
This paper presents the shared ideas from two meetings
of these researchers. The evidence to date is that some
collaboratives have stimulated improvements in patient
care and organisational performance, but there are
significant differences between collaboratives and
teams. The researchers agreed on the possible reasons
why some were less successful than others, and
identified 10 challenges which organisers and teams
need to address to achieve improvement. In the absence
of more conclusive evidence, these guidelines are likely
to be useful for collaborative organisers, teams and their
managers and may also contribute to further research
into collaboratives and the spread of innovations in
health care
- …