Measuring organizational readiness for knowledge translation in chronic care: A mixed methods systematic review on theories and instruments

Poster
2011 Madrid
Gagnon M1, Légaré F2, Ouimet M3, Estabrooks C4, Roch G1, Labarthe J5, Ghandour E5, Tremblay N5, Grimshaw J6
1Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada and Faculty of Nursing, Université Laval, Québec, Canada
2Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada and Department of Family Medicine, Université Laval, Québec, Canada
3Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada and Department of Political Science, Université Laval, Québec, Canada
4Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
5Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada
6Ottawa Hospital Research Institute, Ottawa, Canada and Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

Background:

Organizational readiness for change (ORC) assesses organizational members' collective motivation and capability to imple- ment change. However, the theorization of ORC lacks consensus and the available ORC instruments have shown limited validity and reliability.

Objectives:

We aim to develop an evidence-based, comprehensive, and valid instrument to measure organizational readi- ness (OR) for knowledge translation (KT) in chronic care. The existing evidence on ORC will be reviewed and synthesized as the basis for the development of a comprehensive, bilingual OR for KT instrument.

Methods:

Phase 1: We are conducting a mixed-methods systematic review on theories and instruments assessing ORC in health care. We will synthesize the findings in a conceptual map. A bibliography and a database of the ORC instruments will be prepared based on their psychometric appraisal. A pan-Canadian Delphi study will be carried out for the contextual assessment of these instruments. Phase 2: Individual interviews and focus groups will be conducted with key stakeholders for further development of the proposed instruments. A final bilingual (French/English) OR questionnaire will be tested in the field of chronic care to measure KT regarding the adoption of comprehensive, patient-centered and system-based chronic care models.

Results:

The initial review process retained 98 articles from a database of 2903 articles for full-text evaluation. After evaluation by two independent evaluators, 57 met the inclusion criteria and were critically appraised using quality criteria specific to quantitative, qualitative, and mixed-methods designs. Preliminary findings suggest a lack of consensus on the theoretical domains involved in ORC and limited evidence of ORC instrumentsá validity.

Conclusions:

This study provides a comprehensive synthesis and aims at creating a consensus on the theoretical underpinnings and the instrumentation of ORC. The final product, a validated, comprehensive, bilingual instrument to assess ORC for KT will be useful for supporting the implementation of evidence-based chronic care practices.