Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions
ObjectiveThe success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medica...
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Editorial Office of Medical Journal of Peking Union Medical College Hospital
2025-03-01
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| Series: | Xiehe Yixue Zazhi |
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| Online Access: | https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0651 |
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| author | YANG Wei CAI Yiyuan CHEN Jiajia MAO Run LINGHU Lang LYU Sensen XU Dong |
| author_facet | YANG Wei CAI Yiyuan CHEN Jiajia MAO Run LINGHU Lang LYU Sensen XU Dong |
| author_sort | YANG Wei |
| collection | DOAJ |
| description | ObjectiveThe success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program.MethodsQualitative interviews and quantitative surveys were conducted to evaluate the ORC level and its influencing factors in 12 institutions implementing the SMART program. The Scale for Assessing the Institution's Readiness to Implement Evidence-Based Practices was utilized to measure ORC levels. Qualitative interviews were conducted among change implementers to gather information regarding the status of influencing factors. Thematic analysis was applied to extract factors from the interview data, and an assessment questionnaire was developed to measure the perceived impact of these factors. A fuzzy-set qualitative comparative analysis (fsQCA) method was employed to identify the influencing factors of ORC and pathways leading to high-level ORC.ResultsSeventy implementers from 12 institutions, encompassing administrators, clinicians, and health managers, participated in the interviews and surveys. The median and interquartile of the ORC scores were 105.20 (101.23, 107.33). The fsQCA indicated that a clear understanding of specific tasks and responsibilities, the active engagement of key participants, sufficient preliminary preparation, and the use of audits and feedback mechanisms were critical pathways to a high-level ORC. Conversely, institutions lacking key participants, preliminary preparation, or marginal influence demonstrated a low-level ORC.ConclusionsBefore implementing innovation, Coherence and Cognitive Participation were identified as critical factors in influencing ORC. Strong leadership from key participants played pivotal role in enhancing readiness for change and was essential for improving implementation fidelity and overall program success. |
| format | Article |
| id | doaj-art-e6413f5854ab4017bfff59d453560405 |
| institution | DOAJ |
| issn | 1674-9081 |
| language | zho |
| publishDate | 2025-03-01 |
| publisher | Editorial Office of Medical Journal of Peking Union Medical College Hospital |
| record_format | Article |
| series | Xiehe Yixue Zazhi |
| spelling | doaj-art-e6413f5854ab4017bfff59d4535604052025-08-20T03:06:36ZzhoEditorial Office of Medical Journal of Peking Union Medical College HospitalXiehe Yixue Zazhi1674-90812025-03-0116247949110.12290/xhyxzz.2024-0651Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare InstitutionsYANG WeiCAI YiyuanCHEN JiajiaMAO RunLINGHU LangLYU Sensen0XU DongAcacia Lab for lmplementation Science, Department of Health Management, School of Health Management, Southern Medical University, Guangzhou 510515, ChinaObjectiveThe success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program.MethodsQualitative interviews and quantitative surveys were conducted to evaluate the ORC level and its influencing factors in 12 institutions implementing the SMART program. The Scale for Assessing the Institution's Readiness to Implement Evidence-Based Practices was utilized to measure ORC levels. Qualitative interviews were conducted among change implementers to gather information regarding the status of influencing factors. Thematic analysis was applied to extract factors from the interview data, and an assessment questionnaire was developed to measure the perceived impact of these factors. A fuzzy-set qualitative comparative analysis (fsQCA) method was employed to identify the influencing factors of ORC and pathways leading to high-level ORC.ResultsSeventy implementers from 12 institutions, encompassing administrators, clinicians, and health managers, participated in the interviews and surveys. The median and interquartile of the ORC scores were 105.20 (101.23, 107.33). The fsQCA indicated that a clear understanding of specific tasks and responsibilities, the active engagement of key participants, sufficient preliminary preparation, and the use of audits and feedback mechanisms were critical pathways to a high-level ORC. Conversely, institutions lacking key participants, preliminary preparation, or marginal influence demonstrated a low-level ORC.ConclusionsBefore implementing innovation, Coherence and Cognitive Participation were identified as critical factors in influencing ORC. Strong leadership from key participants played pivotal role in enhancing readiness for change and was essential for improving implementation fidelity and overall program success.https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0651implementation researchintegration of medical and preventionshared medical appointment for diabetesorganizational readiness for changequalitative comparative analysis |
| spellingShingle | YANG Wei CAI Yiyuan CHEN Jiajia MAO Run LINGHU Lang LYU Sensen XU Dong Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions Xiehe Yixue Zazhi implementation research integration of medical and prevention shared medical appointment for diabetes organizational readiness for change qualitative comparative analysis |
| title | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
| title_full | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
| title_fullStr | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
| title_full_unstemmed | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
| title_short | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
| title_sort | organizational readiness for change and factors influencing the implementation of shared medical appointment for diabetes in primary healthcare institutions |
| topic | implementation research integration of medical and prevention shared medical appointment for diabetes organizational readiness for change qualitative comparative analysis |
| url | https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0651 |
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