quality enhancement research initiative (queri) connecting research and patient care assessing...
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Quality Enhancement Research Initiative (QUERI)
Connecting Research and Patient Care
Assessing Organizational Readiness to
Change: A Review of Research to Date and
Development of a Cross-QUERI Agenda
Christian D. HelfrichIschemic Heart Disease-QUERI
Carmen HallPolytrauma and Blast-Related Injuries-QUERI
Bryan J. WeinerUniversity of North Carolina, Chapel Hill
Daniel T. HoltAir Force Institute of Technology
2
Guiding Questions
Where are you
today?
Where do you want
to go?
What do you
need to do to get
there?
‘From-to’
for themesPrioritized
efforts
Direction
Coordination & control
Accounta-bility
LeadershipExternal orientation
Innovation
Capability Motivation
Environment & values
4
Challenges of Change
Source:Kotter (2008); Beer & Nohria (2000); Cameron & Quinn (1997); Caldewell (1994); Gross et al. (1993); Kotter & Heskett (1992); Hickings (1998); Press clippings
70% of planned transformation efforts fail
Succeed
Fail 70
30 What leads to such a dramatic failure
rate within our organizations?
5
Challenges of Change
*Success defined through holistic assessment of company performance (non-public companies) or market out-performance (public companies) 1.5 years after performance transformation initiative
Source:Kotter (2008); Beer & Nohria (2000); Cameron & Quinn (1997); Caldewell (1994); Gross et al. (1993); Kotter & Heskett (1992); Hickings (1998); Press clippings
70% of planned transformation efforts fail
Succeed*
Fail*
Contributing factor examples
Culture & climate
• Misalignment with culture• History of change programs depletes
energy for transformation
Change content
• Initiative not tied to enterprise needs resulting in lack of direction, energy, and focus
Execution & process
• No single point of accountability• Insufficient & inconsistent engagement• No integration of hard & soft levers
Individual attributes
• Capability deficits are not or insufficiently addressed
• No institutionalizing of capabilities
70
30
6
OutcomesOutcomesOutcomesOutcomes
Internal ContextInternal Context
Ask, “Where is the change occurring?”
Internal ContextInternal Context
Ask, “Where is the change occurring?”
Individual AttributesIndividual Attributes
Ask, “Who has to implement the
change?”
Individual AttributesIndividual Attributes
Ask, “Who has to implement the
change?”
Change-specific Change-specific ContentContent
Ask, “What is being changed?”
Change-specific Change-specific ContentContent
Ask, “What is being changed?”
ProcessProcess
Ask, “How is change being implemented?”
ProcessProcess
Ask, “How is change being implemented?”
ReadinessReadiness
for for
ChangeChange
ReadinessReadiness
for for
ChangeChange Time
IntentionsIntentions
&&
ReactionsReactions
IntentionsIntentions
&&
ReactionsReactions
Process
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ReadinessReadinessReadinessReadiness AdoptionAdoptionAdoptionAdoption InstitutionalizationInstitutionalizationInstitutionalizationInstitutionalization
Prescribed Change Prescribed Change Message Delivery Message Delivery
MethodsMethods
Prescribed Change Prescribed Change Message Delivery Message Delivery
MethodsMethods
Prescribed Change Prescribed Change MessageMessage
Prescribed Change Prescribed Change MessageMessage
Appropriate use of Appropriate use of the prescriptions can the prescriptions can ease the transitions ease the transitions between descriptive between descriptive
stages.stages.
Descriptive Descriptive Model Model
ComponentsComponents
Prescriptive Prescriptive Model Model
ComponentsComponents
Connecting Research and Patient Care
Readiness for Change Questionnaire
Daniel T. HoltAir Force Institute of Technology
9
Readiness Instruments
• Process perspective• Culture & climate perspective• Change-specific perspective• Individual perspective
Readiness Perspectives
• Change process perspective• Readiness is reflected in the stage of change (e.g., denial,
resistance, exploration, implementation)
• Culture and climate perspective• Readiness is reflected in the organization’s culture & climate (i.e.,
these characteristics dictate how individuals react to particular situations)
• Change-specific perspective• Readiness is reflected in the characteristics of the proposed
change (e.g., superficial changes are preferred over significant changes)
• Individual perspective• Personality• Knowledge, skills & abilities• Critical attitudes
Available Measures
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Change process
perspective
Culture & climate
perspective
Change-specific
perspective
Individual
perspective
• Readiness is reflected in the stage of change (e.g., denial, resistance, exploration, implementation)
• 2 instruments are available
Of 32 instruments
reviewed, only 2 presented evidence of
content, construct, and
predictive validity.
12 did not even present
evidence of reliability a necessary
precondition for validity.
• Readiness is reflected in the organization’s culture & climate (i.e., these characteristics dictate how individuals react to particular situations)
• 13 instruments are available
• Readiness is reflected in the characteristics of the proposed change (e.g., superficial changes are preferred over significant changes)
• 5 instruments are available
• Readiness is reflected in the characteristics of the employees (e.g., personality, skills)
• 7 instruments are available
Based on Holt et al. (2007). Toward a comprehensive definition of readiness for change: A review of research an instrumentation. (5 measures of reactions were also included in this review that are captured here).
Development Process
Concept definition,
Item generation, &
Adequacy tests
Evaluate the
questionnaire
Administer the
questionnaire
1 2 3 4
• Identified factors that influenced readiness (documents, interviews, open-ended questionnaires)
• Evaluated the factors (291 practicing managers)
• Focused on most influential factors
• Wrote items & evaluated the items ensuring they represented the factors
Replicate the
findings in an
independent sample
Valid & reliable instrument to
assess Change-specific
Readiness
• Administered the questionnaire in a DoD organization with $300M budget
• Exploratory factor analysis indicated four factors were measured
• Change efficacy
• Management support
• Personal benefits
• Appropriateness
• Identified differences between known groups (participants should be more ready)
• Tested whether readiness is related to personality in meaningful ways (i.e., rebelliousness, locus of control)
• Tested whether readiness is related to culture in meaningful ways (i.e., communication, trust)
• Tested its ability to predict
• Administered the questionnaire in a private sector organization
• Test whether readiness is related to personality in meaningful ways (i.e., rebelliousness, locus of control)
• Test whether readiness is related to culture in meaningful ways (i.e., communication, trust)
Change-specific Assessment
Readiness for change assessment
•Identify appropriate interventions to address gaps:
– Communications messages directed toward appropriateness, efficacy, & valence
– Demonstrate visible management support (i.e., align of HR practices
– Introduce training to include members
•Analyze context
– Develop an action plan to address some performance gap
– Determine competitive risks (if appropriate)
– Determine performance risks
•Focus attention on issues connected to indicators of readiness
•Perform focused diagnostic of the internal environment (Readiness for change questionnaire)
Identify performance gaps, context, & competitive environment
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Scores Compared to Successful Organization
Readiness characteristics of an
enterprise introducing change
Appropriateness (e.g., personnel feel that the change will address the gap and congruent with organizational goals)
Change efficacy (e.g., personnel feel that they have the skills to execute the tasks and activities associated with the change)
Personal valence (e.g., personnel feel that the change will be beneficial personally)
Management Support (e.g., personnel feel that senior leaders support the change initiative and its adoption)
4.3
4.2
4.56
3.85
3.67
2.79
3.55
2.88
1
Enterprise compared to an organization that successfully introduced a change (Scale ranged from 1 to 5)
“Ready” organizations
Enterprise introducing a change
Summary
• Flexible• Used in a variety of organizational settings by members
at all organizational levels
• Practical• Consistent with criteria that are identified by practitioners• Guides those who are trying to facilitate changes• Gauges the most influential readiness factors
• Theoretical• Consistent with current theories of organizational
change• Adheres to accepted standards for measurement
Bryan’s Framework
• Is ORC a psychological or structural concept?• Conceptualized as a psychological concept
• Is ORC an individual-level or collective construct?• Measured at the individual-level
• Does ORC refer to a general state of affairs or to a specific change?• Refers to a specific change
• Does ORC apply to adoption or to implementation?• Refers to adopition
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Danny Holt
• Education• B.S., Electrical Engineering• M.A., Human Resource Development• M.S., Engineering & Environmental Mgt• Ph.D., Management
• Human Resource Management• Organizational Analysis• Organizational Change
• Air Force Career• Civil Engineering Officer (Myrtle Beach, SC; Osan AB,
ROK; Al Udeid AB, Qatar; Ft Dix, NJ; Ft Bragg, NC)• Academic (Graduate student; Faculty Air Force Institute of
Technology)
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Air Force Institute of Technology
Danny Holt
AFIT/ENV
2950 Hobson Way
Wright Patterson AFB, OH 45433
(937) 255-3636 extension 7396 (voice)
(937) 656-4699 (fax)