Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care

Hdl Handle:
http://hdl.handle.net/10149/58194
Title:
Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care
Authors:
Hamilton, S. (Sharon); McLaren, S. (Susan); Mulhall, A. (Anne)
Affiliation:
University of Teesside. Centre for Health and Social Evaluation (CHASE); London South Bank University. Faculty of Health and Social Care. Centre for Leadership and Practice Innovation.
Citation:
Hamilton, S., McLaren, S. and Mulhall, A. (2007) 'Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care', Implementation Science; 2 (21): pp.1-11.
Publisher:
Biomed Central
Journal:
Implementation Science
Issue Date:
14-Jul-2007
URI:
http://hdl.handle.net/10149/58194
DOI:
10.1186/1748-5908-2-21
Additional Links:
http://www.implementationscience.com/content/2/1/21
Abstract:
Background. Achieving evidence-based practice in health care is integral to the drive for quality improvement in the National Health Service in the UK. Encapsulated within this policy agenda are challenges inherent in leading and managing organisational change. Not least of these is the need to change the behaviours of individuals and groups in order to embed new practices. Such changes are set within a context of organisational culture that can present a number of barriers and facilitators to change. Diagnostic analysis has been recommended as a precursor to the implementation of change to enable such barriers and facilitators to be identified and a targeted implementation strategy developed. Although diagnostic analysis is recommended, there is a paucity of advice on appropriate methods to use. This paper addresses the paucity and builds on previous work by recommending a mixed method approach to diagnostic analysis comprising both quantitative and qualitative data. Methods. Twenty staff members with strategic accountability for stroke care were purposively sampled to take part in semi-structured interviews. Six recently discharged patients were also interviewed. Focus groups were conducted with one group of registered ward-based nurses (n = 5) and three specialist registrars (n = 3) purposively selected for their interest in stroke care. All professional staff on the study wards were sent the Team Climate Inventory questionnaire (n = 206). This elicited a response rate of 72% (n = 148). Results. A number of facilitators for change were identified, including stakeholder support, organisational commitment to education, strong team climate in some teams, exemplars of past successful organisational change, and positive working environments. A number of barriers were also identified, including: unidisciplinary assessment/recording practices, varying in structure and evidence-base; weak team climate in some teams; negative exemplars of organisational change; and uncertainty created by impending organisational merger. Conclusion. This study built on previous research by proposing a mixed method approach for diagnostic analysis. The combination of qualitative and quantitative data were able to capture multiple perspectives on barriers and facilitators to change. These data informed the tailoring of the implementation strategy to the specific needs of the Trust.
Type:
Article
Keywords:
organisational change; diagnostic analysis; stroke care; acute care
ISSN:
1748-5908
Rights:
Author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 12/11/09]. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. See http://www.implementationscience.com/content/2/1/21
Citation Count:
5 [Scopus, 12/11/2009]

Full metadata record

DC FieldValue Language
dc.contributor.authorHamilton, S. (Sharon)-
dc.contributor.authorMcLaren, S. (Susan)-
dc.contributor.authorMulhall, A. (Anne)-
dc.date.accessioned2009-04-01T10:45:34Z-
dc.date.available2009-04-01T10:45:34Z-
dc.date.issued2007-07-14-
dc.identifier.citationImplementation Science; 2: article number 21-
dc.identifier.issn1748-5908-
dc.identifier.doi10.1186/1748-5908-2-21-
dc.identifier.urihttp://hdl.handle.net/10149/58194-
dc.description.abstractBackground. Achieving evidence-based practice in health care is integral to the drive for quality improvement in the National Health Service in the UK. Encapsulated within this policy agenda are challenges inherent in leading and managing organisational change. Not least of these is the need to change the behaviours of individuals and groups in order to embed new practices. Such changes are set within a context of organisational culture that can present a number of barriers and facilitators to change. Diagnostic analysis has been recommended as a precursor to the implementation of change to enable such barriers and facilitators to be identified and a targeted implementation strategy developed. Although diagnostic analysis is recommended, there is a paucity of advice on appropriate methods to use. This paper addresses the paucity and builds on previous work by recommending a mixed method approach to diagnostic analysis comprising both quantitative and qualitative data. Methods. Twenty staff members with strategic accountability for stroke care were purposively sampled to take part in semi-structured interviews. Six recently discharged patients were also interviewed. Focus groups were conducted with one group of registered ward-based nurses (n = 5) and three specialist registrars (n = 3) purposively selected for their interest in stroke care. All professional staff on the study wards were sent the Team Climate Inventory questionnaire (n = 206). This elicited a response rate of 72% (n = 148). Results. A number of facilitators for change were identified, including stakeholder support, organisational commitment to education, strong team climate in some teams, exemplars of past successful organisational change, and positive working environments. A number of barriers were also identified, including: unidisciplinary assessment/recording practices, varying in structure and evidence-base; weak team climate in some teams; negative exemplars of organisational change; and uncertainty created by impending organisational merger. Conclusion. This study built on previous research by proposing a mixed method approach for diagnostic analysis. The combination of qualitative and quantitative data were able to capture multiple perspectives on barriers and facilitators to change. These data informed the tailoring of the implementation strategy to the specific needs of the Trust.-
dc.publisherBiomed Central-
dc.relation.urlhttp://www.implementationscience.com/content/2/1/21-
dc.rightsAuthor can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 12/11/09]. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. See http://www.implementationscience.com/content/2/1/21-
dc.subjectorganisational change-
dc.subjectdiagnostic analysis-
dc.subjectstroke care-
dc.subjectacute care-
dc.titleAssessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care-
dc.typeArticle-
dc.contributor.departmentUniversity of Teesside. Centre for Health and Social Evaluation (CHASE); London South Bank University. Faculty of Health and Social Care. Centre for Leadership and Practice Innovation.-
dc.identifier.journalImplementation Science-
ref.assessmentRAE 2008-
ref.citationcount5 [Scopus, 12/11/2009]-
or.citation.harvardHamilton, S., McLaren, S. and Mulhall, A. (2007) 'Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care', Implementation Science; 2 (21): pp.1-11.-
All Items in TeesRep are protected by copyright, with all rights reserved, unless otherwise indicated.