Organizational readiness for change towards implementing a sepsis survivor hospital to home transition-in-care protocol.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES Frontiers in health services Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI:10.3389/frhs.2024.1436375
Elaine Sang, Ryan Quinn, Michael A Stawnychy, Jiyoun Song, Karen B Hirschman, Sang Bin You, Katherine S Pitcher, Nancy A Hodgson, Patrik Garren, Melissa O'Connor, Sungho Oh, Kathryn H Bowles
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Abstract

Background: Organizational readiness for change, defined as the collective preparedness of organization members to enact changes, remains understudied in implementing sepsis survivor transition-in-care protocols. Effective implementation relies on collaboration between hospital and post-acute care informants, including those who are leaders and staff. Therefore, our cross-sectional study compared organizational readiness for change among hospital and post-acute care informants.

Methods: We invited informants from 16 hospitals and five affiliated HHC agencies involved in implementing a sepsis survivor transition-in-care protocol to complete a pre-implementation survey, where organizational readiness for change was measured via the Organizational Readiness to Implement Change (ORIC) scale (range 12-60). We also collected their demographic and job area information. Mann-Whitney U-tests and linear regressions, adjusting for leadership status, were used to compare organizational readiness of change between hospital and post-acute care informants.

Results: Eighty-four informants, 51 from hospitals and 33 from post-acute care, completed the survey. Hospital and post-acute care informants had a median ORIC score of 52 and 57 respectively. Post-acute care informants had a mean 4.39-unit higher ORIC score compared to hospital informants (p = 0.03).

Conclusions: Post-acute care informants had higher organizational readiness of change than hospital informants, potentially attributed to differences in health policies, expertise, organizational structure, and priorities. These findings and potential inferences may inform sepsis survivor transition-in-care protocol implementation. Future research should confirm, expand, and examine underlying factors related to these findings with a larger and more diverse sample. Additional studies may assess the predictive validity of ORIC towards implementation success.

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为实施脓毒症幸存者从医院到家庭的过渡护理规程,组织已做好变革准备。
背景:组织变革的准备程度是指组织成员对实施变革的集体准备程度,但在实施脓毒症幸存者护理过渡协议时,对这一点的研究仍然不足。有效的实施有赖于医院和后期护理信息提供者(包括领导和员工)之间的合作。因此,我们的横断面研究比较了医院和后期护理信息提供者的组织变革准备情况:我们邀请了参与实施脓毒症幸存者过渡护理方案的 16 家医院和 5 家附属 HHC 机构的信息提供者完成一项实施前调查,通过组织实施变革准备度量表(ORIC)(范围为 12-60)测量组织的变革准备度。我们还收集了他们的人口统计学和工作领域信息。我们使用曼-惠特尼 U 检验和线性回归(根据领导地位进行调整)来比较医院和后护理机构信息提供者的组织变革准备度:共有 84 位信息提供者完成了调查,其中 51 位来自医院,33 位来自后期护理机构。医院和后期护理信息提供者的 ORIC 中位数分别为 52 分和 57 分。与医院信息提供者相比,护理后信息提供者的 ORIC 得分平均高出 4.39 个单位(p = 0.03):结论:与医院信息提供者相比,康复后护理信息提供者的组织变革准备度更高,这可能归因于卫生政策、专业知识、组织结构和优先事项方面的差异。这些发现和潜在的推论可为脓毒症幸存者过渡护理方案的实施提供参考。未来的研究应使用更大、更多样化的样本来证实、扩展和检查与这些发现相关的潜在因素。其他研究可评估 ORIC 对实施成功的预测有效性。
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