Modelling of factors influencing organizational readiness for change in start-ups during the COVID-19 emergency

PurposeThe purpose of this paper is to "identify”, "analyze” and "construct” a framework to quantify the relationships between several determinants of organizational preparedness for change in the start-ups during the COVID-19 emergencies.Design/methodology/approachTotal interpretive structural modelling (TISM) is used to find characteristics that assist in analyzing the readiness or preparedness level before initiating a change deployment process in start-ups. A cross-impact matrix multiplication applied to classification (MICMAC) analysis is performed to determine the driving and dependent elements of change in start-ups.FindingsFrom literature research and an expert interview, this study selected ten variables of change preparedness to explore inner interconnections and comprehend the inner connections factors. The findings depict that clarity of mission and goals, reward system, technological advancement and motivational readiness have been considered the most important readiness factor for deploying organizational change in start-ups during the COVID-19 emergencies.Practical implicationsThis research will aid the management and researchers gain a better understanding of the factors that influence change preparedness. Constant observation of current changes in the start-ups and the external environment will aid in improving the quality of products or services provided by the start-ups during the COVID-19. The start-ups can use these criteria linked to change readiness. The priority of each element is determined using MICMAC analysis and ranking using the TISM technique, which assists start-ups in ordering the enablers from highest to lowest priority.Originality/valueThere is no research regarding factors influencing organizational readiness for change in start-ups during the COVID-19 emergencies. This research gap is filled by analyzing aspects linked to organizational readiness for change in start-ups. This gap inspired the present study, which uses the "Total Interpretive Structural Modelling (TISM)” technique to uncover change determinants and investigate hierarchical interconnections among factors influencing organizational readiness to change in start-ups during the COVID-19 emergencies.

Using cognitive interviews to improve a measure of organizational readiness for implementation.

BACKGROUND: Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC2 heuristic posits that organizational readiness stems from an organization's motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC2) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs. METHODS: We conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using "think aloud" and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey. RESULTS: Key recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what "better" means). CONCLUSION: Use of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities.

Organizational readiness and innovation in the Jordanian telecommunication companies

Purpose The purpose of this study is to examine the effect of organizational readiness (OR) dimensions (organizational culture, climate and capability) on three types of innovations (INs) (service, process IN and entering new markets) in telecommunication companies. The study also tests the mediating role of employee engagement (EE) in the causal relationship between OR and IN. Design/methodology/approach In the theoretical framework, a deep and broad review of the literature was presented to determine the study variables and hypotheses that were tested in the field study. The study sample consisted of 306 respondents distributed to the headquarters of the three companies (Zain, Orange and Umniah) working in the Jordanian telecommunications sector. The number of questionnaires retrieved and valid for analysis was 255 (83%). Findings Results indicate a positive effect of organizational climate and organizational capacity on process IN and entering new markets. While organizational culture had no significant effect on the three types of IN EE did not have a mediating role in the relationship between OR and IN. Research limitations/implications The results of this study are related to the telecommunications sector as a highly competitive service sector and more able to work remotely with regard to customers, so its results cannot be generalized to other sectors such as the industry sector, which has suffered in recent years from the epidemic more than other sectors. Practical implications The study of OR as a concept, dimensions and effects provides great experience for leaders and managers facing the challenges of competition and threats posed by the Covid-19 pandemic. This study also helps researchers to study OR in new areas and in relation to other concepts. Social implications The OR covers a wide field that includes the individual, the group and the company. Therefore, readiness includes a social experience that can extend from the company to the community. Originality/value The study gains an important value by revealing that organizational culture as a dimension of readiness does not have a significant impact on IN. With the readiness to respond quickly to challenges, culture can be more inclined to the status quo and the prevailing routine than to IN and change.

Using Implementation Science to Understand Teledermatology Implementation Early in the COVID-19 Pandemic: Cross-sectional Study.

Background: Implementation science has been recognized for its potential to improve the integration of evidence-based practices into routine dermatologic care. The COVID-19 pandemic has resulted in rapid teledermatology implementation worldwide. Although several studies have highlighted patient and care provider satisfaction with teledermatology during the COVID-19 pandemic, less is known about the implementation process. Objective: Our goal was to use validated tools from implementation science to develop a deeper understanding of the implementation of teledermatology during the COVID-19 pandemic. Our primary aims were to describe (1) the acceptability and feasibility of the implementation of teledermatology and (2) organizational readiness for the implementation of teledermatology during the COVID-19 pandemic. We also sought to offer an example of how implementation science can be used in dermatologic research. Methods: An anonymous, web-based survey was distributed to Association of Professors of Dermatology members. It focused on (1) the acceptability, feasibility, and appropriateness of teledermatology and (2) organizational readiness for implementing teledermatology. It incorporated subscales from the Organizational Readiness to Change Assessment-a validated measure of organizational characteristics that predict implementation success. Results: Of the 518 dermatologists emailed, 35 (7%) responded, and all implemented or scaled up teledermatology during the pandemic. Of the 11 care providers with the highest level of organizational readiness, 11 (100%) said that they plan to continue using teledermatology after the pandemic. Most respondents agreed or strongly agreed that they had sufficient training (24/35, 69%), financial resources (20/35, 57%), and facilities (20/35, 57%). However, of the 35 respondents, only 15 (43%) agreed or strongly agreed that they had adequate staffing support. Most respondents considered the most acceptable teledermatology modality to be synchronous audio and video visits with supplemental stored digital photos (23/35, 66%) and considered the least acceptable modality to be telephone visits without stored digital photos (6/35, 17%). Overall, most respondents thought that the implementation of synchronous audio and video with stored digital photos (31/35, 89%) and telephone visits with stored digital photos (31/35, 89%) were the most feasible. When asked about types of visits that were acceptable for synchronous video/audio visits (with stored digital photos), 18 of the 31 respondents (58%) said "new patients," 27 (87%) said "existing patients," 19 (61%) said "medication monitoring," 3 (10%) said "total body skin exams," and 22 (71%) said "lesions of concern." Conclusions: This study serves as an introduction to how implementation science research methods can be used to understand the implementation of novel technologies in dermatology. Our work builds upon prior studies by further characterizing the acceptability and feasibility of different teledermatology modalities. Our study may suggest initial insights on how dermatology practices and health care systems can support dermatologists in successfully incorporating teledermatology after the pandemic.

Modelling of factors influencing organizational readiness for change in start-ups during the COVID-19 emergency

Purpose: The purpose of this paper is to “identify”, “analyze” and “construct” a framework to quantify the relationships between several determinants of organizational preparedness for change in the start-ups during the COVID-19 emergencies. Design/methodology/approach: Total interpretive structural modelling (TISM) is used to find characteristics that assist in analyzing the readiness or preparedness level before initiating a change deployment process in start-ups. A cross-impact matrix multiplication applied to classification (MICMAC) analysis is performed to determine the driving and dependent elements of change in start-ups. Findings: From literature research and an expert interview, this study selected ten variables of change preparedness to explore inner interconnections and comprehend the inner connections factors. The findings depict that clarity of mission and goals, reward system, technological advancement and motivational readiness have been considered the most important readiness factor for deploying organizational change in start-ups during the COVID-19 emergencies. Practical implications: This research will aid the management and researchers gain a better understanding of the factors that influence change preparedness. Constant observation of current changes in the start-ups and the external environment will aid in improving the quality of products or services provided by the start-ups during the COVID-19. The start-ups can use these criteria linked to change readiness. The priority of each element is determined using MICMAC analysis and ranking using the TISM technique, which assists start-ups in ordering the enablers from highest to lowest priority. Originality/value: There is no research regarding factors influencing organizational readiness for change in start-ups during the COVID-19 emergencies. This research gap is filled by analyzing aspects linked to organizational readiness for change in start-ups. This gap inspired the present study, which uses the “Total Interpretive Structural Modelling (TISM)” technique to uncover change determinants and investigate hierarchical interconnections among factors influencing organizational readiness to change in start-ups during the COVID-19 emergencies. © 2022, Emerald Publishing Limited.

Assessing facilitating conditions and barriers for innovation implementation in Canadian long-term care homes: a research protocol.

BACKGROUND: The COVID-19 pandemic has profoundly affected the health and care of older adults, with particularly negative consequences for those residing in long-term care homes (LTCH) and retirement homes (RH). To inform the implementation of interventions with the most potential for impact, Healthcare Excellence Canada identified six promising practices and policy options that can be introduced to ensure that LTCH and RH are better prepared for potential future outbreaks. A total of 22 implementation science teams (ISTs) were funded to support LTCH and RH across Canada in their implementation of these practices. This study aims to identify the enablers and barriers to the successful implementation of evidence-based practices and the impact of intervention in LTCH and RH across Canada. METHODS: A survey-based longitudinal correlational design will be used. The Organizational Readiness for Knowledge Translation (OR4KT) tool will be used to assess the readiness of LTCH and RH to implement the selected practice. The OR4KT includes 59 questions and takes about 15 min to complete. Five to ten respondents per organization, holding different job positions, will be invited by the ISTs to complete the OR4KT in 91 LTCH or RH across Canada at the beginning of the project (T1) and 6 months after the first measurement (T2). DISCUSSION: The study will provide a benchmark for assessing the readiness of LTCH and RH to implement evidence-based practices. It will also inform decision-makers about barriers and facilitators that influence the integration of promising practices in these organizations.

Effects of Organizational Atmosphere and Organizational Practice on Knowledge, Attitude, and Practice Toward Diffusion and Utilization of Hepatic Contrast-Enhanced Ultrasound Among Physicians.

Background: Promoting technology diffusion and utilization is a key measure to address the great disparity in technical capacity within integrated health systems. However, even the effectiveness and appropriateness regarding technology has been widely recognized, its diffusion and utilization are still stagnant. The mechanisms that influence the technology from being recognized to being widely applied in practice remain largely unknown. Purpose: Taking hepatic contrast-enhanced ultrasound (CEUS) as an example, this study aimed to investigate the comprehensive influencing mechanism of organizational atmosphere and organizational practice on the knowledge, attitude, and practice toward diffusion and utilization of hepatic CEUS in the medical alliance. Methods: Based on the integration of organizational ready for change (ORC) and knowledge-attitude-practice (KAP), a structured questionnaire was developed. A multistage random sampling method was applied to investigate physicians who directly use CEUS working at the liver disease-related departments of sampled health institutions. Structural equation modeling (SEM) was used to verify the proposed hypotheses, and determine the relationship between the factors. Results: In total, 292 physicians were included. SEM results demonstrated that knowledge influenced both attitude and practice, while attitude positively predicted practice. Organizational practice and organizational atmosphere associated positively with each other. Organizational atmosphere positively affected the physicians' attitude toward CEUS diffusion and utilization (ß = 0.425, p < 0.001), while organizational practice positively affected corresponding knowledge (ß = 0.423, p < 0.001) and practice (ß = 0.275, p < 0.001). Additionally, there was a partial mediating effect between organizational practice and physicians' CEUS diffusion and utilization behavior. Conclusion: By verifying the influencing mechanism of organizational atmosphere and organizational practice on the physicians' KAP of hepatic CEUS diffusion and utilization, this study benefit tailoring strategies for promoting technology diffusion and utilization within medical alliance. It is recommended to develop an organizational atmosphere of advocating technology innovation, establish organizational support mechanism (SM) with multiple concrete supporting countermeasures, and so on.

Organizational e-Health Readiness: How to Prepare the Primary Healthcare Providers' Services for Digital Transformation.

The COVID-19 pandemic has had two main consequences for the organization of treatment in primary healthcare: restricted patients' access to medical facilities and limited social mobility. In turn, these consequences pose a great challenge for patients and healthcare providers, i.e., the limited personal contact with medical professionals. This can be eased by new digital technology. While providing solutions to many problems, this technology poses several organizational challenges for healthcare system participants. As the current global situation and the outbreak of the humanitarian crisis in Europe show, these and other likely emergencies amplify the need to learn the lessons and prepare organizations for exceptional rapid changes. Therefore, a question arises of whether organizations are ready to use modern e-health solutions in the context of a rapidly and radically changing situation, and how this readiness can be verified. The aim of this article is to clarify the organizational e-heath readiness concept of Polish primary healthcare units. This study employs the triangulation of analytical methods, as it uses: (i) a literature review of e-health readiness assessment, (ii) primary data obtained with a survey (random sampling of 371 managers of PHC facilities across Poland) and (iii) the Partial Least Squares Structural Equation Modeling (PLS-SEM) method, employed to estimate the structural model. The evaluation of the model revealed that its concept was adequate for more mature entities that focus on the patient- and employee-oriented purpose of digitization, and on assuring excellent experience derived from a consistent care process. In the context of patients' restricted access to medical facilities and limited social mobility, a simpler version of the research model assesses the readiness more adequately. Finally, the study increases the knowledge base of assets (resources and capabilities), which will help healthcare systems better understand the challenges surrounding the adoption and scaling of e-health technologies.

Elementary Schools' Response to Student Wellness Needs during the COVID-19 Shutdown: A Qualitative Exploration Using the R = MC2 Readiness Heuristic.

During spring of 2020, the COVID-19 pandemic and accompanying public health advisories forced K-12 schools throughout the United States to suspend in-person instruction. School personnel rapidly transitioned to remote provision of academic instruction and wellness services such as school meals and counseling services. The aim of this study was to investigate how schools responded to the transition to remote supports, including assessment of what readiness characteristics schools leveraged or developed to facilitate those transitions. Semi-structured interviews informed by school wellness implementation literature were conducted in the spring of 2020. Personnel (n = 50) from 39 urban and rural elementary schools nationwide participated. The readiness = motivation capacity2 (R = MC2) heuristic, developed by Scaccia and colleagues, guided coding to determine themes related to schools' readiness to support student wellness in innovative ways during the pandemic closure. Two distinct code sets emerged, defined according to the R = MC2 heuristic (1) Innovations: roles that schools took on during the pandemic response, and (2) Readiness: factors influencing schools' motivation and capacity to carry out those roles. Schools demonstrated unprecedented capacity and motivation to provide crucial wellness support to students and families early in the COVID-19 pandemic. These efforts can inform future resource allocation and new strategies to implement school wellness practices when schools resume normal operations.

Workforce Readiness Training: A Comprehensive Training Model That Equips Community Health Workers to Work at the Top of Their Practice and Profession.

Background: Recent reports have recognized that only 20 percent of health outcomes are attributed to clinical care. Environmental conditions, behaviors, and social determinants of health account for 80 percent of overall health outcomes. With shortages of clinical providers stressing an already burdened healthcare system, Community Health Workers (CHWs) can bridge healthcare gaps by addressing these nonmedical factors influencing health. This paper details how a comprehensive training model equips CHWs for workforce readiness so they can perform at the top of their practice and profession and deliver well-coordinated client/patient-centered care. Methods: Literature reviews and studies revealed that training CHWs alone is not sufficient for successful workforce readiness, rather CHW integration within the workforce is needed. Consequently, this comprehensive training model is developed for CHWs with varying skill levels and work settings, and supervisors to support organizational readiness and CHW integration efforts. A systematic training program development approach along with detailed implementation methods are presented. Continuing education sessions to support CHW practice and Organizational Readiness Training for supervisors, leadership and team members directly engaged with CHWs in the workplace are also discussed. CHWs were involved in all phases of the research, development, implementation, and actively serve in evaluations and curriculum review committees. Results: Components of the comprehensive training model are presented with an emphasis on the core CHW training. Two CHW training tracks are offered using three delivery modalities. Process measures with student learning objectives, outcome measures developed using the Kirkpatrick model to capture attitude, perceptions, knowledge acquisition, confidence, behavior, and overall experience, and impact stories by two CHWs are presented. Lessons learned from the implementation of the training program are discussed in three categories: Practice-driven curricula, student-centered training implementation, and adaptations in response to COVID-19 pandemic. Conclusion: This comprehensive training model recognizes that training CHWs in a robust training program is key as the demand for well-rounded CHWs increases. Furthermore, a comprehensive training program must include training for supervisors, leadership, and team members working directly with CHWs. Such efforts strengthen the CHW practice and profession to support the delivery of well-coordinated and holistic client/patient-centered care.