Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions
| Title: | Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions |
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| Authors: | YANG Wei, CAI Yiyuan, CHEN Jiajia, MAO Run, LINGHU Lang, LYU Sensen, XU Dong |
| Source: | Xiehe Yixue Zazhi, Vol 16, Iss 2, Pp 479-491 (2025) |
| Publisher Information: | Editorial Office of Medical Journal of Peking Union Medical College Hospital, 2025. |
| Publication Year: | 2025 |
| Collection: | LCC:Medicine |
| Subject Terms: | implementation research, integration of medical and prevention, shared medical appointment for diabetes, organizational readiness for change, qualitative comparative analysis, Medicine |
| More Details: | 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. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | Chinese |
| ISSN: | 1674-9081 2024-0651 |
| Relation: | https://doaj.org/toc/1674-9081 |
| DOI: | 10.12290/xhyxzz.2024-0651 |
| Access URL: | https://doaj.org/article/e6413f5854ab4017bfff59d453560405 |
| Accession Number: | edsdoj.6413f5854ab4017bfff59d453560405 |
| Database: | Directory of Open Access Journals |
| ISSN: | 16749081 20240651 |
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| DOI: | 10.12290/xhyxzz.2024-0651 |
| Published in: | Xiehe Yixue Zazhi |
| Language: | Chinese |