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Organizational context and the learning and change readiness climate for implementing an evidence-based shared decision-making aid in US rheumatology clinics

Larry Hearld (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Allyson Hall (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Reena Joseph Kelly (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Aizhan Karabukayeva (Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Jasvinder Singh (Division of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 8 July 2021

Issue publication date: 24 February 2022

301

Abstract

Purpose

The purpose of this study was to examine the organizational context that may support learning and change readiness climates that previous research has found to be conducive to implementing evidence-based interventions.

Design/methodology/approach

An exploratory, mixed method evaluation that included 15 rheumatology clinics throughout the United States was performed. Quantitative data were collected using a web-based survey completed by 135 clinic members. Qualitative data were collected via semi-structured interviews with 88 clinic members.

Findings

In general, clinics reported strong, positive learning and change readiness climates. More complex organizations (e.g. multispecialty, academic medical centers) with rational/hierarchical cultures and members with longer tenure were associated with less supportive learning and change readiness climates. The authors’ findings highlight opportunities for organizational leaders and evidence-based intervention sponsors to focus their attention and allocate resources to settings that may be most susceptible to implementation challenges.

Originality/value

First, the authors address a deficit in previous research by describing both the level and strength of the learning and change readiness climates for implementing an evidence-based shared decision-making aid (SDMA) and examine how these vary as a function of the organizational context. Second, the study examines a broader set of factors to assess the organizational context (e.g. organizational culture, organizational structure, ownership) than previous research, which may be especially salient for shaping the climate in smaller specialty clinics like those we study. Third, the authors utilize a mixed methods analysis to provide greater insights into questions of how and why organizational factors such as size and structure may influence the learning and change readiness climate.

Keywords

Acknowledgements

Research reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (SDM-2017C2-8224).

Conflicts of interest: The authors are not aware of any conflicts that would have biased the study findings.

Citation

Hearld, L., Hall, A., Kelly, R.J., Karabukayeva, A. and Singh, J. (2022), "Organizational context and the learning and change readiness climate for implementing an evidence-based shared decision-making aid in US rheumatology clinics", Journal of Health Organization and Management, Vol. 36 No. 1, pp. 121-140. https://doi.org/10.1108/JHOM-10-2020-0397

Publisher

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Emerald Publishing Limited

Copyright © 2021, Emerald Publishing Limited

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