Measuring Organizational Readiness for Implementing Change in Primary Care Facilities in Rural Bushbuckridge, South Africa.

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  • Additional Information
    • Source:
      Publisher: Kerman University of Medical Sciences Country of Publication: Iran NLM ID: 101619905 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2322-5939 (Electronic) Linking ISSN: 23225939 NLM ISO Abbreviation: Int J Health Policy Manag Subsets: MEDLINE
    • Publication Information:
      Original Publication: Kerman, Iran : Kerman University of Medical Sciences, [2013]-
    • Subject Terms:
      Primary Health Care*; Humans ; South Africa ; Reproducibility of Results ; Pilot Projects ; Organizational Innovation ; Surveys and Questionnaires
    • Abstract:
      Meaningful gains in health outcomes require successful implementation of evidence-based interventions. Organizations such as health facilities must be ready to implement efficacious interventions, but tools to measure organizational readiness have rarely been validated outside of high-income settings. We conducted a pilot study of the organizational readiness to implement change (ORIC) measure in public primary care facilities serving Bushbuckridge Municipality in South Africa in early 2019. We administered the 10-item ORIC to 54 nurses and lay counsellors in 9 facilities to gauge readiness to implement the national Central Chronic Medicine Dispensing and Distribution (CCMDD) programme intended to declutter busy health facilities. We used exploratory factor analysis (EFA) to identify factor structure. We used Cronbach alpha and intraclass correlation (ICC) to assess reliability at the individual and facility levels. To assess validity, we drew on existing data from routine clinic monitoring and a 2018 quality assessment to test the correlation of ORIC with facility resources, value of CCMDD programme, and better programme uptake and service quality. Six items from the ORIC loaded onto a single factor with Cronbach's alpha of 0.82 and ICC of 0.23. While facility ORIC score was not correlated with implementation of CCMDD, higher scores were correlated with facility resources, perceived value of the CCMDD program, patient satisfaction with wait time, and greater linkage to care following positive HIV testing. The study is limited by measuring ORIC after programme implementation. The findings support the relevance of ORIC, but identify a need for greater adaptation and validation of the measure.
      (© 2022 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)
    • Grant Information:
      R01 MH103198 United States MH NIMH NIH HHS
    • Contributed Indexing:
      Keywords: HIV Treatment; Implementation Science; Organizational Readiness; Quality of Care; South Africa
    • Publication Date:
      Date Created: 20201210 Date Completed: 20230816 Latest Revision: 20230918
    • Publication Date:
      20240628
    • Accession Number:
      PMC9808169
    • Accession Number:
      10.34172/ijhpm.2020.223
    • Accession Number:
      33300775