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Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study

BACKGROUND: Readiness is a critical precursor of successful change; it denotes whether those involved in the change are motivated and empowered to participate in the change. Research on readiness tends to focus on frontline providers or individuals in non-managerial positions and offers limited atte...

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Autores principales: Austin, Tujuanna, Chreim, Samia, Grudniewicz, Agnes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969476/
https://www.ncbi.nlm.nih.gov/pubmed/31952525
http://dx.doi.org/10.1186/s12913-020-4897-0
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author Austin, Tujuanna
Chreim, Samia
Grudniewicz, Agnes
author_facet Austin, Tujuanna
Chreim, Samia
Grudniewicz, Agnes
author_sort Austin, Tujuanna
collection PubMed
description BACKGROUND: Readiness is a critical precursor of successful change; it denotes whether those involved in the change are motivated and empowered to participate in the change. Research on readiness tends to focus on frontline providers or individuals in non-managerial positions and offers limited attention to individuals in middle management positions who are expected to lead frontline providers in change implementation. Yet middle-level managers are also recipients of changes that are planned and decreed by those in higher positions. This study sought to examine both frontline provider and middle manager readiness for change in the context of primary care program integration. METHODS: Using a qualitative case study approach, we examined how frontline providers and middle managers experienced six readiness factors: discrepancy, appropriateness, valence, efficacy, fairness and trust in management. Data were collected through documents, meeting observation and semi-structured interviews with frontline providers and middle managers involved in the change. RESULTS: The findings highlighted similarities and differences in readiness experiences of frontline providers and middle managers. Across both types of participants, we found that the notion of valence should be expanded to consider individuals’ evaluation of benefits to patients and the health system; efficacy applies to both content and process of change; fairness and trust in management findings require further exploration to determine their appropriateness to be incorporated in models of readiness for change; and trust in management (or lack of trust) has a cascading influence across the levels in the organization. CONCLUSIONS: Our study makes a contribution by nuancing and extending conceptualizations of individual readiness factors, and by highlighting the central role of middle manager readiness for change. Implications of the study include the need to consider readiness factors prior to the implementation of change and the importance of fostering readiness throughout all levels of the organization.
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spelling pubmed-69694762020-01-27 Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study Austin, Tujuanna Chreim, Samia Grudniewicz, Agnes BMC Health Serv Res Research Article BACKGROUND: Readiness is a critical precursor of successful change; it denotes whether those involved in the change are motivated and empowered to participate in the change. Research on readiness tends to focus on frontline providers or individuals in non-managerial positions and offers limited attention to individuals in middle management positions who are expected to lead frontline providers in change implementation. Yet middle-level managers are also recipients of changes that are planned and decreed by those in higher positions. This study sought to examine both frontline provider and middle manager readiness for change in the context of primary care program integration. METHODS: Using a qualitative case study approach, we examined how frontline providers and middle managers experienced six readiness factors: discrepancy, appropriateness, valence, efficacy, fairness and trust in management. Data were collected through documents, meeting observation and semi-structured interviews with frontline providers and middle managers involved in the change. RESULTS: The findings highlighted similarities and differences in readiness experiences of frontline providers and middle managers. Across both types of participants, we found that the notion of valence should be expanded to consider individuals’ evaluation of benefits to patients and the health system; efficacy applies to both content and process of change; fairness and trust in management findings require further exploration to determine their appropriateness to be incorporated in models of readiness for change; and trust in management (or lack of trust) has a cascading influence across the levels in the organization. CONCLUSIONS: Our study makes a contribution by nuancing and extending conceptualizations of individual readiness factors, and by highlighting the central role of middle manager readiness for change. Implications of the study include the need to consider readiness factors prior to the implementation of change and the importance of fostering readiness throughout all levels of the organization. BioMed Central 2020-01-17 /pmc/articles/PMC6969476/ /pubmed/31952525 http://dx.doi.org/10.1186/s12913-020-4897-0 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Austin, Tujuanna
Chreim, Samia
Grudniewicz, Agnes
Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title_full Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title_fullStr Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title_full_unstemmed Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title_short Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
title_sort examining health care providers’ and middle-level managers’ readiness for change: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969476/
https://www.ncbi.nlm.nih.gov/pubmed/31952525
http://dx.doi.org/10.1186/s12913-020-4897-0
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