Measuring organizational readiness for implementing change (ORIC) in a new midwifery model of care in rural South Australia

Abstract

Background The sustainability of Australian rural maternity services is under threat due to current workforce shortages. In July 2019, a new midwifery caseload model of care was implemented in rural South Australia to provide midwifery continuity of care and promote a sustainable workforce in the area. The model is unique as it brings together five birthing sites connecting midwives, doctors, nurses and community teams. A critical precursor to successful implementation requires those working in the model be ready to adopt to the change. We surveyed clinicians at the five sites transitioning to the new model of care in order to assess their organizational readiness to implement change. Methods A descriptive study assessing readiness for change was measured using the Organizational Readiness for Implementing Change scale (ORIC). The 12 item Likert scale measures a participant’s commitment to change and change efficacy. All clinicians working within the model of care (midwives, nurses and doctors) were invited to complete an e-survey. Results Overall, 55% (56/102) of clinicians participating in the model responded. The mean ORIC score was 41.5 (range 12–60) suggesting collectively, midwives, nurses and doctors began the new model of care with a sense of readiness for change. Participants were most likely to agree on the change efficacy statements, “People who work here feel confident that the organization can get people invested in implementing this change and the change commitment statements “People who work here are determined to implement this change”, “People who work here want to implement this change”, and “People who work here are committed to implementing this change. Conclusion Results of the ORIC survey indicate that clinicians transitioning to the new model of care were willing to embrace change and commit to the new model. The process of organizational change in health care settings is challenging and a continuous process. If readiness for change is high, organizational members invest more in the change effort and exhibit greater persistence to overcome barriers and setbacks. This is the first reported use of the instrument amongst midwives and nurses in Australia and should be considered for use in other national and international clinical implementation studies.

Organisational and individual readiness for change to respectful maternity care practice and associated factors in Ibadan, Nigeria: a cross-sectional survey

“…This is in contrast to other instruments assessing organisational readiness for change with a much higher number of constructs and variables 12 30. The ORIC tool is a standardised instrument that has been validated among health worker populations in Western countries24 31 32 and only in South Africa,33 with a similar population as found in our study. All categories of health providers involved in maternal care across cadres within the primary and secondary health facilities were studied.…”

Barriers and facilitators influencing EBP readiness: Building organizational and nurse capacity

“…Many EBP appraisal tools are available to assess various aspects of EBP, including the Information Literacy for Evidence‐Based Nursing Practice Questionnaire (©ILNP; Thorsteinsson, 2012), the Organizational Readiness for Implementing Change (ORIC; Adelson et al, 2021), and the Evidence‐Based Practice Knowledge Assessment in Nursing (EKAN; Nick et al, 2020). Melnyk has developed multiple robust EBP instruments, which include the EBP Beliefs Scale, the EBP Implementation Scale, and the EBP Organization Culture and Readiness Scale (Melnyk, Hsieh, et al, 2021).…”

Implementing the organizational readiness for change (ORIC) survey during a novel midwifery preceptor program in Sierra Leone: Stakeholder results

“…Another study, completed in rural South Australia in 2019 assessed readiness for change, using the ORIC survey, among midwives, nurses, and doctors who were transitioning to a new midwifery model of care. 15 This study provided a composite score for all questions rather than a mean score per question or domain; therefore these results are not exactly comparable. The majority of respondents agreed or strongly agreed with all domain 1 questions; however, there was more variability among domain 2 questions with little consistency.…”