Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework

Helfrich, Christian D.; Li, Yu Fang; Sharp, Nancy; Sales, Anne E.

doi:10.1186/1748-5908-4-38

Cited by 430 publications

(435 citation statements)

References 39 publications

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“…Potential was identified for greater practical use to inform and motivate the change leadership group. Strategies could be designed to directly (Helfrich et al 2009) and ORCA validation work is incomplete (Helfrich et al 2011). However, this drawback also applies to other models and tools in practice change implementation (Chaudoir et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Harris

Jones²,

Heartfield

et al. 2015

Aust. J. Prim. Health

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Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

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Section: Discussionmentioning

confidence: 99%

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Harris

Jones²,

Heartfield

et al. 2015

Aust. J. Prim. Health

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“…Through its Quality Enhancement Research Initiative (QUERI) program and the Center for Implementation Practice and Research Support (CIPRS), a resource center for implementation science, the VHA has provided structures and methods for collaboration between researchers and clinical and operational partners to move evidence-based practices into the field [10][11][12]. HSR&D investigators have generated new conceptual models for translation [8,13,14], innovations in evaluation methodologies [15,16], and working laboratories that facilitate change in health care delivery [11,17,18]. The co-location of research and clinical activities within the VHA and the emphasis on quality and implementation provides an environment where findings from clinical research in behavioral medicine can be applied in clinical settings with close collaboration between researchers and clinicians during the translation [9].…”

Section: An Environment For Translationmentioning

confidence: 99%

Behavioral medicine translation in the Veterans Health Administration: editorial to the special section on the Department of Veterans Affairs

Knight

Kerns

2011

Behav. Med. Pract. Policy Res.

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“…Context is seen as existing on a continuum, from those supporting the use of evidence (high context) moving to those who do not support the use of evidence (low context), and comprises three sub-elements: culture, leadership, and evaluation [10]. Tools aimed at assessing context, and developed within the PARIHS framework, include the Alberta Context Tool (ACT) [11], the Context Assessment Index [12] and the Organizational Readiness to Change Assessment (ORCA) tool [13]. …”

Section: Introductionmentioning

confidence: 99%

Ready to deliver maternal and newborn care? Health providers’ perceptions of their work context in rural Mozambique

Mocumbi

McKee

Munguambe

et al. 2018

Global Health Action

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Background: Deficiencies in the provision of evidence-based obstetric care are common in low-income countries, including Mozambique. Constraints relate to lack of human and financial resources and weak health systems, however limited resources alone do not explain the variance. Understanding the healthcare context ahead of implementing new interventions can inform the choice of strategies to achieve a successful implementation. The Context Assessment for Community Health (COACH) tool was developed to assess modifiable aspects of the healthcare context that theoretically influence the implementation of evidence. Objectives: To investigate the comprehensibility and the internal reliability of COACH and its use to describe the healthcare context as perceived by health providers involved in maternal care in Mozambique. Methods: A response process evaluation was completed with six purposively selected health providers to uncover difficulties in understanding the tool. Internal reliability was tested using Cronbach’s α. Subsequently, a cross-sectional survey using COACH, which contains 49 items assessing eight dimensions, was administered to 175 health providers in 38 health facilities within six districts in Mozambique. Results: The content of COACH was clear and most items were understood. All dimensions were near to or exceeded the commonly accepted standard for satisfactory internal reliability (0.70). Analysis of the survey data indicated that items on all dimensions were rated highly, revealing positive perception of context. Significant differences between districts were found for the Work culture, Leadership, and Informal payment dimensions. Responses to many items had low variance and were left-skewed. Conclusions: COACH was comprehensible and demonstrated good reliability, although biases may have influenced participants’ responses. The study suggests that COACH has the potential to evaluate the healthcare context to identify shortcomings and enable the tailoring of strategies ahead of implementation. Supplementing the tool with qualitative approaches will provide an in-depth understanding of the healthcare context.

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Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework

Cited by 430 publications

References 39 publications

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Behavioral medicine translation in the Veterans Health Administration: editorial to the special section on the Department of Veterans Affairs

Ready to deliver maternal and newborn care? Health providers’ perceptions of their work context in rural Mozambique

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