Are Healthcare Organizations Ready for Change?; Comment on “Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT”

Document Type : Commentary


Deusto Business School, Bilbo, Spain


Worldwide most health systems are facing a series of common challenges characterized by the increasing burden of chronic diseases and multimorbidity, and the accelerated pace of biomedical and technological innovations, on the other side. There is a growing recognition that many changes are needed at the macro, meso and micro management levels to tackle these challenges. Therefore, knowing if healthcare organizations are ready for change is a key issue, as high organizational readiness for change (ORC) has been positively related with higher organizational effort and staff motivation for overcoming barriers and setbacks in change endeavours. In practice, readiness for change is not commonly measured and there is a need of adequate metrics for it. In this commentary, a new tool for measuring readiness change is reviewed, the OR4KT. It has been developed based on a solid theoretical background and with the involvement of experts and potential users in the design and it has been tested and validated in three languages and in different organizational settings. Although its generalizability needs to be further tested, it seems to be a promising and useful tool to diagnose if organizations are ready to implement evidence-informed changes. A broader recognition of the key role that the science of implementation can play in the success of much needed transformations in healthcare provides a good opportunity for the dissemination of the OR4KT.


Main Subjects

  1. Pettigrew A, Ferlie E, McKee L. Shaping Strategic Change: Making Change in Large Organizations: The Case of the National Health Service. London: Sage Publications; 1992.
  2. WHO Regional Office for Europe. Health system transformation: making it happen. Copenhagen: WHO Regional Office for Europe; 2016.
  3. WHO Regional Office for Europe. Leading Health System Transformation to the next level. Copenhagen: WHO Regional Office for Europe; 2018.
  4. Armenakis AA, Harris SG, Mossholder KW. Creating readiness for organizational change. Hum Relat. 1993;46(6):681-703. doi:10.1177/001872679304600601
  5. Washington M, Hacker M. Why change fails: knowledge counts. Leadership & Organization Development Journal. 2005;26(5):400-411. doi:10.1108/01437730510607880
  6. Armenakis AA, Harris SG. Crafting a change message to create transformational readiness. Journal of Organizational Change Management. 2002;15(2):169-183. doi:10.1108/09534810210423080
  7. Kotter JP. Leading Change. Boston: Harvard Business School Press; 1996.
  8. Gagnon MP, Labarthe J, Legare F, et al. Measuring organizational readiness for knowledge translation in chronic care. Implement Sci. 2011;6:72. doi:10.1186/1748-5908-6-72
  9. Attieh R, Gagnon MP, Estabrooks CA, et al. Organizational readiness for knowledge translation in chronic care: a review of theoretical components. Implement Sci. 2013;8:138. doi:10.1186/1748-5908-8-138
  10. Gagnon MP, Attieh R, Ghandour el K, et al. A systematic review of instruments to assess organizational readiness for knowledge translation in health care. PLoS One. 2014;9(12):e114338. doi:10.1371/journal.pone.0114338
  11. Attieh R, Gagnon MP, Estabrooks CA, et al. Organizational readiness for knowledge translation in chronic care: a Delphi study. BMC Health Serv Res. 2014;14:534. doi:10.1186/s12913-014-0534-0
  12. Gagnon MP, Attieh R, Dunn S, et al. Development and content validation of a transcultural instrument to assess organizational readiness for knowledge translation in healthcare organizations: the OR4KT. Int J Health Policy Manag. 2018;7(9):791-797. doi:10.15171/ijhpm.2018.17
  13. Lewin K. Field Theory in Social Science. New York: Harper and Row; 1951.
  14. Weiner BJ. A theory of organizational readiness for change. Implement Sci. 2009;4(1):67. doi:10.1186/1748-5908-4-67
  15. Weiner BJ, Amick H, Lee SY. Conceptualization and measurement of organizational readiness for change: a review of the literature in health services research and other fields. Med Care Res Rev. 2008;65(4):379-436. doi:10.1177/1077558708317802
  16. Holt DT, Armenakis AA, Harris SG, Feild HS. Toward a comprehensive definition of readiness for change: A review of research and instrumentation. In: Pasmore WA, Woodman RW, eds. Research in Organizational Change and Development. Oxford, UK: Elsevier; 2007:289-336.
  17. Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22(4):197-209. doi:10.1016/S0740-5472(02)00233-7
  18. Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014;9(1):7. doi:10.1186/1748-5908-9-7
  19. Nuno-Solinis R, Fernandez-Cano P, Mira-Solves JJ, et al. [Development of an instrument for the assessment of chronic care models]. Gac Sanit. 2013;27(2):128-134. doi:10.1016/j.gaceta.2012.05.012
  20. Grandes G, Bully P, Martinez C, Gagnon MP. Validity and reliability of the Spanish version of the Organizational Readiness for Knowledge Translation (OR4KT) questionnaire. Implement Sci. 2017;12(1):128. doi:10.1186/s13012-017-0664-y
  21. Hunter DJ, Erskine J, Small A, et al. Doing transformational change in the English NHS in the context of "big bang" redisorganisation. J Health Organ Manag. 2015;29(1):10-24. doi:10.1108/jhom-01-2014-0019
  22. Best A, Greenhalgh T, Lewis S, Saul JE, Carroll S, Bitz J. Large-system transformation in health care: a realist review. Milbank Q. 2012;90(3):421-456. doi:10.1111/j.1468-0009.2012.00670.x
  23. Garcia-Goni M, Hernandez-Quevedo C, Nuno-Solinis R, Paolucci F. Pathways towards chronic care-focused healthcare systems: evidence from Spain. Health Policy. 2012;108(2-3):236-245. doi:10.1016/j.healthpol.2012.09.014
Volume 7, Issue 12
December 2018
Pages 1158-1160
  • Receive Date: 29 June 2018
  • Revise Date: 19 September 2018
  • Accept Date: 22 September 2018
  • First Publish Date: 01 December 2018