The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Erna Boone1, M. Kathryn Stewart2, Katharine E. Stewart3, Paul G. Greene3, Deborah M. Bledsoe4; 1College of Health Related Professions/Department of Respiratory and Surgical Technologies, University of Arkansas for Medical Sciences, Little Rock, AR; 2College of Public Health/Department of Health Policy and Management, Univeristy of Arkansas for Medical Sciences, Little Rock, AR; 3College of Public Health/Department of Health Behavior and Health Education, Univeristy of Arkansas for Medical Sciences, Little Rock, AR; 4Better Community Developers, Inc., Little Rock, AR

Background: Health care organizations commonly engage in organizational change aimed at improving the quality of their operations, including implementation of new programs. Achieving successful and complete organizational change is challenging. Not all attempts to implement and sustain change are successful. Change experts and health care practitioners agree that successful implementation of change is critically dependent upon the organization's readiness for the change. The purpose of this study was to measure organizational readiness for implementation of an evidence-based smoking cessation intervention in a small, faith-based, not-for-profit substance abuse treatment program in a southern U.S. city. Methods: Organizational leaders and associates (n = 26) completed a survey battery. Readiness measurements included assessment of both general and specific organizational change conditions and an appraisal of leadership styles. Respondents rated the organization's capacity/ability to implement each of five evidence-based cessation components. The results were compared to conditions suggesting high organizational readiness and to national norms. Recommendations to remedy readiness gaps and an implementation plan were provided to the organization's leadership. Results: A majority (< 60%) of the respondents agreed that organizational climate was conducive to general organizational change, but there was less agreement about member and institutional readiness. Regarding the specific change of adopting a cessation intervention, only 40% were knowledgeable about cessation in this special population. Most counselors (60%) believed they did not have adequate knowledge or skills to provide cessation counseling. Only 50% believed the organization had the capacity/ability to implement the Basic 5 A's. Other evidence-based components were rated less feasible. Leaders disagreed on their ability to provide some system strategies needed for implementation of evidence-based components. The predominant leadership style was "transformational". Conclusions: Results revealed several readiness gaps in key knowledge and resources that could sabotage implementation of a cessation intervention. However, leadership and operational strategies can be tailored to remedy these gaps. Organizations considering adoption of a cessation intervention should attempt to identify readiness gaps to help ensure successful implementation and sustainability of the proposed program.
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