Quality Enhancement Research Initiative (QUERI)

1. Quality Enhancement Research Initiative (QUERI) Assessing Organizational Readiness to Change: A Review of Research to Date and Development of a Cross-QUERI Agenda Christian D. Helfrich Ischemic Heart Disease-QUERI Carmen Hall Polytrauma and Blast-Related Injuries-QUERI Bryan J. Weiner University of North Carolina, Chapel Hill Daniel T. Holt Air Force Institute of Technology Connecting Research and Patient Care

2. Guiding Questions ‘From-to’ for themes What do you need to do to get there? Where are you today? Where do you want to go? Direction Accounta- bility Coordination & control External orientation Leadership Innovation Prioritized efforts Capability Motivation Environment & values 2

3. Challenges of Change 70% of planned transformation efforts fail What leads to such a dramatic failure rate within our organizations? Succeed 30 70 Fail Source: Kotter (2008); Beer & Nohria (2000); Cameron & Quinn (1997); Caldewell (1994); Gross et al. (1993); Kotter & Heskett (1992); Hickings (1998); Press clippings

4. Challenges of Change 70% of planned transformation efforts fail Contributing factor examples Execution & process • No single point of accountability • Insufficient & inconsistent engagement • No integration of hard & soft levers Succeed* 30 Culture & climate • Misalignment with culture • History of change programs depletes energy for transformation Change content • Initiative not tied to enterprise needs resulting in lack of direction, energy, and focus 70 Fail* Individual attributes • Capability deficits are not or insufficiently addressed • No institutionalizing of capabilities * Success defined through holistic assessment of company performance (non-public companies) or market out-performance (public companies) 1.5 years after performance transformation initiative Source: Kotter (2008); Beer & Nohria (2000); Cameron & Quinn (1997); Caldewell (1994); Gross et al. (1993); Kotter & Heskett (1992); Hickings (1998); Press clippings

5. Internal Context Ask, “Where is the change occurring?” Change-specific Content Ask, “What is being changed?” Readiness for Change Intentions & Reactions Outcomes Time Process Ask, “How is change being implemented?” Individual Attributes Ask, “Who has to implement the change?”

6. Process Prescriptive Model Components Descriptive Model Components Prescribed Change Message Readiness Adoption Institutionalization Prescribed Change Message Delivery Methods

7. Readiness for Change Questionnaire Daniel T. Holt Air Force Institute of Technology Connecting Research and Patient Care

8. Readiness Instruments • Process perspective • Culture & climate perspective • Change-specific perspective • Individual perspective

9. Readiness Perspectives • Change process perspective • Readiness is reflected in the stage of change (e.g., denial, resistance, exploration, implementation) • Culture and climate perspective • Readiness is reflected in the organization’s culture & climate (i.e., these characteristics dictate how individuals react to particular situations) • Change-specific perspective • Readiness is reflected in the characteristics of the proposed change (e.g., superficial changes are preferred over significant changes) • Individual perspective • Personality • Knowledge, skills & abilities • Critical attitudes

10. Available Measures • Readiness is reflected in the stage of change (e.g., denial, resistance, exploration, implementation) • 2 instruments are available Of 32 instruments reviewed, only 2 presented evidence of content, construct, and predictive validity. 12 did not even present evidence of reliability a necessary precondition for validity. • Change process • perspective • Culture & climate • perspective • Change-specific • perspective • Individual • perspective • Readiness is reflected in the organization’s culture & climate (i.e., these characteristics dictate how individuals react to particular situations) • 13 instruments are available • Readiness is reflected in the characteristics of the proposed change (e.g., superficial changes are preferred over significant changes) • 5 instruments are available • Readiness is reflected in the characteristics of the employees (e.g., personality, skills) • 7 instruments are available Based on Holt et al. (2007). Toward a comprehensive definition of readiness for change: A review of research an instrumentation. (5 measures of reactions were also included in this review that are captured here).

11. Development Process 1 2 3 4 Valid & reliable instrument to assess Change-specific Readiness Concept definition, Item generation, & Adequacy tests Replicate the findings in an independent sample Evaluate the questionnaire Administer the questionnaire • Identified factors that influenced readiness (documents, interviews, open-ended questionnaires) • Evaluated the factors (291 practicing managers) • Focused on most influential factors • Wrote items & evaluated the items ensuring they represented the factors • Administered the questionnaire in a DoD organization with $300M budget • Exploratory factor analysis indicated four factors were measured • Change efficacy • Management support • Personal benefits • Appropriateness • Identified differences between known groups (participants should be more ready) • Tested whether readiness is related to personality in meaningful ways (i.e., rebelliousness, locus of control) • Tested whether readiness is related to culture in meaningful ways (i.e., communication, trust) • Tested its ability to predict • Administered the questionnaire in a private sector organization • Test whether readiness is related to personality in meaningful ways (i.e., rebelliousness, locus of control) • Test whether readiness is related to culture in meaningful ways (i.e., communication, trust)

12. Change-specific Assessment Design appropriate readiness interventions Identify performance gaps, context, & competitive environment Readiness for change assessment • Analyze context • Develop an action plan to address some performance gap • Determine competitive risks (if appropriate) • Determine performance risks • Focus attention on issues connected to indicators of readiness • Perform focused diagnostic of the internal environment (Readiness for change questionnaire) • Identify appropriate interventions to address gaps: • Communications messages directed toward appropriateness, efficacy, & valence • Demonstrate visible management support (i.e., align of HR practices • Introduce training to include members

13. Scores Compared to Successful Organization 12 “Ready” organizations Enterprise introducing a change Enterprise compared to an organization that successfully introduced a change (Scale ranged from 1 to 5) Readiness characteristics of an enterprise introducing change Appropriateness (e.g., personnel feel that the change will address the gap and congruent with organizational goals) Management Support (e.g., personnel feel that senior leaders support the change initiative and its adoption) Change efficacy (e.g., personnel feel that they have the skills to execute the tasks and activities associated with the change) Personal valence (e.g., personnel feel that the change will be beneficial personally)

14. Summary • Flexible • Used in a variety of organizational settings by members at all organizational levels • Practical • Consistent with criteria that are identified by practitioners • Guides those who are trying to facilitate changes • Gauges the most influential readiness factors • Theoretical • Consistent with current theories of organizational change • Adheres to accepted standards for measurement

15. Bryan’s Framework • Is ORC a psychological or structural concept? • Conceptualized as a psychological concept • Is ORC an individual-level or collective construct? • Measured at the individual-level • Does ORC refer to a general state of affairs or to a specific change? • Refers to a specific change • Does ORC apply to adoption or to implementation? • Refers to adopition

16. Danny Holt • Education • B.S., Electrical Engineering • M.A., Human Resource Development • M.S., Engineering & Environmental Mgt • Ph.D., Management • Human Resource Management • Organizational Analysis • Organizational Change • Air Force Career • Civil Engineering Officer (Myrtle Beach, SC; Osan AB, ROK; Al Udeid AB, Qatar; Ft Dix, NJ; Ft Bragg, NC) • Academic (Graduate student; Faculty Air Force Institute of Technology)

17. Air Force Institute of Technology Danny Holt AFIT/ENV 2950 Hobson Way Wright Patterson AFB, OH 45433 (937) 255-3636 extension 7396 (voice) (937) 656-4699 (fax) daniel.holt@afit.edu