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

摘要: The Promoting Action on Research Implementation in Health Services, or PARIHS, framework is a theoretical widely promoted as guide to implement evidence-based clinical practices. However, it has yet no pool of validated measurement instruments that operationalize the constructs defined framework. present article introduces an Organizational Readiness Change Assessment instrument (ORCA), organized according core elements and sub-elements PARIHS framework, reports initial validation. We conducted scale reliability factor analyses cross-sectional, secondary data from three quality improvement projects (n = 80) Veterans Administration. In each project, identical 77-item ORCA were administered one more staff facility involved projects. Items into 19 subscales primary scales corresponding framework: (1) Strength extent evidence for practice changes represented by QI program, assessed with four subscales, (2) Quality organizational context six (3) Capacity internal facilitation nine subscales. Cronbach's alpha 0.74, 0.85 0.95 evidence, scales, respectively. its constituent failed meet conventional threshold 0.80 reliability, individual items eliminated following testing. exploratory analysis, factors retained. Seven loaded onto first factor; five second third factor. Two load significantly any One measured resources general (from scale), champion role scale). find support structure ORCA. there was poor among measures analysis results did not conform Additional validation needed, including criterion