Factors that Enhance Readiness | Factors that Hinder Readiness | Differences Between Managers and Health care Providers | |
---|---|---|---|
Discrepancy | -Encountering challenges with the status quo of health service delivery with the Senior Care Program | -Limited awareness of problems associated with the current state | -Discrepancy experienced similarly by frontline providers and middle managers |
Appropriate-ness | -Detailed knowledge about the Health Links approach | -Perception that Health Links is a duplication of the Senior Care Program -Poor rapport with Senior Care Program management at the Lead Site | -Newer employees and middle managers were more likely to view the integration as appropriate when compared to other providers |
Valence | -Seeing value to Health Links at the system and the patient level | -Perception of increased workload with the implementation of Health Links (e.g., double documentation) | - Frontline providers mostly discussed benefits of the integration at the patient level and managers discussed the benefits of the integration at the health system level |
Self-Efficacy | -Informal training (e.g. job shadowing) -Learning by doing | -Formal training not comprehensive enough (focused on limited aspects of Health Links) -Lack of training on change management | -Self efficacy experienced similarly by frontline providers and middle managers -Middle managers emphasized the need for training on change process and management |
Fairness | -Working at sites with more administrative support and more opportunities for training | -Not being consulted on the change -Working at sites with minimal opportunities for training and no administrative support | -Lack of procedural and distributive fairness experienced similarly by frontline providers and managers |
Trust in management | -Clear communication from local managers -Local managers’ ability to support and provide solutions | -Limited or unclear communication from managers at higher levels -Leadership ambiguity -Not knowing who to turn to for information or support | -Trust in management experienced similarly by frontline providers and middle managers. -Lead Site managers themselves viewed contact with and information from their superiors as lacking |