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Table 4 Factors enhancing and hindering readiness for change

From: Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study

 

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