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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 ReadinessFactors that Hinder ReadinessDifferences 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