Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship
Background: Targeted antibiotic stewardship interventions are needed to reduce unnecessary treatment of asymptomatic bacteriuria (ASB). Organizational readiness for change is a precursor to successful change implementation. The Organizational Readiness to Change Assessment (ORCA) is a validated surv...
Published in: | Infection Control & Hospital Epidemiology |
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Online Access: | http://dx.doi.org/10.1017/ice.2020.1168 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0899823X2001168X |
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crcambridgeupr:10.1017/ice.2020.1168 2024-09-30T14:40:57+00:00 Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship Goebel, Melanie Trautner, Barbara Wang, Yiqun Van, John Dillon, Laura Patel, Payal Drekonja, Dimitri Graber, Christopher Lichtenberger, Paola Helfrich, Christian Grigoryan, Larissa 2020 http://dx.doi.org/10.1017/ice.2020.1168 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0899823X2001168X en eng Cambridge University Press (CUP) https://www.cambridge.org/core/terms Infection Control & Hospital Epidemiology volume 41, issue S1, page s492-s493 ISSN 0899-823X 1559-6834 journal-article 2020 crcambridgeupr https://doi.org/10.1017/ice.2020.1168 2024-09-18T04:03:20Z Background: Targeted antibiotic stewardship interventions are needed to reduce unnecessary treatment of asymptomatic bacteriuria (ASB). Organizational readiness for change is a precursor to successful change implementation. The Organizational Readiness to Change Assessment (ORCA) is a validated survey instrument that has been used to detect potential obstacles and tailor interventions. In an outpatient stewardship study, primary care practices with high readiness to change trended toward greater improvements in antibiotic prescribing. We used the ORCA to assess barriers to change before implementing a multicenter inpatient stewardship intervention for ASB. Methods: Surveys were self-administered by healthcare professionals in inpatient medicine and long-term care units at 4 geographically diverse Veterans’ Affairs facilities during January–December 2018. Participants included providers (physicians, physician assistants, and nurse practitioners), nurses, pharmacists, infection preventionists, and quality managers. The survey included 7 subscales: evidence (perceived evidence strength) and 6 context subscales (favorability of the organizational context to support change). Responses were scored on a 5-point Likert scale, with 1 meaning very weak or strongly disagree. Scores were compared between professional types and sites. We also measured allocated employee effort for stewardship at each site. Results: Overall, 104 surveys were completed, with an overall response rate of 69.3%. For all sites combined, the evidence subscale had the highest score of the 7 subscales (mean, 4; SD, 0.9); the resources subscale was significantly lower than other subscales (mean, 2.8; SD, 0.9; P < .001). Scores for budget and staffing resources were lower than scores for training and facility resources ( P < .001 for both comparisons). Pharmacists had lower scores than providers for the staff culture subscale ( P = .04). Comparing subscales between sites, ORCA scores were significantly different for leadership behavior ... Article in Journal/Newspaper Orca Cambridge University Press Infection Control & Hospital Epidemiology 41 S1 s492 s493 |
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Cambridge University Press |
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crcambridgeupr |
language |
English |
description |
Background: Targeted antibiotic stewardship interventions are needed to reduce unnecessary treatment of asymptomatic bacteriuria (ASB). Organizational readiness for change is a precursor to successful change implementation. The Organizational Readiness to Change Assessment (ORCA) is a validated survey instrument that has been used to detect potential obstacles and tailor interventions. In an outpatient stewardship study, primary care practices with high readiness to change trended toward greater improvements in antibiotic prescribing. We used the ORCA to assess barriers to change before implementing a multicenter inpatient stewardship intervention for ASB. Methods: Surveys were self-administered by healthcare professionals in inpatient medicine and long-term care units at 4 geographically diverse Veterans’ Affairs facilities during January–December 2018. Participants included providers (physicians, physician assistants, and nurse practitioners), nurses, pharmacists, infection preventionists, and quality managers. The survey included 7 subscales: evidence (perceived evidence strength) and 6 context subscales (favorability of the organizational context to support change). Responses were scored on a 5-point Likert scale, with 1 meaning very weak or strongly disagree. Scores were compared between professional types and sites. We also measured allocated employee effort for stewardship at each site. Results: Overall, 104 surveys were completed, with an overall response rate of 69.3%. For all sites combined, the evidence subscale had the highest score of the 7 subscales (mean, 4; SD, 0.9); the resources subscale was significantly lower than other subscales (mean, 2.8; SD, 0.9; P < .001). Scores for budget and staffing resources were lower than scores for training and facility resources ( P < .001 for both comparisons). Pharmacists had lower scores than providers for the staff culture subscale ( P = .04). Comparing subscales between sites, ORCA scores were significantly different for leadership behavior ... |
format |
Article in Journal/Newspaper |
author |
Goebel, Melanie Trautner, Barbara Wang, Yiqun Van, John Dillon, Laura Patel, Payal Drekonja, Dimitri Graber, Christopher Lichtenberger, Paola Helfrich, Christian Grigoryan, Larissa |
spellingShingle |
Goebel, Melanie Trautner, Barbara Wang, Yiqun Van, John Dillon, Laura Patel, Payal Drekonja, Dimitri Graber, Christopher Lichtenberger, Paola Helfrich, Christian Grigoryan, Larissa Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
author_facet |
Goebel, Melanie Trautner, Barbara Wang, Yiqun Van, John Dillon, Laura Patel, Payal Drekonja, Dimitri Graber, Christopher Lichtenberger, Paola Helfrich, Christian Grigoryan, Larissa |
author_sort |
Goebel, Melanie |
title |
Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
title_short |
Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
title_full |
Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
title_fullStr |
Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
title_full_unstemmed |
Organizational Readiness to Change Assessment Highlights Differential Readiness for Antibiotic Stewardship |
title_sort |
organizational readiness to change assessment highlights differential readiness for antibiotic stewardship |
publisher |
Cambridge University Press (CUP) |
publishDate |
2020 |
url |
http://dx.doi.org/10.1017/ice.2020.1168 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0899823X2001168X |
genre |
Orca |
genre_facet |
Orca |
op_source |
Infection Control & Hospital Epidemiology volume 41, issue S1, page s492-s493 ISSN 0899-823X 1559-6834 |
op_rights |
https://www.cambridge.org/core/terms |
op_doi |
https://doi.org/10.1017/ice.2020.1168 |
container_title |
Infection Control & Hospital Epidemiology |
container_volume |
41 |
container_issue |
S1 |
container_start_page |
s492 |
op_container_end_page |
s493 |
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1811643400291614720 |