Organizational readiness for knowledge translation in chronic care: a Delphi study.
BACKGROUND
Health-care organizations need to be ready prior to implement evidence-based interventions. In this study, we sought to achieve consensus on a framework to assess the readiness of health-care organizations to implement evidence-based interventions in the context of chronic care.


METHODS
We conducted a web-based modified Delphi study between March and May 2013. We contacted 76 potentially eligible international experts working in the fields of organizational readiness (OR), knowledge translation (KT), and chronic care to comment upon the 76 elements resulting from our proposed conceptual map. This conceptual map was based on a systematic review of the existing frameworks of Organizational Readiness for Change (ORC) in health-care. We developed a conceptual map that proposed a set of core concepts and their associated 17 dimensions and 59 sub-dimensions. Experts rated their agreement concerning the applicability and importance of ORC elements on a 5-point Likert scale, where 1 indicates total disagreement and 5 indicates total agreement. Two rounds were needed to get a consensus from the experts. Consensus was a priori defined as strong (≥75%) or moderate (60-74%). Simple descriptive statistics was used.


RESULTS
In total, 14 participants completed the first round and 10 completed the two rounds. Panel members reached consensus on the applicability and importance of 6 out of 17 dimensions and 28 out of 59 sub-dimensions to assess OR for KT in the context of chronic care. A strong level of consensus (≥75%) was attained on the Organizational contextual factors, Leadership/participation, Organizational support, and Motivation dimensions. The Organizational climate for change and Change content dimensions reached a moderate consensus (60-74%). Experts also reached consensus on 28 out of 59 sub-dimensions to assess OR for KT. Twenty-one sub-dimensions reached a strong consensus (≥75%) and seven a moderate consensus (60-74%).


CONCLUSIONS
This study results provided the most important and applicable dimensions and sub-dimensions for assessing OR-KT in the context of chronic care. They can be used to guide the design of an assessment tool to improve knowledge translation in the field of chronic care.
Research Centre of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, 45 rue Leclerc, Quebec City, QC, Canada. randa.attieh.1@ulaval.ca.
Randa
R
Attieh
Research Centre of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, 45 rue Leclerc, Quebec City, QC, Canada. marie-pierre.gagnon@fsi.ulaval.ca.|Faculty of Nursing, Université Laval, Quebec City, QC, Canada. marie-pierre.gagnon@fsi.ulaval.ca.
Marie-Pierre
MP
Gagnon
Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, AB, Canada. carole.estabrooks@ualberta.ca.
Carole A
CA
Estabrooks
Research Centre of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, 45 rue Leclerc, Quebec City, QC, Canada. france.legare@mfa.ulaval.ca.|Department of Family Medicine, Université Laval, Quebec City, QC, Canada. france.legare@mfa.ulaval.ca.
France
F
Légaré
Research Centre of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, 45 rue Leclerc, Quebec City, QC, Canada. mathieu.ouimet@pol.ulaval.ca.|Department of Political Science, Université Laval, Quebec City, QC, Canada. mathieu.ouimet@pol.ulaval.ca.
Mathieu
M
Ouimet
Fundacion Vasca de Innovacion e Investigacion Sanitarias, Bilbao, Spain. p.vazq.prz@gmail.com.
Patricia
P
Vazquez
Fundacion Vasca de Innovacion e Investigacion Sanitarias, Bilbao, Spain. nuno@bioef.org.
Roberto
R
Nuño
D002908:Chronic Disease / Q000628:therapy*; D032921:Consensus; D003695:Delivery of Health Care / Q000458:organization & administration*; D003697:Delphi Technique; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D009937:Organizational Objectives; D057170:Translational Research, Biomedical