title: Measuring organisational readiness for patient engagement (MORE): an international online Delphi consensus study.
abstract: BACKGROUND
  Widespread implementation of patient engagement by organisations and clinical teams is not a reality yet. The aim of this study is to develop a measure of organisational readiness for patient engagement designed to monitor and facilitate a healthcare organisation's willingness and ability to effectively implement patient engagement in healthcare.
  
  
  METHODS
  The development of the MORE (Measuring Organisational Readiness for patient Engagement) scale was guided by Weiner's theory of organisational readiness for change. Weiner postulates that an organisation's readiness is determined by both the willingness and ability to implement the change (i.e. in this context: patient engagement). A first version of the scale was developed based on a literature search and evaluation of pre-existing tools. We invited multi-disciplinary stakeholders to participate in a two-round online Delphi survey. Respondents were asked to rate the importance of each proposed item, and to comment on the proposed domains and items. Second round participants received feedback from the first round and were asked to re-rate the importance of the revised, new and unchanged items, and to provide comments.
  
  
  RESULTS
  The first version of the scale contained 51 items divided into three domains: (1) Respondents' characteristics; (2) the organisation's willingness to implement patient engagement; and (3) the organisation's ability to implement patient engagement. 131 respondents from 16 countries (health care managers, policy makers, clinicians, patients and patient representatives, researchers, and other stakeholders) completed the first survey, and 72 of them also completed the second survey. During the Delphi process, 34 items were reworded, 8 new items were added, 5 items were removed, and 18 were combined. The scale's instructions were revised. The final version of MORE totalled 38 items; 5 on stakeholders, 13 on an organisation's willingness to implement, and 20 on an organisation's ability to implement patient engagement in healthcare.
  
  
  CONCLUSIONS
  The Delphi technique was successfully used to refine the scale's instructions, domains and items, using input from a broad range of international stakeholders, hoping that MORE can be applied in a variety of healthcare contexts worldwide. Further assessment is needed to determine the psychometric properties of the scale.
authors: Department of Psychology, Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hatfield, UK. lindaoostendorp@hotmail.com.
authors: Linda J M
authors: LJ
authors: Oostendorp
authors: Department of Psychology, Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hatfield, UK. m.durand@herts.ac.uk.|The Dartmouth Institute for Health Policy and Clinical Practice, HB 7256, Dartmouth College, Hanover, NH, 03755, USA. m.durand@herts.ac.uk.
authors: Marie-Anne
authors: MA
authors: Durand
authors: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff, UK. lloyda1@cardiff.ac.uk.
authors: Amy
authors: A
authors: Lloyd
authors: The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, USA. glynelwyn@gmail.com.
authors: Glyn
authors: G
authors: Elwyn
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D003697:Delphi Technique; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D009936:Organizational Innovation; D010358:Patient Participation / Q000706:statistics & numerical data*; D011594:Psychometrics; D011795:Surveys and Questionnaires