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READINESS FOR CHANGE AMONG PROVIDERS IN IMPLEMENTATION OF ENHANCED RECOVERY PROGRAMS
Gianina C. Hernandez-Marquez
*1, Wendelyn Oslock
1,2, Alfonsus Adrian H. Harsono
1, Alizeh Abbas
1, Bayley A. Jones
3, Ivan I. iherbey
1, Gurudatta Naik
1, Michael Rubyan
4, Daniel I. Chu
11Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL; 2Birmingham Veterans Affairs Medical Center, Birmingham, AL; 3University Texas Southwestern Medical Center, Dallas, TX; 4University of Michigan, School of Public Health, Ann Arbor, MI
Introduction:Readiness for change among healthcare providers is required for the effective implementation of enhanced recovery programs (ERPs). Assessing this readiness can aid interventions to improve providers’ confidence in adhering to ERPs. However, gaps remain in understanding the degree of readiness for change among providers involved in ERP. The aim of this study was to assess ERP-engaged providers’ readiness for change.
Methods:Readiness for implementing change was assessed utilizing the 10-item Organizational Readiness for Implementing Change (ORIC) survey, a widely used and previously validated implementation instrument assessing organizational readiness for change. The ORIC survey was administered to ERP-engaged providers between July 2023 and October 2024 using REDCap. ORIC was scored using a 5-point Likert scale and aggregate scores were stratified into quartiles with low defined as (?27), moderate (28-35), and high (?36) ORIC levels. Levels of ORIC and confidence in adhering to ERPs were calculated using Kruskal-Wallis and Chi-Square tests.
Results:A total of 388 participants were included: 290 (75.9%) were female and 282 (73.4%) identified as White. Participants included 33 (8.5%) surgeons, 57 (14.7%) anesthesia providers, 193 (49.7%) nurses, and 105 (27.1%) other healthcare professionals. Overall, 198 (51.0%) of the participants reported moderate ORIC levels while 28.4% (n=110) reported low ORIC levels. Surgeons and other providers reported more confidence than nurses and anesthesia team in organizations’ ability to support people in adjusting to change (p=0.01). Among participants who reported high ORIC levels, 38.8% (n=31) participants reported high levels of ERP knowledge. In the preoperative period, high confidence in preoperative education, oral antibiotics, regional anesthesia, multimodal pain management, and no prolonged fasting were associated with high mean ORIC levels of 38.9 (all p<0.05). In the intraoperative period, high confidence in minimally invasive surgery was associated with high mean ORIC levels of 38.9 (p<0.05). In the postoperative period, low confidence in early discontinuation of intravenous fluids education was associated with low mean ORIC levels of 22.7 (p=0.002) while high confidence in education about early regular diet, multimodal analgesia, venous thromboembolism (VTE) prophylaxis, and foley removal were associated with high mean ORIC levels of 38.9 (p=0.0016, p=0.0016, p=0.0023, p=0.0045, respectively) (
Table 1).
Conclusion:Providers’ level of readiness for change is associated with their confidence in delivering information about ERP components. Increasing ERP knowledge may improve providers’ confidence in delivering ERPs and their readiness for change for effective implementation of ERPs.
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