EBP Proposal: Organizational Culture and Readiness Essay

EBP Proposal: Organizational Culture and Readiness Essay

EBP Proposal: Organizational Culture and Readiness Essay

Successful change in healthcare settings depends largely on the organizational culture. According to Mannion and Davies (2018), organizational culture represents the organization’s shared values, practices, and attitudes that guide everyday decision-making. It influences leaders and health staff behaviors and responses to people and situations. Cultures that support change are critical for successful evidence-based practice (EBP) integration into health processes. They enable an organization to embrace innovation and other critical elements for improving patients’ and populations’ health. The purpose of this assignment is to describe the organizational culture and readiness for change.


Organization’s Culture and Degree of Supporting Change

The organization is primarily hierarchical. Despite this structure where the management is responsible for the final decisions, elements of clan and adhocracy cultures dominate routine practice and relationships. Such elements include people-centered decisions, a collaborative work environment, horizontal communication, and supporting innovation. The organization’s mission is to empower individuals and populations through quality care. Core values include equality, equity, sustainability, and high-quality care. Leaders engage the staff in decision-making, which is critical in enhancing employee satisfaction and care quality (Janes et al., 2021). The entire staff is readily informed about practice changes and other developments through horizontal communication. Leadership support, employee engagement, and support for innovative practices make the health care staff perceive the organization positively. In such a setting, the overall culture can be correctly deduced as inclined to change. It readily supports constructive change for improving care processes and outcomes.

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Readiness for Change Assessment

The Organizational Readiness to Change Assessment (ORCA) tool can effectively assess the organization’s readiness for change. The ORCA tool focuses on three critical elements for change: the strength of the evidence recommending the change, the context of the environment, and facilitation (Kononowech et al., 2021). Facilitation implies helping people change their attitudes and behaviors, which is critical in reducing resistance to change. The survey results (Appendix A) show that the proposed change (case management for chronic disease management) is backed by solid evidence from randomized controlled trials. Regarding the context, leaders support innovation and believe that the current practice patterns can be improved (Appendix A). On facilitation, there is adequate staff and other resources to make the current project successful. Stakeholder support is guaranteed, and the timing is also appropriate. Combining these factors implies that the culture will fully support and sustain the proposed project.

Improving Quality, Safety, and Cost-Effectiveness

The organization can use both organization-wide and employee-centered processes and systems to improve quality, safety, and cost-effectiveness. Organization-wide interventions include adopting appropriate technologies for care improvement and regular performance appraisals. Technologies enhance efficiency and accuracy, which is critical in reducing medication errors (Schneider, 2018). Some, like telehealth, facilitate remote care to reduce physical travel to care facilities, which helps to reduce healthcare spending. Performance appraisals help leaders to identify skill gaps and empower employees through training and development and other strategies. Effective employee-centered processes include employee motivation since it improves satisfaction and prevents turnover. It plays a critical role in care continuity and ensuring that patients receive readily and appropriate care.

Strategies to Better Facilitate Readiness

An organization’s readiness for change determines the outcomes of change. An effective way to improve change readiness is to conduct change readiness assessments frequently. Such assessments can identify barriers and facilitators for change to help change proponents prepare appropriately. Another effective strategy is active communication. It is crucial to inform people about the change besides ensuring positive attitudes and beliefs (Vax et al., 2021). Stakeholders should also be actively engaged to welcome the proposed change readily. Employee training and development are also crucial to transforming employees’ mindsets and perceptions of innovation and other critical success factors for progressive change.

Stakeholders and Team Members

The project involves three main stakeholders. The first group is the organization’s leadership since it is responsible for creating the necessary environment for incremental change. Leaders also support EBP projects financially, and the proposed project requires similar support. The second stakeholder group includes the nurses, particularly in the emergency department. Their beliefs, values, and attitudes toward case management will affect the project’s outcomes. They should embrace case management and integrate it into chronic illnesses management for the project to succeed. The third group is the patients. Their primary role is to embrace case management and involve families in care coordination as required.

Information and Communication Technologies

Case management requires healthcare providers and patients to communicate throughout the treatment process actively. Appropriate technologies for a successful project include screening gadgets, risk assessment tools, and communication devices. Leaders should purchase the needed technologies and help nurses and patients to understand their application. They will be integral in improving nursing practice and care delivery for patients with chronic diseases since they will help to facilitate value-based and coordinated care.


Healthcare facilities should be ready for progressive change for EBP project proposals to be implemented successfully. An in-depth evaluation of the organization through the ORCA tool demonstrates an organization ready for change. There is adequate and strong evidence supporting the change, and the organization has the appropriate climate and facilitators for change. Leaders, nurses in the emergency department, and patients should collaborate for the project to achieve the desired outcomes.


Janes, G., Mills, T., Budworth, L., Johnson, J., & Lawton, R. (2021). The association between health care staff engagement and patient safety outcomes: A systematic review and meta-analysis. Journal of Patient Safety, 17(3), 207-216. doi: 10.1097/PTS.0000000000000807

Kononowech, J., Hagedorn, H., Hall, C., Helfrich, C. D., Lambert-Kerzner, A. C., Miller, S. C., … & Damschroder, L. (2021). Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research. Implementation Science Communications, 2(1), 1-6. https://doi.org/10.1186/s43058-021-00121-0

Mannion, R., & Davies, H. (2018). Understanding organisational culture for healthcare quality improvement. Bmj, 363. https://doi.org/10.1136/bmj.k4907

Schneider, P. J. (2018). The impact of technology on safe medicines use and pharmacy practice in the US. Frontiers in Pharmacology, 1361. https://doi.org/10.3389/fphar.2018.01361

Vax, S., Gidugu, V., Farkas, M., & Drainoni, M. L. (2021). Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health. Implementation Research and Practice, 2, 2633489520988254. https://doi.org/10.1177%2F2633489520988254


Appendix A: The Organizational Readiness to Change Assessment (ORCA) Tool

Evidence Assessment

Scale/sub-scale Rating
The project’s Evidence Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree Don’t know/NA
Supported by RCTs and other high-level scientific evidence         5  
Evidence informed by clinical experience         5  
Patient preferences are considered         5  

Context Assessment (Leadership)

Scale/sub-scale Rating
Senior leadership Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5) Don’t know/NA
Recommends and supports clinical innovation and creativity         5  
Solicits opinions from clinical staff         5  
Seek interventions to improve patient education and increase participant in care processes.       4    

Readiness for Change

Scale/sub-scale Rating
(Readiness for change) Opinion leaders in your organization. Strongly disagree (1) Disagree (2) Neither agree nor disagree (3)      
Believe that the current practice patterns can be improved       4    
Encourage and support changes in practice patterns to improve patient care       4    
Are willing to try new clinical protocols         5  
Work cooperatively with senior leadership/clinical management to make appropriate changes         5  

Facilitation Assessment

Scale/sub-scale Rating
Senior Leadership/Clinical management/staff opinion leaders Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5) Don’t know/NA
Agree on the goals for this intervention         5  
Will be informed and involved in the intervention         5  
Agree on adequate resources to accomplish the intervention         5  
Set a high priority on the success of the intervention       4    
The implementation team members: Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5) Don’t know/NA
Share responsibility for the success of this project       4    
Have clearly defined roles and responsibilities       4    
Have release time or can accomplish intervention tasks within their regular work load       4    
Have staff support and other resources required for the project       4    


In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed. You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
Propose strategies to better facilitate the readiness of the organization.
Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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