Appendix 1c.

	Readiness measures	Factors & Purpose	Example of items
26	LehmanWE, Greener JM, Simpson DD. Assessing organizational readiness for change. Journal of Substance Abuse Treatment. 2002 Jun;22(4):197–209.	Motivational readiness. Creates pressure and initiation to change behaviors. Composed of three subscales: need for improvement, training needs, and pressure for change (internal or external). Institutional resources. Gauges the feasibility of change given the resources. Variables to consider: adequacy of offices and equipment, staffing and workload, training resources/availability of resources. Staff attributes. Assesses the personal traits that facilitate change in the workplace, such as: values professional growth, confidence in professional skills (efficacy), willingness and ability to influence coworkers, and ability to adapt to a changing environment. Organizational climate. Measures the degree to which collective appraisals represent an environment that lends itself to change, such as: staff awareness of goals for organization, work group trust and cooperation (cohesion), staff autonomy, openness of communication from staff to management, and level of stress.	You feel immediate needs to get specialized training for [job task]. Offices here meet the needs for [job task]; There are enough [job role] to meet the current business needs; The budget here allows staff to attend conferences each year. You do a good job of regularly updating and improving your skills; You consistently plan ahead and carry out your plans; Other staff often ask your advice about procedures; You are willing to try new ideas even if some employees are reluctant. This [department] operates with clear goals and objectives; Staff here are always quick to help one another when needed; Management here fully trusts your professional judgment; Ideas and suggestions from staff get fair consideration by management; You are under too many pressures to do your job effectively; It is easy to change procedures here to meet new conditions.
27	Helfrich CD, Li YF, Sharp ND, Sales AE. Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implementation Science. 2009 Dec;4(1):38.	This instrument is specific to implementing research-based behaviors in clinical practice. Evidence. The strength and nature of the evidence as perceived by multiple stakeholders. Includes two main subscales: 1research evidence gained from publications/experiments, and evidence gained from clinical practice or professional knowledge. Context. The quality of the context in which the research is implemented. Includes three main subscales:organizational culture (at the managerial and staff levels), leadership (formal leaders/team builders and informal leaders/opinion leaders), and evaluation/feedback (goal setting, communicating performance). Facilitation. Processes by which implementation is facilitated.	(Culture) Senior leadership/clinical management in your organization: reward clinical innovation and creativity to improve patient care. solicit opinions of clinical staff regarding decisions about patient care. seek ways to improve patient education and increase patient participation in treatment. (Leadership) Senior leadership/Clinical management in your organization: provide effective management for continuous improvement of patient care. clearly define areas of responsibility and authority for clinical managers and staff. promote team building to solve clinical care problems. promote communication among clinical services and units.
28	Holt DT, Armenakis AA, Feild HS, Harris SG. Readiness for organizational change the systematic development of a scale. The Journal of Applied Behavioral Science. 2007 Jun;43(2):232–55.	This is a change-specific readiness instrument development. Appropriateness. This factor is a combination of two constructs; the extent to which one feels that there are legitimate reasons/needs for the prospective change, and the degree to which one feels that the organization will benefit from the change. Management Support. The extent to which organizational members feel senior leaders support the change. Change Efficacy. The degree to which employees feel confident that they can perform well and be successful. PersonallyBeneficial. Measures whether the change was perceived to be personally beneficial	I think that the organization will benefit from this change; This change matches the priorities of our organization. Our senior leaders have encouraged all of us to embrace this change; Our organization’s top decision makers have put all their support behind this change effort. When we implement this change, I feel I can handle it with ease; When I set my mind to it, I can learn everything that will be required when this change is adopted. I am worried I will lose my status in the organization when this is implemented (reverse); My future job will be limited because of this change (reverse).
29	Shea CM, Jacobs SR, Esserman DA, BruceK, Weiner BJ. Organizational readiness for implementing change: A psychometric assessment of a new measure. Implementation Science. 2014 Dec;9(7):1–15.	The authors use Weiner’s (2009) theory of organizational readiness for change to develop a psychometrically sound tool to assess readiness in healthcare settings. Change Commitment. Collective resolve to implement a change. Change Valence. Degree to which the change is valued collectively. Change Efficacy. Organizational members’ shared belief in their collective capability to implement change. Task Knowledge, Resource Availability, and Situational Factors: Perception of what is required, the resources available and situational opportunities and constraints (e.g. timing).	We are committed to implementing this change; We are determined to implement this change; We are motivated to implement this change. We value this change; We feel that implementing this change is a good idea; We believe this change will benefit our community. We can support people as they adjust to this change; We can coordinate tasks so that implementation goes smoothly. We know what each of us has to do to implement this change; We have the time to implement this change; We have the resources to implement this change.