A systematic review of the relationship between staff perceptions of organizational readiness to change and the process of innovation adoption in substance misuse treatment programs.

Translating innovation, such as contemporary research evidence, into policy and practice is a challenge, not just in substance misuse treatment programs, but across all spheres of healthcare. Organizational readiness to change (ORC) has been described as a fundamental concept, and an important determinant of the process of innovation adoption. The aim of this review was to describe the relationship between staff perceptions of ORC and the process of innovation adoption: exposure, adoption, implementation and integration into practice, in substance misuse treatment programs. This systematic review was conducted in accordance with PRISMA guidelines and fourteen papers were identified as being eligible for inclusion. This review was designed to include all constructs of ORC, but only one tool was used in all of the included papers. Despite this, the heterogeneity of studies in this review made a direct comparison of ORC related variables challenging. None of the included papers clearly related to one stage of the process of innovation adoption, and all of the included papers related to the early stages of the process. Only one paper attempted to measure the sustained integration of an innovation into practice. Overall, the papers were assessed as being low in terms of evidential hierarchy and the quality of the papers was assessed as being on average fair. ORC measurements provide us with a measure of organizational functioning which can be important in terms of predicting how successfully new innovations are adopted. Motivation for change was high in programs where staff identified more program deficits and these staff could also identify more specific needs, but were less likely to have exposure to new innovations. Better program resources and specific staff attributes, increase the likely hood of successful innovation adoption. A good organizational climate is potentially the strongest predictor for the adoption of new practices. It may be beneficial to measure ORC in conjunction with other variables such as program size, location, staff workloads and financial resources. More evidence is required on how to address ORC deficits once they are identified in practice.