Readiness for organizational change: A longitudinal study ...

1 377 Journal of Occupational and organizational Psychology (2002). 75, 377-392 2002 The British Psychological for organizational change :A longitudinal study of workplace, psychologicaland behavioural correlatesCharles E. Cunningham'*, Christel A. Woodward^,Harry S. Shannon^, John Macintosh', Bonnie Lendrum',David Rosenbloom' and Judy Brown^'Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada^McMaster University, Hamilton, Ontario, CanadaTo examine factors influencing Readiness for healthcare organizational change , 654randomly selected hospital staff completed questionnaires measuring the logisticaland occupational risks of change , ability to cope with change and to solve job-related problems, social support, measures of Karasek's (1979) active vs. passive jobconstruct (job demand x decision latitude) and Readiness for organizational in active jobs (Karasek, 1979) v/hich afforded higher decision latitude andcontrol over challenging tasks reported a higher Readiness for organizational changescores.

2 Workers with an active approach to job problem-solving with higher jobchange self-efficacy scores reported a higher Readiness for change . In hierarchicalregression analyses, active jobs, an active job problem-solving style and job-changeself-efficacy contributed independently to the prediction of Readiness for organiz-ational change . Time I Readiness for organizational change scores and an activeapproach to job problem-solving were the best predictors of participation inredesign activities during a year-long re-engineering organizations are undergoing unprecedented changes (Shortell, Gillies,Anderson, Erickson, & Mitchell, 1996). (Competition, funding reductions, efforts toimprove cost-efficiency, mergers and the re-engineering of work processes are placingenormous demands on healthcare organizations and their employees (Woodwardet al., 1999). Research on individual differences in Readiness for organizationalchange, workplace processes that facilitate change and factors that influence theimpact of organizational change on the health and emotional well-being of employeesIs important to the success of efforts to improve the health service delivery for change research suggests that a demonstrable need for change , a senseof one s ability to successfully accomplish change (self-efficacy) and an opportunity toparticipate in the change process contribute to Readiness for organizational change (Armenakis, Harris, & Mossholder, 1993).)

3 Readiness for change models havebeen applied widely in the organizational and behavioural sciences. Prochaska and^Requests for reprints should be addressed to Charles E. Cunningham, Department of Psychiatry and BehaviouralNeurosdences. Faculty of Health Sciences. McMaster University, 1200 Main Street, Homiltor], Ontario, L8N 3Z5. Canada(e-mail: Charles E. Cunningham et , for example, found that Readiness for individual change proceeded throughstages (Prochaska et al., 1994; Prochaska, Redding, & Evers, 1997) beginning at theprecontemplative stage, where the need for change is not acknowledged. At thecontemplative stage, individuals consider but do not initiate change . As a preparatorystage is reached, planning for change occurs (Prochaska etal., 1994, 1997). Individualsengaged in the process of behavioural change are at the action stage, whereas thoseattempting to sustain changes are at the maintenance stage.)

4 Movement throughthese stages is governed by decisional balance, the anticipated risks of change vs. thepotential benefits of study applied an individual Readiness for change model to a longitudinal studyof organizational re-engineering in healthcare settings. We developed a brief measureof individual Readiness for organizational change based on Prochaska et a/.'s (1994)questionnaires and tested several assumptions of individual and organizationalreadiness for change vs. risks of organizational changeReadiness for change begins with an individual's perception of the benefits of change (Prochaska et al., 1994), the risks of failing to change (Armenakis et al., 1993; Beer,1980; B. A. Spector, 1989), or the demands of externally imposed changes (Pettigrew,1987). We hypothesized, therefore, that workers' perceptions of opportunities forimprovement in staff competence, service quality, quality improvement programme ororganizational staff relationships would contribute to Readiness for change for change research suggests that staff perceptions regarding the risks ofre-engineering should also influence Readiness for organizational change (Prochaskaet al.)

5 , 1994). Employees in healthcare organizations facing re-engineering are con-fronted with at least three types of risks. First, because organizational re-engineeringposes a threat of job change or loss, we postulated that perceptions of occupationalinsecurity would lower Readiness for organizational change scores and limit partici-pation in re-engineering activities. Second, the logistical burden of re-engineeringrepresents a risk that may shift decisional balance and reduce Readiness for organiz-ational change (Prochaska et al., 1997). In a healthcare work force composed largely ofwomen, the domestic responsibilities assumed by many employees might increase thelogistical demands of organizational re-engineering (Hall, 1989, 1992). Shift workmight contribute to an already difficult logistical burden. We predicted, therefore, thatchild care, household tasks, shift work and a perception of conflict between domesticand occupational responsibilities would reduce Readiness for organizational changeand limit participation in re-engineering.

6 Third, because organizational changerepresents a considerable source of stress (Eerrie, Shipley, Marmot, Stansfeld, & Smith,1995; Woodard et al., 1999), re-engineering may pose special risks lor employeesexperiencing psychological distress. We hypothesized that emotional exhaustion anddepression would reduce Readiness for organizational change and participation inredesign contributors to Readiness for organizational changeSelf-efficacy, the perceived ability to manage change successfully, exerts a mediatingeffect on Readiness for individual (Prochaska et al., 1997) and organizational change (Armenakis et al., 1993; Pond, Armenakis, & Green, 1984). Workers with confi-dence in their ability to cope with change should be more likely to contribute toReadiness for organizational change 379organizational redesign. In contrast, workers may resist cbanges that they believeexceed their coping capabilities (Armenakis et al.)

7 , 1993; Bandum, 1982). We pre-dicted, therefore, tbat staff who were cotifidetit in their ability to cope with job changeand who adopted ati active approach to job problem-solvitig would bave a higherreadiness for cbatige scores and participate in a greater number of organizationalredesign contributors to Readiness for organizational changeFinally, we that individual Readiness for cbange would be influenced bybroader organizational factors. Jobs wbich empower (Spreitzer, 1995) employees withthe skills, attitudes and opportunities to manage change should increase work-relatedself-efficacy (Conger & Kanungo, 1988) and Readiness for organizational change (Armenakis et al., 1993; Neuman, 1989). Karasek (1979) described active jobs aspsycbologically demanding positions affording bigh decision latitude. Jobs with lowdemands and low^ decision latitude were defined as passive (Karasek, 1979)- Activejobs increase learning opportunities and contribute to desirable stress, whicb increasesmotivation and tbe development of new bebaviour patterns (Tbeorell & Karasek,1996).

8 Active jobs provide opportunities for enactive mastery and incremental prep-anition for larger-scale organizational cbange (Armenakis et al., 1993). Workers inactive jobs should be more confident in their ability to manage cbange (Spreitzer,1995) and better prepared to participate in organizational redesign (Armenakis et ,1993; Beer & Walton, 1987; Neuman, 1989). Passive jobs, wliicb limit opportunities fordecision-making and control, may compound tbe anticipated occupational risks oforganizational re-engineering, lower self-efficacy and limit Readiness for change . A thirdfactor, .social support (Johnson, 1991; Karasek, Triantis, & C^haudhry, 1982; LaRocco,House, & French, 1980; Stansfeld, North, White, & Marmot, 1995) appears to interactwitb active jobs to predict workplace adjustment. We predicted, therefore, thathigher scores on both Karasek and Tbeorell's (1990) active vs. passive job dimensionand social support would be associated witb Readiness for organizatiotial cbange andstibsequent participation in a year-long hospital re-engineering sample ot 880 staff, =21% of the employees at a large Canadian teaching hospital, wasrandomly selected from tbe organization s human resources files.

9 Participants weredrawn from a wide range of job descriptions ( nurses, pbysiotherapists, housekeep-ing) at two former general hospital sites wbich eacb possessed a ntimber of units (acbildren s bospital, a cbildren's outpatient developmental and mental bealth centre,a rehabilitation hospital and a chrotiic care setting).ProceduresBaseline surveys were sent to staff selected for tbe study after the intent to re-engineerwas amioimced, but several months before redesign planning began. Staff wereitiformed tbat the purpose of the stirvey was to understand bow workplace cbangesaffect both employees and services. Staff returned questionnaires to a universityresearch unit witb assurance tbat data would remain confidential, and tbe hospitaladmitiistnition would not have access to individual scores. Following baseline sitrveys,380 Charles E. Cunningham et extensive programme of organizational re-engineering began.

10 Design teams workedfor a year to achieve cost reductions and service improvements by introducing pro-gramme management, designing evidenced-based clinical pathways, redistributingtasks (multiskilling) and reducing staff. Staff were informed by regular newsletters andtown hall discussions and encouraged to pose questions, make suggestions or offerfeedback anonymously. Staff were given opportunities to participate in a wide range ofredesign activities and provided with transitional workshops and supports ( resumepreparation, interview training, computer skills and career planning). At Time 2, oneyear following the completion of the first survey, the same cohort of employees wassent a second of the risks ofchatigeFamily demographics. Participants completed questions regarding marital status, numberof chiitlren, time devoted to child care, care of extended family members and insecurity.