Introduction
Continual innovation to address emerging population needs necessitates
health service ongoing redesign and transformation worldwide. Recent
examples include service transformations in response to covid-19. The
pandemic has catalysed several changes to how healthcare is delivered,
particularly in the rapid acceleration of virtual and hybrid models of
care.(1) As work processes, systems and models of care shift in response
to health system needs, so too must individual and collective behaviours
of the workforce and its consumers.(2, 3) Ensuring effective change
management processes occur is therefore central to transformative
changes that deliver their intended outcomes and are sustained. Yet
change management is notoriously challenging in healthcare contexts,
with limited evidence available for healthcare managers to optimise
their implementation of current change management models.
Achieving ‘change readiness’ amongst healthcare staff is identified as
an important precursor to whether staff accept and adopt a change
initiative. Change readiness is influenced by the extent to which staff
perceive that a given change is needed (their commitment to the change)
and that they have the required capability and support to work in a new
way (change self-efficacy).(1)(4, 5) Commitment to change arises for
three reasons: a) because there is a requirement to support the change
due to recognition of cost associated with failure to do so (continuance
commitment), b) because there is a sense of obligation to support the
change (normative commitment), and c) because an individual wants or
desires to support the change due to the benefits associated with it
(affective commitment).(6, 7)
Recent evidence indicates that affective commitment to change is an
important contributor to achieving change readiness but understudied in
relation to healthcare projects.(8-10) A systematic review of 38 studies
of healthcare change projects highlights that management approaches
rarely focus on the influence of affective commitment to change.(11) Our
analysis sought to address the evidence gap regarding the association
between affective commitment to change and change readiness in
healthcare by exploring change readiness amongst clinical and
non-clinical staff directly involved in one of four transformational
change projects in New South Wales, Australia.