Discussion

Our findings indicate that affective commitment to change; healthcare worker’s emotional and personal perception of the value of the proposed change, is independently associated with individual and collective change readiness. Given that achieving change readiness is a central goal of change management strategies, this pilot work provides valuable insight to inform change management practices in healthcare contexts. Larger scale replication of this analysis is warranted to explore these findings across health systems and a wider range of change projects.
Many factors contribute to an employee’s affective commitment to change, which may warrant further exploration to underpin interventional approaches that promote change readiness in healthcare. Factors that contribute to an employee’s affective commitment to change include employees interpersonal workplace relationships with managers and with colleagues, change frequency (more frequent change reduces commitment to change), organisational communication about change, and employee’s participation or engagement in decisions about the change.(15)
Wider research literature indicates that employee engagement in decisions about the change process have been linked with individuals feeling more positive emotions towards change proposals and greater understanding of the purpose of change proposals and the possible gains to be made. These reactions, in turn, are associated with a greater likelihood of employees making the behavioural changes required for changes to be adopted and sustained.(16) When employees engage in decision-making about changes and how change occurs, it also promotes interpersonal trust, attachment to their organisation and their sense of competence to achieve the changes needed.(17) Employee engagement in decision-making about changes may also therefore be a factor to consider in attempts to promote affective commitment to change.
Our findings must be considered in light of the limitations of the research. As a pilot project, the results need to be treated cautiously due to the small sample size and cross-sectional nature of this research. Change readiness is not static and it is important to consider in future analysis how the environmental factors (e.g. the extent to which a health service environment has a culture that is conducive to change, the level of resourcing and support for changes to be made successfully and leadership) influence whether change readiness is achieved and sustained. The sample was also made up largely of females and of clinicians who consented to participate, which may have also influenced the resulting data.