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.