Skip to main content

Becoming an Evidence-Based Service Provider: Staff Perceptions and Experiences of Organizational Change

The Journal of Behavioral Health Services & Research volume 39, pages 314–332 (2012)Cite this article

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Ministry of Child and Youth Services. A Shared Responsibility: Ontario’s Policy Framework for Child and Youth Mental Health 2006. ISBN 1-4249-2723-4. Toronto, ONT: Queens Printer for Ontario.

    Google Scholar 

  2. Waddell C, Godderis R, Wong W, et al. Implementing Evidence-Based Practice in Children’s Mental Health: A Research Report Prepared for the British Columbia Ministry of Children and Family Department 2005. Vancouver, BC: Children’s Mental Health Policy Research Program.

    Google Scholar 

  3. Glisson C. The Organizational Context of Children’s Mental Health Services. Clinical Child and Family Psychology Review 2002; 5: 233–253.

    PubMed  Article  Google Scholar 

  4. Barwick M A, Boydell KM, Stasiulis E, et al. Knowledge Transfer and Evidence-Based Practice in Children’s Mental Health 2005; Toronto, ON: Children’s Mental Health Ontario.

    Google Scholar 

  5. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science. 2009; 4:50.

    PubMed  Article  Google Scholar 

  6. Proctor EK, Landsverk J, Aarons G, Chambers D, Glisson C, & Mittman B. Implementation research in mental health services: An emerging science with conceptual, methodological and training challenges. Administrative Policy in Mental Health. 2009; 36: 24–34.

    Article  Google Scholar 

  7. Barwick M, Kimber M & Fearing G. Shifting sands: A Case Study of Process Change in Scaling Up for Evidence-Based Practice. International journal of knowledge, culture and change management 2011; 10: 97.

    Google Scholar 

  8. Brown J, Rounthwaite J, & Barwick M. Implementing Evidence-Based Practices: A Transformational Organizational Change Process. International Journal of Knowledge, Culture and Change Management 2011; 10: 33.

    Google Scholar 

  9. Gershon R, Stone PW, Bakken S, Larson E: Measurement of Organizational Culture and Climate in Healthcare. Journal of Nursing Administration. 2004; 34: 33.

    PubMed  Article  Google Scholar 

  10. Zhang A, Tsui A, Song L, et al. How do I trust thee? The Employee-Organization Relationship, Supervisor Support, and Middle Manager Trust in the Organization. Human Resource Management 2008; 47: 111–132.

    Article  CAS  Google Scholar 

  11. Findler L, Wind L, & Mor Barak M. The Challenge of Workforce Management in a Global Society: Modeling the Relationship Between Diversity, Inclusion, Organizational Culture, and Employee Well-Being, Job Satisfaction and Organizational Commitment. Administration in Social Work 2007; 31: 63–94.

    Article  Google Scholar 

  12. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 2004; 82:581.

    PubMed  Article  Google Scholar 

  13. Klein KJ, Sorra JS. The Challenge of Innovation Implementation. The Academy of Management Review 1996; 21:1055.

    Google Scholar 

  14. Aarons GA, Sommerfeld D, Hecht D, et al. The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect. Journal of Consulting & Clinical Psychology 2009; 77: 270–280.

    Article  Google Scholar 

  15. Ingersoll GL, Kirsch JC, Merk SE, et al. Relationship of Organizational Culture and Readiness for Change to Employee Commitment to the Organization. Journal of Nursing Administration 2000; 30: 11–20.

    PubMed  Article  CAS  Google Scholar 

  16. Weeks WA, Roberts J, Chonko LB, et al. Organizational Readiness for Change, Individual Fear of Change, and Sales Manager Performance: An Empirical Investigation. Journal of Personal Selling and Sales Management 2004; 24: 7–17.

    Google Scholar 

  17. VanDeusen Lukas CV, Holmes SK, Cohen AB, Restuccia J, Cramer IE, Shwartz M, Charns MP. Transformational change in health care systems: An organizational model. Health Care Management Review 2007; 32:309.

    Google Scholar 

  18. Kavanagh MH & Ashkanasy NM. The Impact of Leadership and Change Management Strategy on Organizational Culture and Individual Acceptance of Change During a Merger. British Journal of Management 2006; 17: S81-S103.

    Article  Google Scholar 

  19. Aarons GA, Wells RS, Zagursky K, et al. Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis, American Journal of Public Health 2009; 99: 2087–2095.

    PubMed  Article  Google Scholar 

  20. Kuoppala J, Lamminpää A, Liira J, et al. Leadership, Job Well-Being, and Health Effects: A Systematic Review and a Meta-Analysis. Journal of Occupational & Environmental Medicine 2008; 50: 904–915.

    Article  Google Scholar 

  21. Aarons GA. Transformational and Transactional Leadership: Association with Attitudes Toward Evidence Based Practice. Psychiatric Services 2006; 57: 1162–1169.

    PubMed  Article  Google Scholar 

  22. Howell J, & Avolio B. Transformational Leadership, Transactional Leadership, Locus of Control, and Support for Innovation: Key Predictors of Consolidated-Business-Unit Performance. Journal of Applied Psychology 1993, 78(6), 891–902.

    Article  Google Scholar 

  23. Stordeur S, Vandenberghe C, & D'hoore W. On Examining the Moderators of Leader Behaviors in Nursing: An Investigation of Substitutes for, and Neutralizers and Enhancers of, Leadership. In Organizational Psychology and Health Care at the Start of a New Millennium 2001. Munich, Germany: Rainer Hampp Verlag, pp. 85–104.

    Google Scholar 

  24. Klein KJ, Conn AB, Sorra JS. Implementing computerized technology: An organizational analysis. Journal of Applied Psychology 2001; 86:811.

    PubMed  Article  CAS  Google Scholar 

  25. Kirsh SR, Lawrence RH, Aron DC. Tailoring an intervention to the context and system redesign related to the intervention: A case study of implementing shared medical appointments for diabetes. Implementation Science 2008; 3:34.

    PubMed  Article  Google Scholar 

  26. Pettigrew AM, Woodman RW, Cameron KS. Studying organizational change and development: Challenges for future research. Academy of Management Journal 2001; 44:697.

    Article  Google Scholar 

  27. Estabrooks CA, Thompson DS, Lovely JJ, Hofmeyer A. A guide to knowledge translation theory. Journal of Continuing Education in the Health Professions 2006; 26: 25.

    PubMed  Article  Google Scholar 

  28. Aarons GA. Mental health provider attitudes toward adoption of Evidence-Based Practice: The Evidence-Based Practice Attitude Scale (EBPAS) Mental Health Services Research 2004; 6: 61–74.

    PubMed  Article  Google Scholar 

  29. Frambach RT, & Schillewaert N. Organizational Innovation Adoption: A Multi-Level Framework of Determinants and Opportunities for Future Research. Journal of Business Research 2002; 55: 163–176.

    Article  Google Scholar 

  30. Barwick M, Chaban P, Johnson S, et al. Bringing the Evidence to the Classroom: Teacher and Principal Perspectives on Practice Change. Paper presented at American Academy of Health Behavior Conference, February 10, 2010, Clearwater Florida, USA.

  31. Morris JA, & Hanley JH. Human Resource Development: A Critical Gap in Child Mental Health Reform. Administration and Policy in Mental health and Mental Health Services Research 2001; 28: 219.

    PubMed  Article  CAS  Google Scholar 

  32. Rogers E. What Are Innovators Like? Theory into Practice 1963; 2: 252.

    Article  Google Scholar 

  33. Barwick M. Master’s level clinical competencies in child and youth behavioral healthcare. Report on emotional & behavioral disorders in youth. 2011; 8: 32–39.

    Google Scholar 

  34. Aarons GA. Measuring Provider Attitudes toward Evidence-Based Practice: Organizational Context and Individual Differences. Child and Adolescent Psychiatric Clinics of North America 2005; 14: 255.

    PubMed  Article  Google Scholar 

  35. Fixsen DL, Naoom SF, Blasé KA, et al. Implementation Research: A Synthesis of the Literature FMHI Publication # 231, Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network, 2005.

    Google Scholar 

  36. de Shazer S. Keys to Solution in Brief Therapy 1985; NewYork: Norton.

    Google Scholar 

  37. Kendall PC, Choudhurry M, Hudson J, & Webb A. The C.A.T. project" manual for the cognitive behavioral treatment of anxious adolescents 2002; Toronto: Workbook Publishing.

    Google Scholar 

  38. Howard B, Chu BC, Krain AL, Marrs-Garcia, AL, & Kendall, PC. Cognitive-behavior therapy for anxious children: therapist manual (2nd ed) 2000; Toronto: Workbook Publishing.

    Google Scholar 

  39. Augimeri LK, Farrington DP, Koegl CJ, Day DM.The Under 12 Outreach Project: Effects of a community based program for children with conduct problems. Journal of Child and Family Studies 2007; 16: 799–807.

    Article  Google Scholar 

  40. Henggeler, S. W., Schoenwald, S K, Borduin, CM, Rowland, M D, & Cunningham, P B. Multisystemic treatment of antisocial behavior in children and adolescents. 1998; New York: Guilford Press.

    Google Scholar 

  41. Linehan, MM. Dialectical behavior therapy: A cognitive behavioral approach to parasuicide. Journal of Personality Disorders 1987; 1: 328–333.

    Article  Google Scholar 

  42. Steese, S, Dollette, M, Phillips, W, Hossfeld, B, & Taormina, G. Understanding Girls’ Circle as an Intervention on Perceived Social Support, Body Image, Self-Efficacy, Locus of Control and Self-Esteem. Adolescence, 2006; 41: 55–74.

    PubMed  Google Scholar 

  43. Sanders M R, & Dadds MR. Behavioral family intervention 1993; Needham Heights, MA: Allyn & Bacon.

    Google Scholar 

  44. Patterson GR, Chamberlin P, & Reid JB. Comparative evaluation of a parent-training program. Behavior therapy, 1982; 13, 638–650.

    Article  Google Scholar 

  45. Yin RK. Case study research: Design and methods (4th ed). Thousand Oaks, CA: Sage Publications.

  46. Goh S, & Richards G. Benchmarking the Learning Capability of Organizations. European Management Journal 1997; 15: 575–583.

    Article  Google Scholar 

  47. Morse J. The significance of saturation. Qualitative health research 1995; 5: 147–149.

    Article  Google Scholar 

  48. Guest G, Bunce A, & Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006; 18: 59–82.

    Article  Google Scholar 

  49. Marshall C, & Rossman GB. Designing Qualitative Research (2nd ed) 1995, Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  50. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health 2000; 23, 334–340.

    PubMed  Article  CAS  Google Scholar 

  51. Polit DF, & Beck CT. Nursing Research: Principle and Methods, 2004; Philadelphia: Lippincott and Wilkins.

    Google Scholar 

  52. Elo S, & Kyngas H. The Qualitative Content Analysis Process. Journal of Advanced Nursing 2008; 62, 101–115.

    Article  Google Scholar 

  53. Green J, & Thorogood N. Qualitative Methods for Health Research 2004; Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  54. Kothari A, & Armstrong, R. Community-based knowledge translation: Unexplored opportunities. Implementation Science 2011; 6:59.

    PubMed  Article  Google Scholar 

  55. Annapolis Coalition on the Behavioral Health Workforce. An Action Plan for Behavioral Health Workforce Development. 2007. SAMHSA, U.S. Department of Health and Human Services.

  56. Byalin K. Managing to Win: Front-line Leadership in Public Mental Health Settings. Administration and Policy in Mental Health 1989; 16: 191–199.

    Article  Google Scholar 

  57. Barwick M, Bennett L, Boydell KM, Wotring J, Parker K, Van Dyke M & Darling J. Setting the pace: Curriculum for implementing evidence-informed practices (2011); Ontario, Canada: Ontario Centre of Excellence for Child and Youth Mental Health. Available online at http://www.excellenceforchildandyouth.ca/about-learning-organizations/make-it-happen/support-services/pace.

Download references

Acknowledgment

The research team wishes to thank Kinark Child and Family Services.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Health Research Methodology Program, McMaster University and Offord Centre for Child Studies, 1200 Main Street West, Chedoke Site, Central Building 301, Hamilton, Ontario, Canada, L8N 3Z5

    Melissa Kimber MSW

  2. Learning Institute, Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8

    Melanie Barwick PhD, C.Psych

  3. Community Health Systems Resource Group, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8

    Melanie Barwick PhD, C.Psych

  4. Residential Program, Lynwood Hall Child and Family Centre, 526 Upper Paradise Rd, Hamilton, Ontario, Canada

    Gwendolyn Fearing BA, BSW

Authors
  1. Melissa Kimber MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melanie Barwick PhD, C.Psych
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gwendolyn Fearing BA, BSW
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melanie Barwick PhD, C.Psych.

Appendix A

Appendix A

Kinark Staff Interview Protocol

Preamble

Kinark Child and Family Services and The Hospital for Sick Children are working in partnership on an evaluation of Kinark’s clinical transformation process. The evaluation is intended to review and provide feedback of the effectiveness of Kinark’s implementation of evidenced-based practices across the agency. In evaluating the process, the project also sets out to

  • Assess staff members’ experience and understanding of clinical transformation

  • Assess effectiveness of the meetings

  • Document the major accomplishments and lessons of the clinical transformation initiative

  • Document the activities undertaken as part of Kinark’s clinical transformation.

Questions address the effectiveness of the implementation process

  1. 1.

    Assess staff members’ understanding of the process (category 2)

  2. 2.

    Assess effectiveness of meeting process (category 4)

  3. 3.

    Document major successes and accomplishments of the Clinical Transformation (CT) Process (category 5)

  4. 4.

    Assess staff members’ satisfaction (category 6)

  5. 5.

    Document CT-related activities

Kinark Staff Interview Protocol

Category 1: Background information (demographics, who they are, and general info)

  1. 1.

    In which part of the organization do you work? What is your job?

  2. 2.

    How long have you worked for Kinark?

Category 2: Understanding CT

  1. 1.

    Kinark is undergoing a clinical transformation process: what do you think is the purpose of CT?

  2. 2.

    What difference has clinical transformation made? (should this be future or present as we have now lived with this for several years)

    • For clients

    • For you in your role

    • Your team

    • For Kinark?

  3. 3.

    What do you think has stayed the same?

Category 3: Role in CT process

  1. 4.

    In what ways have you been involved in clinical transformation?

    • Have you or are you taking part in a working group, installation team or implementation team? What is the purpose of the group?

  2. 5.

    Are you involved in other ways (e.g., CTSC or CEC)?

Category 4: Effectiveness of group’s process in CT

  1. 6.

    If you were involved in a group, what things did your group accomplish in moving the CT process forward?

    • What was needed to accomplish your work?

    • What was your process for working as a group?

    • What things were effective?

    • What could have been done differently?

    • Are there any barriers or challenges to implementing your recommendations? If so what do you think they may be?

  2. 7.

    Were there things you wanted to accomplish but couldn’t/can’t. If not, why?

Specific Working Group Questions—where they apply to the interviewee

(Note: participants choosing to disclose their experience using a process of CT (i.e., direct response)—use questions that are in italic font)

  1. 8a.

    What was or will be needed in order for you to accomplish your task as part of a working group? (i.e., materials, resources, training, changes in supervision, and ongoing evaluation)

    • What EBPs did your group recommend? OR What process did your group recommend?

    • How did your working group come with these EBPs? What was your process? OR How did your working group come up with their process of recommendation?

    • Based on the EBP recommendation of your working group will staff training be required? If so, do you anticipate any challenges, why or why not?

      (Ignore this question if you have a participant talking about a process, i.e., Direct Response or Interdisciplinary consultation, there may be other ones as well)

  2. 8b.

    What, if any, challenges were encountered in and by your working group?

    • How were those being handled or how are those being handled?

    • What was effective about the process?

    • Could things have been done differently, if so, what sort of things? If not describe how your process was effective.

Specific Installation Team Questions—where they apply

  1. 9a.

    What was or will be needed in order for you to accomplish your task as part of a working group? (i.e., materials, resources, training, changes in supervision, and ongoing evaluation)

    • How did your installation team develop their preliminary plan? What was your process?

  2. 9b.

    What if any challenges were encountered in and by your installation team?

    • How were those being handled or how are those being handled?

    • What was effective about the process?

    • Could things have been done differently, if so, what sort of things? If not describe how your process was effective.

    • What are the anticipated barriers to implementing the EBPs recommend by the work group?

    • Based on your plan will staff training be required? If so, do you anticipate any challenges, why or why not?

Specific Implementation Team Questions—where they apply

  1. 10a.

    What was or will be needed in order for you to accomplish your task as part of a working group? (i.e., materials, resources, training, changes in supervision, and ongoing evaluation)

    • What was your process in implementing the preliminary installation plan?

    • What are the barriers to implementing the preliminary installation plan?

  2. 10b.

    What if any challenges were encountered in and by your implementation team?

    • How were those being handled or how are those being handled?

    • What was effective about the process?

    • Could things have been done differently, if so, what sort of things? If not describe how your process was effective.

  3. 10c.

    What do you think the benefits will be as a result of implementing evidence-based practices?

    • For the organization?

    • For you?

    • For the client?

Category 5: Staff Satisfaction

  1. 11.

    Has your involvement in CT had any impact on your work load? How so?

  2. 12.

    Has your involvement in CT affected your work in your role? If so, how?

  3. 13.

    Would you like another clinical transformation assignment? If so, what might that be?

Category 6: Outcome of Clinical Transformation

  1. 14.

    In your view, what is the intended benefit to the client to move towards an evidence-based service agency?

  2. 15.

    What are the implications of CT for:

    1. a.

      Clients

    2. b.

      You

    3. c.

      Colleagues

    4. d.

      Managers

    5. e.

      Kinark as an agency

  3. 16.

    How is the move towards the implementation of EBPs being supported by your program area?

  4. 17.

    Has supervision and practice fidelity been discussed? If so, what do you understand of the process?

  5. 18.

    Is CT a worthwhile process? Why or why not?

  6. 19.

    Would CT be a worthwhile process for other CMH agencies? Why or why not?

  7. 20.

    Moving forward, how can the CT process be used by Kinark?

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kimber, M., Barwick, M. & Fearing, G. Becoming an Evidence-Based Service Provider: Staff Perceptions and Experiences of Organizational Change. J Behav Health Serv Res 39, 314–332 (2012). https://doi.org/10.1007/s11414-012-9276-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11414-012-9276-0

Keywords

  • Change Process
  • Transformational Leader
  • Organizational Climate
  • Youth Mental Health
  • Behavioral Health Care