EBP Project Proposal: Organizational Culture and Readiness Paper

EBP Project Proposal: Organizational Culture and Readiness Paper

EBP Project Proposal: Organizational Culture and Readiness Paper

Effective implementation of evidence-based practice (EBP) initiatives requires a positive organizational culture and readiness assessment that evaluate the capacity, ability, and attitude of the organization’s stakeholders to incorporate change in their practices. A change readiness assessment assists in gauging the level of preparedness in an organization to implement new interventions to enhance quality care (Kononowech et al., 2021). The purpose of this paper is to assess the culture and readiness level of acute care setting to incorporate mindfulness as an EBP intervention to lower stress among nurses experienced in the facility based on the PICOT question.

Culture and Its Support for Change

The culture of an organization affects its ability to institute and implement change. Acute care settings have structures; from leadership to nurses, that impact their readiness and support for change. The culture of an organization is depicted by values, mission, and vision and the kind of leadership style practice. It also entails aspects like team engagement and communication, employees’ perception of the organization and a common approach to dealing with issues (Crittendon et al., 2020). The healthcare environment needs a team approach based on concepts like inter-professional collaboration and need to enhance overall quality outcomes.

The assessment of the acute care setting shows that the culture is unit is ready and supports change. The unit has a patient-centered culture because it provides critical care services. The unit’s mission and vision focus on promoting quality care due to the nature of services offered. The acute care setting uses an inter-professional collaboration based on the nature of patients handled and the level of care required. The team comprises of physicians, laboratory technologists and pathologists, nutritionist, nurses and nurse informatics among others who develop a common approach to care interventions. Innovation is at the core of care delivery in this unit; demonstrating the need for change to enhance the welfare of nurses by reducing their stress levels using mindfulness.

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The values in the unit include compassionate care, dignity, and mutual respect for patients as a way of ensuring that they have trust and confidence in the system’s ability to deliver quality care. The leadership engages nurses as demonstrated by planning meetings with nurse leaders and managers for nurses to express their opinions and develop strategies to attain quality care outcomes in the facility. The nurses in the unit feel motivated to participate in changes aimed at enhancing their welfare by addressing the stress levels which can impact patient care quality.

Organizational Readiness Tool

Miake-Lye et al. (2020) assert that organizational readiness assessment is essential tool for effective change implementation. The study shows that readiness tools aim at contextual aspects within the entity and individuals’ features of employees. The implication is that readiness assessment should close the difference between measuring a theoretical model and important aspects to each case implementation. The selected readiness tool to implement the intervention in this unit is Organizational Readiness to Change Assessment (ORCA) survey. The tool has 77 items categorized in three scales or areas: evidence assessment, context assessment, and facilitation assessment (Crittendon et al., 2020). The survey approach entailed evaluating the level of evidence to determine the need for change. Evidence showed that many nurses in the unit suffered from acute stress levels due to increased workload and strain associated with long-hour shifts.

The contextual assessment showed looked at the general resources, culture of the staff and leadership behaviors and feedback to employees. All these areas demonstrated the need to integrate change and enhance overall response to stress levels among nurses. The facilitation assessment focuses on the organization’s ability for internal processes that support change (Diab et al., 2018). These include communication, project resources and context, leadership roles in implementation, champion characteristics and evaluation of the EBP project. These aspects showed that leaders were ready and willing to provide resources; both material and human, to facilitate change.

The assessment shows that the culture in the acute care unit and the entire organization will support and sustain an EBP change based on the conduct of leaders, willingness among employees, and presence of change agents, especially the affected nurses. The implication is that the nurses are a source of strength for the project based on their support. The project’s other strength lies in the change mood in the facility as stress has negative effects on quality care delivery. Further, the stakeholders support the change initiative as its timing is good to help mitigate the number of adverse events like medication errors associated with stressed nurses (De la Perrelle et al., 2020). The evaluation also shows that the leaders and management are willing to offer sufficient resources to implement the change initiative as proposed by the EBP project proposal.


Processes and Systems to Improve Quality, Safety & Cost-Effectiveness

The acute nursing care unit needs quality, safety, and cost-effectiveness approaches to deliver better care for patients to attain recovery. The unit should focus on implementing value-based purchasing as its way of improving its processes and systems to attain quality, safe, and cost-effective care. Value-based purchasing considers the level of quality care a facility offers as opposed to the quantity it gives. Being an acute care setting, the facility has delicate patients who require quality as safe care to recover at affordable rates (Ghawadra et al., 2018). Therefore, value-based purchasing as an innovative model by the Centers for Medicare and Medicaid Services (CMS) compensates providers and facilities for the quality of care offered and not quantity. The approach will help the organization focus on quality to reduce adverse events like hospital acquired infections and medication administration errors.

Strategies to Facilitate Readiness of the Organization

Vax et al. (2021) opine that organizational readiness for implementation (ORI) is the willingness and ability of all essential stakeholders to alter processes to attain expected goals or outcomes. Therefore, the study suggests that one of the ways for organizations to facilitate readiness for change is to use the trans-theoretical model (TTM) which classifies a combination of implementation strategies to effective change execution. The model comprises readiness levels as pre-contemplation, contemplation, and preparation. As such, this EBP project proposal recommends the TTM approach as one of the ways to enhance and facilitate readiness in the unit to implement the intervention identified in the PICOT question.

Stakeholders, Team Members and their Roles

The implementation of the EBP intervention focusing on mindfulness requires a collaborative approach with stakeholders and team comprising of individual practitioners, management and experts. These include the acute care nurses and their manager, the organization’s leadership and management, and informatics nurses. The acute nurses will be the ones to integrate the proposed intervention while the informatics nurses will keep data of the outcomes and feedback during the implementation for effective analysis. The management and leadership will provide resources and support that is critical in project’s overall implementation. The nurse managers will be in charge of inter-professional team. These stakeholders will work through effective coordination to attain quality outcomes for the project.

Information and Communication Technologies

The use of information and technology tools in implementing EBP projects is critical due to the role that they play in effective delivery and quality outcomes, especially in improving communication. The core technologies that will be needed in this EBP project include telehealth and clinical decision support (CDS) systems. Telehealth will improve the response by nurses to mindfulness when they are off duty to monitor their stress levels. Through the CDS, nurses will mitigate possible errors like medication administration-associated mistakes by guiding them on solution-based models. The internal stakeholders will integrate these technologies to enhance communication and inter-professional collaboration (De la Perrelle et al., 2020). These technologies will improve the nursing practice and care delivery for patients in the acute care unit through better communication and feedback to the management. The technologies will also improve their decision-making abilities for better outcomes.


The need to reduce stress levels among acute care nurse is essential in improving their welfare while allowing them to deliver quality care. The implementation of this EBP intervention will be important and allow them to have better abilities to offer quality care. The overall assessment shows that the organization is ready to execute the EBP based on its culture and level of readiness. The management and other stakeholders will play a critical role in implementation and will leverage existing technologies to attain better outcomes for patients in acute care.


Crittendon, D. R., Cunningham, A., Payton, C., Mills, G., Kelly, S., LaNoue, M., & Arenson, C.

(2020). Organizational readiness to change: Quality improvement in family medicine residency. PRiMER: Peer-Review Reports in Medical Education Research, 4(14). DOI: 10.22454/PRiMER.2020.441200

De la Perrelle, L., Radisic, G., Cations, M., Kaambwa, B., Barbery, G., & Laver, K. (2020).

Costs and economic evaluations of a quality improvement collaborative in healthcare: A systematic review. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-4981-5

Diab, G. M., Safan, S. M., & Bakeer, H. M. (2018). Organizational change readiness and

manager’ behavior in managing change. Journal of Nursing Education and Practice, 8(7), 68-77. https://doi.org/10.5430/jnep.v8n7p68

Ghawadra, S. F., Abdullah, K. L., Choo, W. Y., & Phang, C. K. (2019). Mindfulness-based

stress reduction for psychological distress among nurses: A systematic review. Journal of Clinical Nursing, 28(21–22), 3747–3758. https://doi.org/10.1111/jocn.14987

Kononowech, J., Hagedorn, H., Hall, C., Helfrich, C. D., Lambert-Kerzner, A. C., Miller, S. C.,

… & Damschroder, L. (2021). Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research. Implementation science communications, 2(1), 1-6. doi: 10.1186/s43058-021-00121-0

Miake-Lye, I. M., Delevan, D. M., Ganz, D. A., Mittman, B. S., & Finley, E. P. (2020).

Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments. BMC health services research, 20(1), 1-13. DOI: https://doi.org/10.1186/s12913-020-4926-z

Vax, S., Farkas, M., Russinova, Z., Mueser, K. T., & Drainoni, M. L. (2021). Enhancing

organizational readiness for implementation: constructing a typology of readiness-development strategies using a modified Delphi process. Implementation Science, 16(1), 1-11. DOI: https://doi.org/10.1186/s13012-021-01132-0

Appendix A: APA Checklist

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 Assessment Description
In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed. You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
Propose strategies to better facilitate the readiness of the organization.
Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.1: Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.

3.3: Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations.

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