Factors Contributing to Organizational Readiness for Adopting and Implementing Trauma-Informed Evidence-Based Practice

Background

Implementation of evidence-based practice (EBP) is of critical interest to social work practitioners and researchers. Yet while significant progress was made in integrating evidence-based models in the social work curriculum, less emphasis was placed on agencies, as key participants in the social work education process.  

This paper presents the findings of an evaluation study assessing the effectiveness of a comprehensive approach in increasing organizational readiness, for mental health agencies preparing to adopt and implement trauma-informed EBPs. Using the implementation science (IS) framework (Metz & Bartley, 2012; Fixsen et al., 2009) organizational readiness was conceptualized as a composite measure of three drivers – leadership, organization and competency – and a fourth factor, measuring staff and agency leadership attitudes towards evidence-based practices.

Research question:

What factors contribute to a positive change in organizational readiness to adopt and implement trauma-informed EBPs?

Methods:

The study used a quasi-experimental time series design, to measure changes in organizational readiness, at 6, 12, and 18 months. This paper presents the findings of the 6-months measure, as compared to the baseline assessment.

Eight agencies were selected to participate in this project, coordinated by 6 schools of social work. One agency experienced a complete staff turn-over; a second agency dropped out of the project. Three agencies completed the 6-months follow-up measure of organizational readiness and were included in this analysis.

Organizational readiness was measured using a survey adapted from three standardized organizational assessment tools. A Principal Component factor analysis (with Varimax rotation) extracted 8 factors, grouped under the main IS drivers: Leadership (2 factors); Organization (3 factors); Competency (2 factors); and Attitudes toward EBPs (F3) as a separate factor. 294 completed baseline surveys and 215 6-months follow-up surveys have been collected. At the 6-months measure, 35% of participants had a social work background (BSW or MSW) and 22% were clinicians.

Three readiness factors increased singificantly: F3 - Attitudes towards EBP (M₁ = 19.48; M₂ = 21, t = - 2.048, p = .041); F7 = Written Policies/Standards – Facilitative Administration (M₁ = 8.77; M₂ = 11.10, t = -3.577, p<.0001); and F8 = Training and Supervision (M₁ = 12.57; M₂= 16.88, t = -5.335, p<.0001). Significant positive correlations between Adaptive (F1) and Technical Leadership (F2) and the overall change in organizational readiness were identified. The Organization Driver remained lowest at the 6-months measure, followed by the Competency Driver. Of all participants, 35% assessed the impact of their agencies’ participation in this project as signficant; 55% suggested that more training will continue to increase the organizational readiness and support EBPs effective implementation.

Implications for Research and Practice

This evaluation indicates the IS framework effectively supports the work on increasing organizational readiness to adopt and implement EBPs. Leadership’s readiness appears to have a significant impact on organizational readiness. The impact of training on organizational readiness needs to continue to be measured at the 12 and 18 months follow-ups. Further research is needed to explore other mediating factors potentially affecting organizational readiness, external systems/policy frameworks.