The Role of Leadership on Employee Adaptability to Organizational Change in Addiction Health Services

Background and Purpose:

Leaders of addiction health service (AHS) organizations face significant pressures to respond to the service delivery and payment changes enacted by health care reform. Specifically, AHS organizations providing care to low income and ethnically diverse population have a limited organizational capacity to respond to these changes (Guerrero, Garner, Grella, Kong, Cook, 2015). To increase capacity to implement evidence-based and culturally competent services, as well as to integrate information technology in health care settings, AHS organizations need to increase their adaptability to an ever-changing service environment. The purpose of this study is to examine the role of leadership to increase staff adaptability to organizational change, as one of the main contributors of capacity building to implement changes and improve standards of care in AHS.  

Methods:

We rely on baseline data collected from a longitudinal mixed-method study funded by the National Institute of Drug Abuse. The baseline data collected in 2011 included 122 participants, each representing an adult outpatient substance use treatment program in Los Angeles County. We relied on multivariate regressions to analyze the data. The main dependent variable was measured using a four-item subscale on adaptability from the Organizational Readiness for Change measure (Simpson and Flynn, 2007). Rated on a five-point Likert Scale, the subscale asked, (1) you are willing to try new ideas even if some staff members are reluctant, (2) learning and using new procedures are easy for you, (3) you are sometimes too cautious or slow to make changes, and (4) you are able to adapt quickly when you have to shift focus. The subscale reported an acceptable alpha (α >.92).

Results:

The scale scores on staff adaptability ranged from 22.5 to 50 with a mean average of 37.4 (sd=4.12). Most respondents were female (n = 74, 61%), program directors (60%). Most programs were licensed by the state (83%). Results from a regression analysis showed a positive relationship between directorial leadership and staff adaptability (β=.21, t=3.41, p<.001). Also, compared with directors, clinical supervisors were positively associated with reports of staff adaptability (β=3.68, t=1.12, p<.001). We controlled for age, gender, education level, job-level, program licensed, program accreditation, and public funding. Among these controls, we only found the job-level control (i.e., supervisor) to be positively associated with adaptability. Our regression model accounted for 37.9% of the variance in adaptability.

Conclusion and Implications:

Directorial leadership seems to play an important role in promoting adaptation to organizational change among staff in addiction health services. Given the increased pressures to improve health-care value, quality, and efficiency, it is critical to consider leadership interventions to impact staff’ adaptability and responsiveness to implement critical changes in service delivery and payment systems. Implications of these findings for building organizational capacity to improve standard of care in AHS are discussed.