A systematic review of the relationship between staff perceptions of organizational readiness to change and the process of innovation adoption in substance misuse treatment programs Peter Kelly a, ⁎, Josephine Hegarty a , Joe Barry c , Kyle R. Dyer b , Aine Horgan a a School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Ireland b Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 4 Windsor Walk, Denmark Hill, London SE58BB, United Kingdom c Department of Public Health and Primary Care, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin 2, Ireland abstract article info Article history: Received 20 October 2016 Received in revised form 31 May 2017 Accepted 1 June 2017 Available online xxxx Translating innovation, such as contemporary research evidence, into policy and practice is a challenge, not just in substance misuse treatment programs, but across all spheres of healthcare. Organizational readiness to change (ORC) has been described as a fundamental concept, and an important determinant of the process of innovation adoption. The aim of this review was to describe the relationship between staff perceptions of ORC and the pro- cess of innovation adoption: exposure, adoption, implementation and integration into practice, in substance mis- use treatment programs. This systematic review was conducted in accordance with PRISMA guidelines and fourteen papers were identified as being eligible for inclusion. This review was designed to include all constructs of ORC, but only one tool was used in all of the included papers. Despite this, the heterogeneity of studies in this review made a direct comparison of ORC related variables challenging. None of the included papers clearly relat- ed to one stage of the process of innovation adoption, and all of the included papers related to the early stages of the process. Only one paper attempted to measure the sustained integration of an innovation into practice. Over- all, the papers were assessed as being low in terms of evidential hierarchy and the quality of the papers was assessed as being on average fair. ORC measurements provide us with a measure of organizational functioning which can be important in terms of predicting how successfully new innovations are adopted. Motivation for change was high in programs where staff identified more program deficits and these staff could also identify more specific needs, but were less likely to have exposure to new innovations. Better program resources and specific staff attributes, increase the likely hood of successful innovation adoption. A good organizational climate is potentially the strongest predictor for the adoption of new practices. It may be beneficial to measure ORC in conjunction with other variables such as program size, location, staff workloads and financial resources. More ev- idence is required on how to address ORC deficits once they are identified in practice. © 2017 Elsevier Inc. All rights reserved. Keywords: Organizational readiness to change Innovation Dissemination Training Evidence based practice Substance misuse 1. Introduction Over the last two decades, treatment programs have been chal- lenged by diminishing resources while simultaneously, the scientific foundation on which treatment is based has changed substantially, and the range of substances available and patterns of use have broad- ened significantly (Barlow, 2010; Roche, 2001;Simpson & Dansereau, 2007). The context in which healthcare organizations operate is dynam- ic and systems must constantly change to meet demands on resources, adapt to new practices, and respond to significant shifts in policy (Bazzoli, Dynan, Burns, & Yap, 2004). Whatever the nature or stimulus for a given change, if organizations are to respond effectively to rapidly changing and turbulent environments, then engaging successfully with ongoing innovation is essential (Armenakis, Harris, & Mossholder, 1993; Cinite, Duxbury, & Higgins, 2009; Holt & Vardaman, 2013). Organizational change can be described as any modification in orga- nizational structure, composition or behaviour (Bowditch, Buono, & Stewart, 2008). Managing effective organizational change in healthcare is challenging. Depending on how changes are measured in the healthcare context, the failure rate for implementing change in organi- zations ranges from 30% to 90% (Jacobs et al., 2015). However, the type of change and the context of organizational change is important as it in- fluences whether or not a change will be successful (Rafferty & Simons, 2006). Failure to implement successful organizational change is fre- quently attributed to a failure to establish sufficient organizational Journal of Substance Abuse Treatment 80 (2017) 6–25 ⁎ Corresponding author at: School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland. E-mail addresses: peter.kelly@ucc.ie (P. Kelly), J.Hegarty@ucc.ie (J. Hegarty), joebarry@tcd.ie (J. Barry), kyle.dyer@kcl.acuk (K.R. Dyer), aine.horgan@ucc.ie (A. Horgan). http://dx.doi.org/10.1016/j.jsat.2017.06.001 0740-5472/© 2017 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Journal of Substance Abuse Treatment