AACN Change Readiness Assessment
INSTRUCTIONS
What is this tool?
Determining a unit’s readiness to undertake meaningful changes in the way it operates is one of
the first steps to creating lasting change. Identifying and addressing barriers to change will
improve your unit’s success in implementing successful performance improvements.
The Change Readiness Assessment tool is designed to help teams evaluate their unit’s
organizational infrastructure and readiness to support effective implementation efforts. Use this
checklist to verify that essential capabilities are in place in your unit before launching
improvement activities.
Who should use this tool?
The assessment works best when several unit leaders and staff members independently
complete the survey. At a minimum, consider including the Nursing Manager or Director, unit
Clinical Nurse Specialist or Nurse Educator, and leaders of the unit self-governance council.
Collecting feedback on the check-listed items from trusted staff members and other leaders of
the multidisciplinary team may also be helpful, since they may bring alternative viewpoints and
have a greater knowledge of operational issues.
What should each person do?


For each assessment area, those taking the survey should rate the extent to which the
statement characterizes his or her unit: “Not at all,” “To some extent” or “To a great
extent.”
Individuals providing feedback should note any particular concerns in each area to
facilitate later discussion.
How to review the results together?
Once the individual reviews of the checklist are completed, schedule a meeting of the unit’s key
leaders. The discussion at this meeting should focus on areas where the infrastructure needs
strengthening or where a lack of consensus exists.
In addition, discuss the greatest vulnerabilities for your unit—those vulnerabilities that will most
likely cause quality improvement efforts to fail. Based on this discussion, identify an action plan
with specific steps, the individuals responsible for each step and a timeline for revisiting
progress.
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Unit Change Readiness Assessment
Not at
all
A. Quality and patient safety as priorities

We have a shared sense of purpose that quality and patient safety
are our highest priorities.

Quality and patient safety are included in our unit’s main goals or
pillars of performance.

The unit leadership is actively involved in reviewing our unit’s
performance on quality and patient safety measures.

We have open communication among physicians, staff and patients
concerning quality and patient safety.
Overall, our unit’s organizational structure places a high
priority on quality and patient safety.
My concerns in this area are:
B. Management processes

Our management processes emphasize meeting quality
performance standards; our leadership also provides the resources
we need to support quality improvement.

We have an anonymous, nonpunitive way of reporting events and
errors.

Our leadership actively responds when patient safety issues are
identified.
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Copyright © 2013 American Association of Critical-Care Nurses
To
some
extent
To a
great
extent
Not at
all

We document patient safety standards in protocols and guidelines
that are clear and easy to understand.
Overall, our unit’s management processes are designed to
place a high priority on quality and patient safety.
My concerns in this area are:
C. Unit leadership

Everyday events are connected to our larger purpose through
stories and rituals.

Our unit governance structures and practices minimize conflict
between the multiple missions and priorities of the various
professional disciplines.

Our unit is led as an alliance between the leadership team and the
clinical team.
Overall, leaders in our unit are passionate about service, quality
and safety, and have an authentic, hands-on style.
My concerns in this area are:
D. Training
We provide ongoing training for staff members that helps them
build skills to improve quality and patient safety.
My concerns in this area are:
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Copyright © 2013 American Association of Critical-Care Nurses
To
some
extent
To a
great
extent
Not at
all
E. Accountability

Our unit provides incentives or rewards (financial or nonfinancial) for
high levels of patient safety.

Our unit leaders, such as nurses, pharmacists, and physicians,
accept responsibility for quality and safety.

We have accountability, innovation, and redundant processes to
ensure quality.

Our unit has a policy of transparency, and information is shared at
all levels—from top to bottom and vice versa.
Overall, our leaders are accountable for service, quality, and
safety
My concerns in this area are:
F. Data systems
Overall, we have effective data systems. They are functional
and allow us to obtain data when needed.
My concerns in this area are:
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Copyright © 2013 American Association of Critical-Care Nurses
To
some
extent
To a
great
extent
Not at
all
G. Results focused

We continuously strive to improve, and we benchmark our
performance against external standards as a measure of success.

In decision-making, we focus on the likely results to guide our choice
of performance improvement approach, rather than always following
a particular approach (e.g., Six Sigma).
Overall, we are driven to focus on results.
My concerns in this area are:
H. Collaboration

The relationships among administration, physicians, nurses and
other staff members are typically collaborative in our unit.

We provide frequent recognition of employee contributions at every
level.

Employees value each other’s critical knowledge when solving
problems.

We have a sense that teamwork among staff members is
encouraged.
Overall, we have a sense of collaboration among all staff
members in working to improve patient safety.
My concerns in this area are:
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Copyright © 2013 American Association of Critical-Care Nurses
To
some
extent
To a
great
extent
References
1. Farley DO, Tharp-Taylor S. Factors required for successful implementation of new practices or
products.
2. Keroack MA, Youngberg BJ, Cerese JL, Krsek C, Prellwitz LW, Trevelyan EW. Organizational
factors associated with high performance in quality and safety in academic medical centers. Acad
Med. 2007;82(12):1178-1186.
3. Taylor SL, Ridgely MS, Greenberg MD, et al. Experiences of Agency for Healthcare Research and
Quality-funded projects that implemented practices for safer patient care. Health Serv Res. 2009;
44:(2 Pt 2):665-683.
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