Perceived Organizational Readiness for Assisting the System (PORAS)

PORAS Motivation items measure perceived organizational/leadership commitment, not individual motivation. Items focus on 'Our organization is committed,' 'Leadership supports this change,' etc. If the scale instead measured individual motivation (e.g., 'I am motivated to learn the new system'), results would reflect enthusiasm rather than organizational readiness. The distinction is critical: high individual motivation but low perceived leadership commitment predicts low sustained adoption. Always use organizationally-focused motivation items.

Low self-reported Resource Adequacy despite objectively available resources indicates a communication or visibility gap—staff may not perceive the resources because they were not informed, or resources are available but not allocated to this specific initiative. Respond by: (1) auditing what resources exist and were allocated; (2) conducting staff interviews to understand what resources are perceived as lacking; (3) launching targeted communication about available resources; (4) removing barriers to resource access. Readminister PORAS after communication intervention; Resource Adequacy should improve 0.5–1.0 point.

Priority typically follows: (1) Valence—if staff don't see the change as important, other readiness dimensions are irrelevant; invest in goal clarification first; (2) Motivation—if leadership commitment is not visible, staff perceive low organizational readiness regardless of resources; secure visible leadership engagement next; (3) Resource Adequacy—ensure adequate budget, staffing, and training are allocated; (4) Change Efficacy—provide hands-on training and support to build staff confidence. However, interdependencies exist: low resources (Adequacy) undermine Efficacy, so these may need parallel attention.

Best practice includes three timepoints: baseline (pre-implementation), mid-implementation (6–12 weeks post-launch), and post-implementation (6+ months). Mid-implementation reassessment is critical for troubleshooting—if Change Efficacy drops from 3.8 to 2.5 by week 8, this signals need for immediate training, technical support, or timeline adjustment. Organizations that readminister PORAS mid-course and respond to findings recover from implementation plateau more effectively.

Yes, with item rewording. PORAS was developed for IT but the underlying dimensions (Valence, Motivation, Resource Adequacy, Change Efficacy) apply to any organizational change. Reword items: 'This EHR is important for our organization' becomes 'This care model change is important for our organization.' Pilot the reworded PORAS on 50+ respondents to confirm factor structure is preserved before full administration. Alternatively, use the more generic readiness tool ORIC, which is less IT-specific.