Researchers don't always think about how exactly they want to use the ORCA in a research study or a quality improvement program.
Click on the button below to view Dr. Anne Sales' presentation where she provides a nice example of how to use the ORCA for planning.
We have found that respondents often can’t answer facilitation items right at the beginning of a project—they don’t have any basis for the questions and find it confusing. In response to that, we have begun recommending that only the evidence & context scales be used at baseline, and fielding the facilitation scale at a point when they’ve had some initial experience trying to implement the practice, e.g., 3-6 months into the program. A mental health study out of Little Rock (implementation of CBT as a first-line treatment for depression by primary-care based mental health providers) fielded the baseline survey at about 2 months and they were able to get good responses to the facilitation scale.
You may want to consider conducting secondary analyses where “don’t know/not applicable” are recoded as negative based on the assumption that if a respondent reports “don’t know/not applicable” when asked how frequently they observed senior leadership/clinical management rewarding clinical innovation and creativity to improve patient care, we might infer that it happens very infrequently. We have done that in unrelated work on barriers and facilitators.
We would also highly recommend conducting some interviews with participants about some of the readiness domains to better understand both what is happening on the ground and to understand how they are responding to the ORCA (or any other instrument).