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Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
- Source :
- BMJ Quality & Safety; Jul2022, Vol. 31 Issue 7, p493-502, 10p
- Publication Year :
- 2022
-
Abstract
- Background Given rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of our study was to develop survey items to assess clinician and staff perspectives about the extent to which the organisational culture in hospitals and medical offices supports value and efficiency. Methods Development began with a literature review and interviews with experts and clinicians and staff from hospitals and medical offices. We identified key areas of value and efficiency culture, drafted survey items and conducted cognitive testing. Using purposive sampling to select sites, the 36-item surveys were pilot tested in 47 hospitals and 96 medical offices. Psychometric analysis was conducted on data from 3951 hospital respondents (42% response) and 1458 medical office respondents (63% response). Results Factor loadings, multilevel confirmatory factor analysis model fit and reliability estimates were acceptable for the 13 items grouped into 4 composite measures: Empowerment to Improve Efficiency (3 items), Efficiency and Waste Reduction (3 items), Patient Centeredness and Efficiency (3 items) and Management Support for Improving Efficiency and Reducing Waste (4 items). All composite measures were significantly intercorrelated and related to the four Overall Ratings of Healthcare Quality, indicating adequate conceptual convergence among the measures. Eight items assessing Experiences With Activities to Improve Efficiency were also included. Conclusion We developed psychometrically sound survey items measuring value and efficiency culture. When added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets extend those surveys by assessing additional dimensions of organisational culture that affect care delivery. Healthcare organisations can use these item sets to assess how well their organisational culture supports value and efficiency and identify areas for improvement. [ABSTRACT FROM AUTHOR]
- Subjects :
- EVALUATION of organizational effectiveness
PILOT projects
RELIABILITY (Personality trait)
HEALTH facilities
MATERIALS management
RESEARCH evaluation
RESEARCH methodology
ATTITUDES of medical personnel
RESEARCH methodology evaluation
LEADERSHIP
INTERVIEWING
PATIENT-centered care
SURVEYS
PSYCHOMETRICS
SELF-efficacy
CRONBACH'S alpha
FACTOR analysis
QUALITY assurance
CHI-squared test
INTRACLASS correlation
RESEARCH funding
JUDGMENT sampling
MEDICAL waste disposal
DATA analysis software
CORPORATE culture
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 20445415
- Volume :
- 31
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- BMJ Quality & Safety
- Publication Type :
- Academic Journal
- Accession number :
- 158099955
- Full Text :
- https://doi.org/10.1136/bmjqs-2020-012407