Development and Psychometric Properties of a Scale to Measure Hospital Organizational Culture for Cardiovascular Care
Development and Psychometric Properties of a Scale to Measure Hospital Organizational Culture for Cardiovascular Care
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DOI：
10.1161/circoutcomes.116.003422
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发表时间：
2017-03-01
影响因子：
6.9
通讯作者：
Curry, Leslie A.
中科院分区：
文献类型：
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作者：
Bradley, Elizabeth H.;Brewster, Amanda L.;Curry, Leslie A.
背景：由于组织文化越来越被理解为在医院和其他医疗保健环境中实现高绩效的基础，因此从经验上衡量这一微妙概念的能力变得越来越重要。除了患者安全文化的措施外，没有任何组织文化的措施在医学文献中得到广泛认可，这限制了先前研究结果的复制和在介入性研究中的更广泛应用。方法和结果：我们试图开发并评估在医院努力降低急性心肌梗死后30天风险标准化死亡率的背景下评估组织文化的量表的效度和可靠性。问卷共31项，由10家医院147人于2014年8月至9月完成。编制的组织文化量表具有较高的结构效度和内部一致性。因子分析表明，这31个项目加载良好（加载值为0.48 ~ 0.90），支持(1)学习环境、(2)心理安全、(3)对组织的承诺、(4)高层管理支持和(5)改进努力的时间等可区分的领域。量表的Cronbach alpha系数为0.94，子量表的Cronbach alpha系数为0.77 ~ 0.88。量表显示出合理的收敛效度和统计上显著的医院差异，医院认同占被调查者文化得分差异的11.3%。结论：我们开发并验证了一项相对易于管理的调查，该调查能够发现不同医院组织文化的实质性差异，并且可能有助于衡量医院文化并评估文化随时间的变化，作为绩效改进工作的一部分。
Background-Because organizational culture is increasingly understood as fundamental to achieving high performance in hospital and other healthcare settings, the ability to measure this nuanced concept empirically has gained importance. Aside from measures of patient safety culture, no measure of organizational culture has been widely endorsed in the medical literature, limiting replication of previous findings and broader use in interventional studies.Methods and Results-We sought to develop and assess the validity and reliability of a scale for assessing organizational culture in the context of hospitals' efforts to reducing 30-day risk-standardized mortality after acute myocardial infarction. The 31-item scale was completed by 147 individuals representing 10 hospitals during August and September 2014. The resulting organizational culture scale demonstrated high level of construct validity and internal consistency. Factor analyses indicated that the 31 items loaded well ( loading values 0.48-0.90), supporting distinguishable domains of ( 1) learning environment, ( 2) psychological safety, ( 3) commitment to the organization, ( 4) senior management support, and ( 5) time for improvement efforts. Cronbach alpha coefficients were 0.94 for the scale and ranged from 0.77 to 0.88 for the subscales. The scale displayed reasonable convergent validity and statistically significant variability across hospitals, with hospital identity accounting for 11.3% of variance in culture scores across respondents.Conclusions-We developed and validated a relatively easy-to-administer survey that was able to detect substantial variability in organizational culture across different hospitals and may be useful in measuring hospital culture and evaluating changes in culture over time as part performance improvement efforts.