The Improvement Readiness scale of the SCORE survey: a metric to assess capacity for quality improvement in healthcare.

dc.contributor.author

Adair, Kathryn C

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Quow, Krystina

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Frankel, Allan

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Mosca, Paul J

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Profit, Jochen

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Hadley, Allison

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Leonard, Michael

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Bryan Sexton, J

dc.date.accessioned

2019-11-01T13:34:42Z

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2019-11-01T13:34:42Z

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2018-12-17

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2019-11-01T13:34:39Z

dc.description.abstract

BACKGROUND:Quality improvement efforts are inextricably linked to the readiness of healthcare workers to take them on. The current study aims to clarify the nature and measurement of Improvement Readiness (IR) by 1) examining the psychometric properties of a novel IR scale, 2) assessing relationships between IR and other safety culture domains 3) exploring whether IR differs by healthcare worker demographic factors, and 4) examining linguistic differences in word type use between high and low scoring IR work settings from their free text responses. METHODS:Of 13,040 eligible healthcare workers across a large academic health system, 10,627 (response rate 81%) completed the 5-item IR scale, demographics, safety culture scales, and two open-ended questions. Psychometric analyses, correlations and ANOVAs tested the properties of IR. Linguistic Inquiry Word Count software assessed comments from open-ended questions. RESULTS:The IR scale exhibited strong psychometric properties and a one factor model fit the data well (Cronbach's alpha = .93; RMSEA = .07; CFI = 99; TLI = .99). IR scores differed significantly by role, shift, shift length, and years in specialty. IR correlated significantly and in expected directions with safety culture scales. Linguistic analyses revealed that people in low versus high IR work settings used significantly more words in their responses, and specifically more past tense verbs (e.g., "ignored"), negative emotion words (e.g., "upset"), and first person singular ("I"). Workers from high IR work settings used significantly more positive emotions words (e.g., "grateful") and social words (e.g., "team"). CONCLUSION:The IR scale exhibits strong psychometric properties, is associated with better safety and teamwork climate, lower burnout, and predicts linguistic differences in high versus low IR groups.

dc.identifier

10.1186/s12913-018-3743-0

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1472-6963

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1472-6963

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https://hdl.handle.net/10161/19452

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eng

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Springer Science and Business Media LLC

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BMC health services research

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10.1186/s12913-018-3743-0

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Humans

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Analysis of Variance

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Cross-Sectional Studies

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Attitude of Health Personnel

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Psychometrics

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Safety Management

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Adult

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Delivery of Health Care

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Female

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Male

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Quality Improvement

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Surveys and Questionnaires

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The Improvement Readiness scale of the SCORE survey: a metric to assess capacity for quality improvement in healthcare.

dc.type

Journal article

duke.contributor.orcid

Adair, Kathryn C|0000-0003-4886-0002

pubs.begin-page

975

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1

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Staff

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Duke

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Psychiatry & Behavioral Sciences, General Psychiatry

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Psychiatry & Behavioral Sciences

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Clinical Science Departments

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School of Medicine

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Duke Cancer Institute

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Institutes and Centers

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Surgical Oncology

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Surgery

pubs.publication-status

Published

pubs.volume

18

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