Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare
Tóm tắt
Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.
Tài liệu tham khảo
Olsson J, Elg M, Lindblad S: System characteristics of healthcare organizations conducting successful improvements. J Health Organizat Manag. 2007, 21: 283-296. 10.1108/14777260710751744.
Walshe K: Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care. 2009, 21: 153-159. 10.1093/intqhc/mzp012.
Streiner DL, Norman GR: Health Measurement Scales, a practical guide to their development and use. 2008, Oxford: Oxford University Press, 4th
Ekvall G: Organizational Climate for Creativity and Innovation. Eur J Work and Organ Psychol. 1996, 5: 105-123. 10.1080/13594329608414845.
Carlfjord S, Andersson A, Nilsen P, Bendtsen P, Lindberg M: The importance of organizational climate and implementation strategy at the introduction of a new working tool in primary health care. J Eval Clin Pract. 2010, 16: 1326-1332. 10.1111/j.1365-2753.2009.01336.x.
Olsson JA, Øvretveit J, Kammerlind P: Developing and Testing a Model to Predict Outcomes of Organizational Change. Qual Manag Health Care. 2003, 12: 240-249. 10.1136/qhc.12.4.240.
Lombarts MJMH, Rupp I, Vallejo P, Suñol R, Klazinga NS: Application of quality improvement strategies in 389 European hospitals: results of the MARQuIS project. Qual Saf Health Care. 2009, 18: i28-i37. 10.1136/qshc.2008.029363.
Research on Management of Innovation: The Minnesota Studies. Edited by: Ven AH, Angle HL, Poole MS. 2000, Oxford: Oxford University Press
Kvalitetswebben (in Swedish): http://www.ltkalmar.se/lttemplates/SubjectPage____2226.aspx.
IHI: The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. 2003
Rhydderch M, Edwards A, Elwyn G, Marshall M, Engels Y, Van den Hombergh P, Grol R: Organizational assessment in general practice: a systematic review and implications for quality improvement. J Eval Clin Pract. 2004, 11 (4): 366-378.
Pett MA, Lackey NR, Sullivan JJ: Making sense of factor analysis: the use of factor analysis for instrument development in health care research. 2003, Thousand Oaks, California: Sage Publications
Hair JF, Black WC, Babin BJ, Anderson RA: Multivariate Data Analysis: A Global Perspective. 2010, Pearson International Edition, 7th
Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiology. 2007, 60: 34-42. 10.1016/j.jclinepi.2006.03.012.
Kvist T, Vehviläinen-Julkunen K, Jokela V: Do Organizational Factors Explain the Quality of Care?. J Nurs Care Qual. 2007, 22 (4): 365-370. 10.1097/01.NCQ.0000290419.73134.6e.
Herlitz C: Svenskarna nobbar sexundersökningar – nya metodologiska grepp krävs (in Swedish). http://www.lakartidningen.se/07engine.php?articleId=16973.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/13/48/prepub