Developmental stages associated with organizational learning in hospitals: An instrument development study.
factor analysis
instrument development
multilevel analysis
nurse administrators
nurse managers
organizational learning
quality improvement
safety
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
revised:
12
03
2022
received:
01
12
2021
accepted:
02
04
2022
pubmed:
21
4
2022
medline:
20
10
2022
entrez:
20
4
2022
Statut:
ppublish
Résumé
To develop and test the Organizational Learning Instrument: Development Stages instrument, a measure of hospital units' readiness to engage in organizational learning. Cognitive interviewing, expert review and a quantitative, cross-sectional survey. Item development was informed by previous research on organizational learning. Content validity was assessed and strengthened using cycles of cognitive interviewing and expert review. The resulting instrument was distributed by email to all nurses providing direct patient care in inpatient units in 11 Magnet® hospitals. Data were collected in 2018. Intraclass correlations, using hospital unit as the grouping variable, indicated the need to use multilevel methods to analyse the survey data. Thus, coefficient omega and multilevel confirmatory factor analysis were used to estimate the instrument's reliability and construct validity, respectively. The Organizational Learning Instrument: Development Stages is a 35-item survey comprised of four scales: Identity & Ownership, Team & Respect, Accountability & Support and Reliability & Sustainability. The expert review yielded scale-level content validity scores from 0.90 to 1.0 and item-level content validity scores from 0.86 to 1.0. Survey participants were 1212 nurses, working in 99 inpatient units, across 11 Magnet® hospitals. Intraclass correlations ranged from 0.113 to 0.158. Coefficient omega reliability for the four scales was 0.981-0.993. Standardized factor loadings for the 35 items were 0.699-0.961, with acceptable model fit statistics (comparative fit index = 0.980, Tucker-Lewis Fit Index = 0.979, and root mean squared error of approximation = 0.060). These results indicate the instrument meets or exceeds generally accepted criteria for content validity, reliability and construct validity instrument, and is suitable for further use and testing. Nurse administrators, managers and researchers now have a valid, reliable instrument to better foster and study organizational learning in hospital units. Advances in organizational learning are expected to improve a variety of patient, staff and organizational outcomes in hospital units.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3662-3672Subventions
Organisme : Brigham Young University College of Nursing
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Arefin, M. S., Hoque, M. R., & Rasul, T. (2021). Organizational learning culture and business intelligence systems of health-care organizations in an emerging economy. Journal of Knowledge Management, 25(3), 573-594. https://doi.org/10.1108/JKM-09-2019-0517
Chyung, S. Y., Roberts, K., Swanson, I., & Hankinson, A. (2017). Evidence-based survey design: The use of a midpoint on the Likert scale. Performance Improvement, 56(10), 15-23. https://doi.org/10.1002/pfi.21727
Dietermann, K., Winter, V., Schneider, U., & Schreyögg, J. (2021). The impact of nurse staffing levels on nursing-sensitive patient outcomes: A multilevel regression approach. The European Journal of Health Economics, 22(5), 833-846. https://doi.org/10.1007/s10198-021-01292-2
Edwards, M. T. (2017). An organizational learning framework for patient safety. American Journal of Medical Quality, 32(2), 148-155. https://doi.org/10.1177/1062860616632295
Flores, L. G., Zheng, W., Rau, D., & Thomas, C. H. (2012). Organizational learning: Subprocess identification, construct validation, and an empirical test of cultural antecedents. Journal of Management, 38(2), 640-667. https://doi.org/10.1177/0149206310384631
Geldhof, G. J., Preacher, K. J., & Zyphur, M. J. (2014). Reliability estimation in a multilevel confirmatory factor analysis framework. Psychological Methods, 19(1), 72-91. https://doi.org/10.1037/a0032138
Heene, M., Hilbert, S., Draxler, C., Ziegler, M., & Bühner, M. (2011). Masking misfit in confirmatory factor analysis by increasing unique variances: A cautionary note on the usefulness of cutoff values of fit indices. Psychological Methods, 16(3), 319-336. https://doi.org/10.1037/a0024917
Henderson, A., Walker, R., Creedy, D., Boorman, R., & Cooke, M. (2010). Development and psychometric testing of the Clinical Learning Organisational Culture Survey (CLOCS). Nurse Education Today, 30(7), 598-602. https://doi.org/10.1016/j.nedt.2009.12.006
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. doi:10.1080/10705519909540118
Institute of Medicine. (2012). Best care at lowest cost: The path to continuously learning health care in America. The National Academies Press.
Ishii, K., Takemura, Y., & Ichikawa, N. (2020). Relationships between the components of nurse managers' transformational leadership and organisational learning subprocesses in a hospital ward: A cross-sectional study. Journal of Nursing Management, 29(4), 672-680. https://doi.org/10.1111/jonm.13203
Janis, R. A., Burlingame, G. M., & Olsen, J. A. (2016). Evaluating factor structures of measures in group research: Looking between and within. Group Dynamics: Theory, Research, and Practice, 20(3), 165. https://doi.org/10.1037/gdn0000043
Johantgen, M., Weiss, M., Lundmark, V., Newhouse, R., Haller, K., Unruh, L., & Shirey, M. (2017). Building research infrastructure in Magnet® hospitals: Current status and future directions. Journal of Nursing Administration, 47(4), 198-204. https://doi.org/10.1097/NNA.0000000000000465
Kearney, M. H. (2016a). Under-appreciated steps in instrument development, part I: Starting with validity. Research in Nursing & Health, 39(2), 81-83. https://doi.org/10.1002/nur.21713
Kearney, M. H. (2016b). Under-appreciated steps in instrument development, part II: Ending with validity. Research in Nursing & Health, 39(3), 135-138. https://doi.org/10.1002/nur.21721
Keliat, B. A., & Hariyati, R. T. S. (2019). Learning culture of nurse about patient safety in hospital: A qualitative study. Enfermería Clínica, 29, 488-494. https://doi.org/10.1016/j.enfcli.2019.04.073
Lake, E. T., Sanders, J., Duan, R., Riman, K. A., Schoenauer, K. M., & Chen, Y. (2019). A meta-analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes. Medical Care, 57(5), 353-361. https://doi.org/10.1097/MLR.0000000000001109
Lyman, B., Biddulph, M. E., Hopper, V. G., & Brogan, J. L. (2020). Nurses' experiences of Organisational learning: A qualitative descriptive study. Journal of Nursing Management, 28(6), 1241-1249. https://doi.org/10.1111/jonm.13070
Lyman, B., Biddulph, M. E., Hopper, V. G., Horton, M. K., Mendon, C. R., Thorum, K. C., & Smith, E. L. (2021). Creating a work environment conducive to organizational learning. The Journal of Continuing Education in Nursing, 52(6), 281-285.
Lyman, B., Ethington, K. M., King, C., Jacobs, J. D., & Lundeen, H. (2017). Organizational learning in a cardiac intensive care unit. Dimensions of Critical Care Nursing, 36(2), 78-86. https://doi.org/10.1097/DCC.0000000000000233
Lyman, B., Hammond, E., & Cox, J. (2018). Organizational learning in health systems: A concept analysis. Journal of Nursing Management., 27, 633-646. https://doi.org/10.1111/jonm.12722
Lyman, B., Jacobs, J. D., Hammond, E. L., & Gunn, M. M. (2019). Organizational learning in hospitals: A realist review. Journal of Advanced Nursing, 75(11), 2352-2377. https://doi.org/10.1111/jan.14091
Lyman, B., & Moore, C. (2019). The learning history: A research method to advance the science and practice of organizational learning in healthcare. Journal of Advanced Nursing, 75(2), 472-481. https://doi.org/10.1111/jan.13858
Lyman, B., & Parchment, J. (2020). Sustaining exemplary practice: leading through the lens of organizational learning. JONA: The Journal of Nursing Administration, 50(11), 557-559. doi:10.1097/NNA.0000000000000935
Lyman, B., Shaw, L., & Moore, C. (2017). Organizational learning in an orthopaedic unit. Orthopaedic Nursing, 36(6), 424-431. https://doi.org/10.1097/NOR.0000000000000403
Lynn, M. R. (1986). Determination and quantification of content validity. Nursing Research, 35(6), 382-386.
Maas, C. J., & Hox, J. J. (2005). Sufficient sample sizes for multilevel modeling. Methodology, 1(3), 86-92. https://doi.org/10.1027/1614-1881.1.3.86
McNeish, D. (2018). Thanks coefficient alpha, we'll take it from here. Psychological Methods, 23(3), 412-433. doi:10.1037/met0000144
Milstein, R., & Schreyoegg, J. (2020). The relationship between nurse staffing levels and nursing-sensitive outcomes in hospitals: Assessing heterogeneity among unit and outcome types. Health Policy, 124(10), 1056-1063. https://doi.org/10.1016/j.healthpol.2020.07.013
Moafimadani, S. K., Kazempour, E., Khalkhali, A., & Rahimaghaee, F. (2020). Effective factors on management of nurses organizational learning: A qualitative study. Journal of Nursing and Midwifery Sciences, 7(1), 52-59. https://doi.org/10.4103/JNMS.JNMS_35_19
Muthén, L. K., & Muthén, B. (2017). Mplus user's guide: Statistical analysis with latent variables, user's guide. Muthén & Muthén.
Nelson-Brantley, H. V., Park, S. H., & Bergquist-Beringer, S. (2018). Characteristics of the nursing practice environment associated with lower unit-level RN turnover. JONA: The Journal of Nursing Administration, 48(1), 31-37. https://doi.org/10.1097/NNA.0000000000000567
Nembhard, I. M., Alexander, J. A., Hoff, T. J., & Ramanujam, R. (2009). Why does the quality of health care continue to lag? Insights from management research. Academy of Management Perspectives, 23(1), 24-42. https://www.jstor.org/stable/27747492
Nunnally, J. C. (1994). Psychometric theory (2nd ed.). McGraw-Hill.
Pituch, K. A., & Stevens, J. P. (2016). Applied multivariate statistics for the social sciences: Analyses with SAS and IBM's SPSS. Routledge.
Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459-467. https://doi.org/10.1002/nur.20199
Pornprasertmanit, S., Lee, J., & Preacher, K. J. (2014). Ignoring clustering in confirmatory factor analysis: Some consequences for model fit and standardized parameter estimates. Multivariate Behavioral Research, 49(6), 518-543. https://doi.org/10.1080/00273171.2014.933762
Senge, P. M. (1990). The fifth discipline: The art & practice of the learning organization. Doubleday.
Shuman, C. J., Liu, X., Aebersold, M. L., Tschannen, D., Banaszak-Holl, J., & Titler, M. G. (2018). Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study. Implementation Science, 13(1), 1-10. https://doi.org/10.1186/s13012-018-0753-6
Sideridis, G., Saddaawi, A., & Al-Harbi, K. (2018). Internal consistency reliability in measurement: Aggregate and multilevel approaches. Journal of Modern Applied Statistical Methods, 17(1), 15. https://doi.org/10.22237/jmasm/1530027194
Singer, S. J., Moore, S. C., Meterko, M., & Williams, S. (2012). Development of a short-form learning organization survey: The LOS-27. Medical Care Research and Review, 69(4), 432-459. https://doi.org/10.1177/1077558712448135
Watkins, K. E., & O'Neil, J. (2013). The dimensions of the learning organization questionnaire (the DLOQ): A nontechnical manual. Advances in Developing Human Resources, 15(2), 133-147. https://doi.org/10.1177/1523422313475854
Willis, G. B. (2004). Cognitive interviewing: A tool for improving questionnaire design. Sage Publications.