Measuring practice capacity for change: A tool for guiding quality improvement in primary care settings

Sarah N. Bobiak, Stephen J. Zyzanski, Mary C. Ruhe, Caroline A. Carter, Brian Ragan, Sue Flocke, David Litaker, Kurt C. Stange

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

PURPOSE: Capacity for change, or the ability and willingness to undertake change, is an organizational characteristic with potential to foster quality management in health care. We report on the development and psychometric properties of a quantitative measure of capacity for change for use in primary care settings. METHODS: Following review of previous conceptual and empirical studies, we generated 117 items that assessed organizational structure, climate, and culture. Using information from direct observation and key informant interviews, a research team member rated these items for 15 primary care practices engaged in a quality improvement intervention. Distributional statistics, pairwise correlation analysis, Rasch modeling, and item content review guided item reduction and instrument finalization. Reliability and convergent validity were assessed. RESULTS: Ninety-two items were removed because of limited response distributions and redundancy or because of poor Rasch model fit. The final instrument comprising 25 items had excellent reliability (α = .94). A Rasch model-derived capacity for change score correlated well with an independently determined, qualitatively derived summary assessment of each practice's capacity for change (ρS = 0.82), suggesting good convergent validity. CONCLUSION: We describe a new instrument for quantifying organizational capacity for change in primary care settings. The ability to quantify capacity for change may enable better recognition of practices likely to be successful in their change efforts and those first requiring capacity building prior to change interventions.

Original languageEnglish (US)
Pages (from-to)278-284
Number of pages7
JournalQuality management in health care
Volume18
Issue number4
DOIs
StatePublished - Oct 1 2009
Externally publishedYes

Fingerprint

Quality Improvement
Organizational Innovation
Primary Health Care
Aptitude
Capacity Building
Climate
Psychometrics
Reproducibility of Results
Observation
Interviews
Delivery of Health Care
Research
quality management
ability
redundancy
organizational structure
psychometrics
statistics
climate
health care

Keywords

  • Capacity for change
  • Primary care practice
  • Quality improvement

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy
  • Care Planning

Cite this

Measuring practice capacity for change : A tool for guiding quality improvement in primary care settings. / Bobiak, Sarah N.; Zyzanski, Stephen J.; Ruhe, Mary C.; Carter, Caroline A.; Ragan, Brian; Flocke, Sue; Litaker, David; Stange, Kurt C.

In: Quality management in health care, Vol. 18, No. 4, 01.10.2009, p. 278-284.

Research output: Contribution to journalArticle

Bobiak, Sarah N. ; Zyzanski, Stephen J. ; Ruhe, Mary C. ; Carter, Caroline A. ; Ragan, Brian ; Flocke, Sue ; Litaker, David ; Stange, Kurt C. / Measuring practice capacity for change : A tool for guiding quality improvement in primary care settings. In: Quality management in health care. 2009 ; Vol. 18, No. 4. pp. 278-284.
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