Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams

Background: The organizational culture (shared beliefs, perceptions, and values) of teams informs their behaviours and practices. Little is known about organizational culture for resuscitation teams. Our objective was to develop a reliable and valid resuscitation-specific organizational culture inst...

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Main Authors: Sara C. Handley, Ingrid M. Nembhard, Cecelia L. Corson, Molly Passarella, Charlotte Cecarelli, Henry C. Lee, Jennifer Cohen, John Chuo, Jennifer Tioseco, Christopher P. Bonafide, Elizabeth E. Foglia
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520424002479
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author Sara C. Handley
Ingrid M. Nembhard
Cecelia L. Corson
Molly Passarella
Charlotte Cecarelli
Henry C. Lee
Jennifer Cohen
John Chuo
Jennifer Tioseco
Christopher P. Bonafide
Elizabeth E. Foglia
author_facet Sara C. Handley
Ingrid M. Nembhard
Cecelia L. Corson
Molly Passarella
Charlotte Cecarelli
Henry C. Lee
Jennifer Cohen
John Chuo
Jennifer Tioseco
Christopher P. Bonafide
Elizabeth E. Foglia
author_sort Sara C. Handley
collection DOAJ
description Background: The organizational culture (shared beliefs, perceptions, and values) of teams informs their behaviours and practices. Little is known about organizational culture for resuscitation teams. Our objective was to develop a reliable and valid resuscitation-specific organizational culture instrument (ROCI) with the goal of improving team performance. Methods: Using Neonatal Resuscitation Program principles, literature review, and discussion of existing culture measures with experts, we identified organizational culture components for resuscitation and adapted existing measures to resuscitation. We developed a ROCI with five subscales (role clarity, shared-mental models, closed-loop communication, team adaptability, and psychological safety) and administered it to neonatal resuscitation team members across a hospital network. Survey psychometric assessment included reliability analyses (Cronbach’s α, Pearson correlation coefficients) and validity testing (confirmatory factor analysis [CFA] and regression models examining the association of culture with implementation outcomes: climate and perceived success). Results: Across 11 hospitals there were 318 complete responses (41 % response rate). Of the 22-items tested, 18 were retained after iterative psychometric assessment. The ROCI had excellent overall reliability (Cronbach’s α = 0.994) and very good subscale reliability (Cronbach’s α = 0.789–0.867). The CFA goodness-of-fit statistics confirmed five constructs (subscales). At the individual-level, the ROCI and all subscales were associated with both implementation outcomes. At the hospital-level, the ROCI overall and three subscales were associated with perceived success. Conclusion: The ROCI is a reliable and valid measure of the organizational culture of resuscitation teams. Future ROCI assessments may provide a foundation to inform culture change initiatives to improve resuscitation quality and outcomes across populations and contexts.
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spelling doaj-art-6c9cfcba6fbd46cea3f5fd8b7418a8e42024-12-21T04:29:53ZengElsevierResuscitation Plus2666-52042024-12-0120100796Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teamsSara C. Handley0Ingrid M. Nembhard1Cecelia L. Corson2Molly Passarella3Charlotte Cecarelli4Henry C. Lee5Jennifer Cohen6John Chuo7Jennifer Tioseco8Christopher P. Bonafide9Elizabeth E. Foglia10The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United States; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, United States; Corresponding author.The Wharton School, University of Pennsylvania, 3641 Locust Walk #207, Philadelphia, PA 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United StatesUC San Diego, 9300 Campus Point Drive, La Jolla, CA, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United States; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United States; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, United StatesThe Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, United States; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United StatesBackground: The organizational culture (shared beliefs, perceptions, and values) of teams informs their behaviours and practices. Little is known about organizational culture for resuscitation teams. Our objective was to develop a reliable and valid resuscitation-specific organizational culture instrument (ROCI) with the goal of improving team performance. Methods: Using Neonatal Resuscitation Program principles, literature review, and discussion of existing culture measures with experts, we identified organizational culture components for resuscitation and adapted existing measures to resuscitation. We developed a ROCI with five subscales (role clarity, shared-mental models, closed-loop communication, team adaptability, and psychological safety) and administered it to neonatal resuscitation team members across a hospital network. Survey psychometric assessment included reliability analyses (Cronbach’s α, Pearson correlation coefficients) and validity testing (confirmatory factor analysis [CFA] and regression models examining the association of culture with implementation outcomes: climate and perceived success). Results: Across 11 hospitals there were 318 complete responses (41 % response rate). Of the 22-items tested, 18 were retained after iterative psychometric assessment. The ROCI had excellent overall reliability (Cronbach’s α = 0.994) and very good subscale reliability (Cronbach’s α = 0.789–0.867). The CFA goodness-of-fit statistics confirmed five constructs (subscales). At the individual-level, the ROCI and all subscales were associated with both implementation outcomes. At the hospital-level, the ROCI overall and three subscales were associated with perceived success. Conclusion: The ROCI is a reliable and valid measure of the organizational culture of resuscitation teams. Future ROCI assessments may provide a foundation to inform culture change initiatives to improve resuscitation quality and outcomes across populations and contexts.http://www.sciencedirect.com/science/article/pii/S2666520424002479Neonatal resuscitation teamsOrganizational cultureSurvey developmentSurvey instrumentRole clarityShared-mental models
spellingShingle Sara C. Handley
Ingrid M. Nembhard
Cecelia L. Corson
Molly Passarella
Charlotte Cecarelli
Henry C. Lee
Jennifer Cohen
John Chuo
Jennifer Tioseco
Christopher P. Bonafide
Elizabeth E. Foglia
Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
Resuscitation Plus
Neonatal resuscitation teams
Organizational culture
Survey development
Survey instrument
Role clarity
Shared-mental models
title Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
title_full Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
title_fullStr Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
title_full_unstemmed Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
title_short Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams
title_sort development and testing of a resuscitation specific measure of organizational culture for resuscitation teams
topic Neonatal resuscitation teams
Organizational culture
Survey development
Survey instrument
Role clarity
Shared-mental models
url http://www.sciencedirect.com/science/article/pii/S2666520424002479
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