评估医疗保健中的领导行为：引入 SCORE 调查的本地领导力量表。

Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey.

出版信息

Jt Comm J Qual Patient Saf. 2023 Mar;49(3):166-173. doi: 10.1016/j.jcjq.2022.12.007. Epub 2022 Dec 23.

DOI:10.1016/j.jcjq.2022.12.007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10294561/

Abstract

BACKGROUND

Engaged and accessible leadership is a key component of care excellence. However, the field lacks brief, reliable, and actionable measures of feedback and coaching-related behaviors of local leaders (for example, provides frequent feedback). The current study introduces a five-item Local Leadership (LL) scale by examining its psychometric properties, providing benchmarking across demographic factors and work settings, assessing its association with psychological safety, and testing whether LL predicts reports of restricted activities and absenteeism.

METHODS

In this cross-sectional study, 23,853 questionnaires were distributed across 31 Midwestern US hospitals. The survey included the LL scale, as well as safety culture and well-being scales. Psychometric analyses (Cronbach's α, confirmatory factor analysis [CFA] fit: root square mean error of the approximation [RMSEA], comparative fit index [CFI], Tucker-Lewis index [TLI]), Spearman correlations, t-tests, and analyses of variance (ANOVAs) were used to test the properties of the LL scale and differences by health care worker and work setting characteristics.

RESULTS

A total of 16,797 surveys were returned (70.4% response rate). The LL scale exhibited strong psychometric properties (Cronbach's α = 0.94; RMSEA = 0.079; CFI = 0.99; TLI = 0.98). LL scores differed by role, shift, shift length, and years in specialty. Of all roles, leaders (for example, managers) rated leaders most favorably. Nonclinical (vs. clinical) and nonsurgical (vs. surgical) work settings reported higher LL. LL scores correlated positively with psychological safety, absenteeism, and activities restricted due to illness.

CONCLUSION

The LL scale exhibits strong psychometric properties, convergent validity with psychological safety, and variation by work setting, work setting type, role, shift, shift length, and specialty. The study indicates that assessing leadership behaviors with the LL scale is useful and offers actionable behaviors for leaders to improve safety culture within teams.

摘要

背景

积极且易于接触的领导力是卓越护理的关键组成部分。然而，该领域缺乏对当地领导者（例如，提供频繁反馈）的反馈和辅导相关行为的简短、可靠且可操作的衡量标准。本研究通过考察其心理测量学特性，提供跨人口统计学因素和工作环境的基准测试，评估其与心理安全性的相关性，并测试其是否可以预测因疾病而限制活动和缺勤的报告，从而引入了一个由五项组成的“本地领导力（LL）”量表。

方法

在这项横断面研究中，向美国中西部的 31 家医院发放了 23853 份调查问卷。该调查包括 LL 量表以及安全文化和幸福感量表。使用心理测量学分析（克朗巴赫的 α、验证性因素分析[CFA]拟合：近似均方根误差[RMSEA]、比较拟合指数[CFI]、塔克-刘易斯指数[TLI]）、Spearman 相关系数、t 检验和方差分析（ANOVA）来测试 LL 量表的特性以及卫生保健工作者和工作环境特征的差异。

结果

共收回 16797 份调查问卷（70.4%的回复率）。LL 量表具有很强的心理测量学特性（克朗巴赫的 α=0.94；RMSEA=0.079；CFI=0.99；TLI=0.98）。LL 得分因角色、班次、班次长度和专业年限而异。在所有角色中，领导者（例如，经理）对领导者的评价最高。非临床（与临床）和非外科（与外科）工作环境报告的 LL 较高。LL 得分与心理安全性、缺勤和因疾病而限制的活动呈正相关。