Handley Sara C, Nembhard Ingrid M, Corson Cecelia L, Passarella Molly, Cecarelli Charlotte, Lee Henry C, Cohen Jennifer, Chuo John, Tioseco Jennifer, Bonafide Christopher P, Foglia Elizabeth E
The 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.
Resusc Plus. 2024 Oct 4;20:100796. doi: 10.1016/j.resplu.2024.100796. eCollection 2024 Dec.
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.
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).
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.
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.
团队的组织文化（共同的信念、认知和价值观）影响其行为和实践。关于复苏团队的组织文化，我们了解甚少。我们的目标是开发一种可靠且有效的特定于复苏的组织文化工具（ROCI），以提高团队绩效。
利用新生儿复苏项目原则、文献综述以及与专家讨论现有文化测量方法，我们确定了复苏的组织文化组成部分，并使现有测量方法适用于复苏。我们开发了一个具有五个子量表（角色清晰度、共享心智模型、闭环沟通、团队适应性和心理安全）的ROCI，并将其应用于医院网络中的新生儿复苏团队成员。调查心理测量评估包括可靠性分析（克朗巴哈α系数、皮尔逊相关系数）和效度测试（验证性因素分析[CFA]以及检验文化与实施结果之间关联的回归模型：氛围和感知成功）。
在11家医院中，共有318份完整回复（回复率41%）。在测试的22个项目中，经过反复心理测量评估后保留了18个。ROCI具有出色的总体可靠性（克朗巴哈α系数 = 0.994）和非常好的子量表可靠性（克朗巴哈α系数 = 0.789 - 0.867）。CFA拟合优度统计证实了五个结构（子量表）。在个体层面，ROCI及其所有子量表均与两种实施结果相关。在医院层面，ROCI总体及三个子量表与感知成功相关。
ROCI是复苏团队组织文化的可靠且有效测量工具。未来的ROCI评估可能为文化变革举措提供基础，以改善不同人群和环境下的复苏质量及结果。
