medigraphic.com
Instituto Nacional de Salud Pública

2018, Number 5

<< Back Next >>

salud publica mex 2018; 60 (5)

Psychometric validation of an instrument to evaluate the context of quality improvement and accreditation of hospitals

Zapata-Vanegas M, Saturno-Hernández PJ

Language: Spanish
References: 31
Page: 528-538
PDF size: 272.93 Kb.


ABSTRACT

Objective. To adapt and validate an instrument to measure the context factors which favor quality improvement initiatives and accreditation of hospitals. Materials and methods. The model and questionnaire Model for Understanding Success in Quality (MUSIQ) is adapted and validated for application in Spanish-speaking countries and its specific use in hospital accreditation projects. The theoretical construct of its dimensions is assessed by confirmatory factor analysis (Bartlett test and Kaiser-Meyer-Olkim index) and internal consistency (Cronbach’s α), in a study carried out in a sample of 54 hospitals of medium and high complexity in Colombia. Results. Instrument with four dimensions of context (environment, macrosystem, microsystem, quality team), composed of 23 elements that are measured through 35 variables. Factor analysis showed statistical significance and adequacy of the dimensions, which had also good internal consistency. Conclusion. Adapted instrument with usefulness for measurement of context elements that can promote initiatives of improvement and accreditation in hospitals.


REFERENCES

  1. Palmer RH. Considerations in defining quality of health care. En: Palmer RH, Donabedian A, Povar GJ, (eds.). Striving for quality in health care: an inquiry into policy and practice. Ann Arbor: Health Administration Press, 1991;1-53.

  2. Robledo H, Meljem J, Fajardo G, Olvera D. De la idea al concepto en la calidad en los servicios de salud. Rev Conamed. 2012;17(4):172-5.

  3. Saturno-Hernández PJ. Capítulo 1. Marco conceptual para la gestión de la calidad. En: Saturno-Hernández PJ. Métodos y herramientas para la realización de ciclos de mejora de la calidad en servicios de salud. Cuernavaca, México: Instituto Nacional de Salud Pública, 2015;13-38.

  4. Cortés-Martinez A. La economía de la salud en el hospital. Rev Gerenc Polit Salud. 2010;9(19):138-49.

  5. Boaden R, Harvey G, Moxham C, Proudlove N. Quality Improvement: theory and practice in healthcare. Coventry, UK: NHS Institute for Innovation and Improvement, 2008.

  6. Walshe K. Understanding what Works and why in quality improvement: the need for theory driven evaluation, Int J Qual Health Care. 2007;19(2):57-9. https://doi.org/10.1093/intqhc/mzm004

  7. Øvretveit J. Understanding the conditions for improvement: research to discover which context influences affect improvement success. BMJ Qual Saf. 2011;20(supl 1):i18-23. https://doi.org/10.1136/bmjqs.2010.045955

  8. Kaplan HC, Provost LP, Froehle CM, Margolis PA. The Model for Understanding Success en quality (MUSIQ): building a theory of context in healthcare quality improvement. BMJ Qual Saf. 2012;21:13-20. https://doi. org/10.1136/bmjqs-2011-000010

  9. Kaplan HC, Froehle CM, Cassedy A, Provost LP, Margolis P. An exploratory analysis of the Model for Understanding Success in Quality. Health Care Manage Rev. 2013;38(4):325-38. https://doi.org/10.1097/ HMR.0b013e3182689772

  10. Viswanathan HN, Salmon JW. Accrediting Organizations and Quality Improvement. Am J Manag Care. 2000;6(10):1117-29.

  11. Kirsten B, Vist G, Bukholm G, Barach P, Tjomsland O. A systematic review of hospital accreditation: the challenges of measuring complex intervention effects. BMC Health Services Research. 2015;15:280. https:// doi.org/10.1186/s12913-015-0933-x

  12. Van de Ven AH, Delbecq AL. The nominal group as a research instrument for exploratory health studies. Am J Public Health. 1972;62(3):337- 42. https://doi.org/10.2105/AJPH.62.3.337

  13. Callegaro J, Figueiredo B, Ruschel D. Cross-cultural adaptation and validation of psychological instruments: Some considerations. Paidéia. 2012;22:423-32. https://doi.org/10.1590/S0103-863X2012000300014

  14. Zapata-Vanegas MA. Factores predictivos del resultado para el mejoramiento de la calidad en salud (tesis). Murcia, España: Universidad de Murcia, 2016 [citado septiembre 2017]. Disponible en: http://hdl.handle. net/10803/396357

  15. República de Colombia, Ministerio de Salud. Resolución 8430 de 1993, “Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud”. Bogotá: República de Colombia, Ministerio de Salud, 1993 [citado septiembre 2017]. Disponible en: https://www. minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION- 8430-DE-1993.PDF

  16. Escobar M. Adaptación transcultural de instrumentos de medida relacionados con la salud. Enferm Clin. 2004;14:102-6. https://doi.org/10.1016/ S1130-8621(04)73863-2

  17. Scheneider A, Szecsenyi J, Barie S, Joest K, Rosemann T. Validation and cultural adaptation of a German version of Physician’ Reactions to Uncertainty scales. BMC Health Serv Res. 2007;7:81. https://doi. org/10.1186/1472-6963-7-81

  18. Shortell SM, Levin DZ, O`Brien JL, Hughes EF. Assessing the evidence on CQI: Is the glass half empty or half full? Hosp Health Serv Adm. 1995;40(1):4-24.

  19. Lemieux-Charles L, Murray M, Bakeer GR, Barnsley J, Tasa K, Ibrahim SA. The effects of quality improvement practices on team effectiveness; A mediational model. J Organ Behav. 2002;23(5):533-53. https://doi. org/10.1002/job.154

  20. RAND Corporation. Improving chronic illness care evaluation. Healthcare Organization survey for Quality Management Director, 1999 [citado septiembre 2016]. Disponible en: https://www.rand.org/content/ dam/rand/www/external/health/projects/icice/pdfs/qmd.pdf

  21. Helfrich CD, Li YF, Mohr DC, Meterko M, Sales AE. Assessing an organizational culture instrument base on the Competing Values Framework: Exploratory and confirmatory factor analyses. Implement Sci. 2007;2:13. https://doi.org/10.1186/1748-5908-2-13

  22. Strating M, Nieboer A. Norms for creativity and implementation in health care teams: testing the group innovation inventory. Qual Assur Health Care. 2010;22(4):275-82. https://doi.org/10.1093/intqhc/mzq027

  23. Edmonson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999; 44(2):350-83. https://doi.org/10.2307/2666999

  24. Zapata MA, Saturno PJ. Encuesta para la evaluación de elementos y factores del contexto asociados a la mejora de la calidad y acreditación en hospitales [Internet]. Figshare, 2018. https://doi.org/10.6084/ m9.figshare.6220373.v1

  25. Rickards G, Magee C, Artino A. You can’t fix by analysis what you’ve spoiled by design: developing survey instruments and collecting validity evidence. J Grad Med Educ. 2012;4(4):407-10. https://doi. org/10.4300%2FJGME-D-12-00239.1

  26. Likert R. A Technique for the Measurement of Attitudes. Nueva York: Archives of Psichology, 1932.

  27. Pérez-Gil JA, Chacón S, Moreno R. Validez de constructo: el uso de análisis factorial exploratorio-confirmatorio para obtener evidencias de validez científica. Pshicotema. 2000;12(2):442-46.

  28. Lloret S, Ferreres A, Hernández A, Tomás I. El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. An Psicol. 2014;30(3):1151-69. https://doi.org/10.6018/analesps.30.3.199361

  29. Hartley J. Some thoughts on Likert-type scales. Int J Clin Health Psychol. 2013;13:83-6. https://doi.org/10.1016/S1697-2600(14)70040-7

  30. Lozano LM, García-Cueto E, Muñiz J. Effect of the Number of Response Categories on the Reliability and Validity of Rating Scales. Methodology. 2008;4(2):73-9. https://doi.org/10.1027/1614-2241.4.2.73

  31. Hernández A, Espejo B, González V, Gómez J. Escala de respuesta tipo Likert: ¿Es irrelevante la alternativa “indiferente”?. Metodología de Encuestas. 2001;3(2):135-50. [citado septiembre 2016]. Disponible en: http:// casus.usal.es/pkp/index.php/MdE/article/viewFile/901/842




2020     |     www.medigraphic.com