title: Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire.
abstract: OBJECTIVE
  The objective of this study is to develop and validate a questionnaire designed to assess the culture, organization, and management of intensive care units.
  
  
  METHODS
  This is a prospective multicenter study.
  
  
  METHODS
  The study was conducted in 26 intensive care units located in Paris.
  
  
  METHODS
  All personnel were asked to complete the questionnaire.
  
  
  METHODS
  The questionnaire was developed in 2 steps: (1) development of a theoretical framework based on organizational theory and (2) testing of the reliability and validity of a comprehensive set of measures.
  
  
  METHODS
  The internal consistency of the items composing each scale was tested by using the Cronbach alpha. Convergent, and discriminant validity was assessed by factor analysis with varimax rotation.
  
  
  RESULTS
  The overall completion rate was 74% with 1000 respondents (750 nurses, 26 head nurses, 168 physicians, and 56 medical secretaries). Starting with a 220-item questionnaire, we constructed a short version-conserving metrological characteristics with good reliability and validity. The short questionnaire, entitled Culture, Organization, and Management in Intensive Care, consists of 106 items distributed in 9 dimensions and 22 scales: culture (n = 3), coordination and adaptation to uncertainty (n = 3), communication (n = 3), problem solving and conflict management (n = 2), organizational learning and organizational change (n = 2), skills developed in a patient-caregiver relationship (n = 1), subjective unit performance (n = 3), burnout (n = 3), and job satisfaction and intention to quit (n = 2). All the scales showed good-to-high reliability, with Cronbach alpha scores higher than .7 (with the exception of coordination [.6]). Team satisfaction-oriented culture is positively correlated with good managerial practices and individual well-being.
  
  
  CONCLUSIONS
  The Culture, Organization, and Management in Intensive Care questionnaire enables staff and managers to assess the organizational performance of their intensive care unit.
authors.affiliation: Center for Health Economics and Administration Research (INSERM U 537/CNRS Esa 8052), Le Kremlin-Bicêtre, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Minvielle
authors.forename: Benoît
authors.initials: B
authors.lastname: Dervaux
authors.forename: Aurélia
authors.initials: A
authors.lastname: Retbi
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerter
authors.forename: Ariane
authors.initials: A
authors.lastname: Boumendil
authors.forename: Marie Claude
authors.initials: MC
authors.lastname: Jars-Guincestre
authors.forename: Alain
authors.initials: A
authors.lastname: Tenaillon
authors.forename: Bertrand
authors.initials: B
authors.lastname: Guidet
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010297:Paris; D010564:Personnel, Hospital / Q000523:psychology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires