Measuring organizational attributes of primary care practices: development of a new instrument.
OBJECTIVE
To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff.


METHODS
Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices.


METHODS
A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent constructs of practices' internal resources for capacity to change. ANOVA methods were used to confirm that the factors differentiated practices.


METHODS
The survey was administered to all staff from 51 practices.


RESULTS
The factor analysis resulted in four stable and internally consistent factors. Three of these factors, "communication,""decision-making," and "stress/chaos," describe resources for change in primary care practices. One factor, labeled "history of change," may be useful in assessing the success of interventions.


CONCLUSIONS
A 21-item questionnaire can reliably measure four important organizational attributes relevant to family practices. These attributes can be used both as outcome measures as well as important features for targeting system interventions.
Ohman-Strickland
Pamela A
PA
Department of Family Medicine, UMDNJ-RWJMS, One World's Fair Drive, Somerset, NJ 08873, USA.
John Orzano
A
A
Nutting
Paul A
PA
Perry Dickinson
W
W
Scott-Cawiezell
Jill
J
Hahn
Karissa
K
Gibel
Michelle
M
Crabtree
Benjamin F
BF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D019985:Benchmarking / Q000379:methods*; D003142:Communication; D003154:Community Medicine / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005194:Family Practice / Q000458:organization & administration*; D019538:Health Care Surveys / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D017146:Models, Organizational; D009515:New Jersey; D009936:Organizational Innovation; D010414:Pennsylvania; D011320:Primary Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires