title: Validity and usefulness of members reports of implementation progress in a quality improvement initiative: findings from the Team Check-up Tool (TCT).
abstract: BACKGROUND
  Team-based interventions are effective for improving safety and quality of healthcare. However, contextual factors, such as team functioning, leadership, and organizational support, can vary significantly across teams and affect the level of implementation success. Yet, the science for measuring context is immature. The goal of this study is to validate measures from a short instrument tailored to track dynamic context and progress for a team-based quality improvement (QI) intervention.
  
  
  METHODS
  
  
  
  METHODS
  Secondary cross-sectional and longitudinal analysis of data from a clustered randomized controlled trial (RCT) of a team-based quality improvement intervention to reduce central line-associated bloodstream infection (CLABSI) rates in intensive care units (ICUs).
  
  
  METHODS
  Forty-six ICUs located within 35 faith-based, not-for-profit community hospitals across 12 states in the U.S.
  
  
  METHODS
  Team members participating in an ICU-based QI intervention.
  
  
  METHODS
  The primary measure is the Team Check-up Tool (TCT), an original instrument that assesses context and progress of a team-based QI intervention. The TCT is administered monthly. Validation measures include CLABSI rate, Team Functioning Survey (TFS) and Practice Environment Scale (PES) from the Nursing Work Index.
  
  
  METHODS
  Temporal stability, responsiveness and validity of the TCT.
  
  
  RESULTS
  We found evidence supporting the temporal stability, construct validity, and responsiveness of TCT measures of intervention activities, perceived group-level behaviors, and barriers to team progress.
  
  
  CONCLUSIONS
  The TCT demonstrates good measurement reliability, validity, and responsiveness. By having more validated measures on implementation context, researchers can more readily conduct rigorous studies to identify contextual variables linked to key intervention and patient outcomes and strengthen the evidence base on successful spread of efficacious team-based interventions. QI teams participating in an intervention should also find data from a validated tool useful for identifying opportunities to improve their own implementation.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA. kchan@jhsph.edu
authors.forename: Kitty S
authors.initials: KS
authors.lastname: Chan
authors.forename: Yea-Jen
authors.initials: YJ
authors.lastname: Hsu
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Lubomski
authors.forename: Jill A
authors.initials: JA
authors.lastname: Marsteller
mesh_terms: D055499:Catheter-Related Infections / Q000517:prevention & control; D003430:Cross-Sectional Studies; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards; D008137:Longitudinal Studies; D010348:Patient Care Team; D016730:Program Development / Q000379:methods / Q000592:standards; D015397:Program Evaluation / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care / Q000458:organization & administration / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results