title: Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales.
abstract: OBJECTIVE
  Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals.
  
  
  METHODS
  Testing of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-country research project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE).
  
  
  METHODS
  A sample of 3386 leading physicians and nurses working in 188 hospitals located in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey.
  
  
  METHODS
  Validity and reliability of professional involvement scales and subscales.
  
  
  RESULTS
  Psychometric analysis yielded four subscales for leading physicians: (i) Administration and budgeting, (ii) Managing medical practice, (iii) Strategic management and (iv) Managing nursing practice. Only the first three factors applied well to the nurses. Cronbach's alpha for internal consistency ranged from 0.74 to 0.86 for the physicians, and from 0.61 to 0.81 for the nurses. Except for the 0.74 correlation between 'Administration and budgeting' and 'Managing medical practice' among physicians, all inter-scale correlations were <0.70 (range 0.43-0.61). Under testing for construct validity, the subscales were positively correlated with 'formal management roles' of physicians and nurses.
  
  
  CONCLUSIONS
  The professional involvement scales appear to yield reliable and valid data in European hospital settings, but the scale 'Managing medical practice' for nurses needs further exploration. The measurement instrument can be used for international research on clinical management.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Meibergdreef 9, 1100 DE Amsterdam J2-211, The Netherlands; t.plochg@amc.uva.nl.
authors.forename: Thomas
authors.initials: T
authors.lastname: Plochg
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
authors.forename: Daan
authors.initials: D
authors.lastname: Botje
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Thompson
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: Russell
authors.initials: R
authors.lastname: Mannion
authors.forename: Kiki
authors.initials: K
authors.lastname: Lombarts
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006739:Hospital Administration; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D010819:Physician's Role; D011795:Surveys and Questionnaires / Q000592:standards*; D014421:Turkey
keywords: clinical management; hospital management; professional involvement; quality systems