The ConCom Safety Management Scale

Developing and testing a measurement instrument for control-based and commitment-based safety management approaches in hospitals

C.W. Alingh, M.M.H. Strating, J.D.H. van Wijngaarden, J. Paauwe, R. Huijsman

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background
Nursing management is considered important for patient safety. Prior research has predominantly focused on charismatic leadership styles, although it is questionable whether these best characterise the role of nurse managers. Managerial control is also relevant. Therefore, we aimed to develop and test a measurement instrument for control-based and commitment-based safety management of nurse managers in clinical hospital departments.

Methods
A cross-sectional survey design was used to test the newly developed questionnaire in a sample of 2378 nurses working in clinical departments. The nurses were asked about their perceptions of the leadership behaviour and management practices of their direct supervisors. Psychometric properties were evaluated using confirmatory factor analysis and reliability estimates.

Results
The final 33-item questionnaire showed acceptable goodness-of-fit indices and internal consistency (Cronbach’s α of the subscales range: 0.59–0.90). The factor structure revealed three subdimensions for control-based safety management: (1) stressing the importance of safety rules and regulations; (2) monitoring compliance; and (3) providing employees with feedback. Commitment-based management consisted of four subdimensions: (1) showing role modelling behaviour; (2) creating safety awareness; (3) showing safety commitment; and (4) encouraging participation. Construct validity of the scale was supported by high factor loadings and provided preliminary evidence that control-based and commitment-based safety management are two distinct yet related constructs. The findings were reconfirmed in a cross-validation procedure.

Conclusion
The results provide initial support for the construct validity and reliability of our ConCom Safety Management Scale. Both management approaches were found to be relevant for managing patient safety in clinical hospital departments. The scale can be used to deepen our understanding of the influence of patient safety management on healthcare professionals’ safety behaviour as well as patient safety outcomes.
Original languageEnglish
JournalBMJ Quality & Safety
Volume27
Issue number10
DOIs
Publication statusPublished - 2018

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Nurse Administrators
Nurses
Statistical Factor Analysis
Compliance
Cross-Sectional Studies
Delivery of Health Care
Surveys and Questionnaires

Keywords

  • BEHAVIORAL INTEGRITY
  • CARE
  • CLIMATE
  • FIT INDEXES
  • NURSING LEADERSHIP
  • ORGANIZATIONS
  • OUTCOMES
  • PATIENT SAFETY
  • QUALITY
  • TRANSFORMATIONAL LEADERSHIP

Cite this

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title = "The ConCom Safety Management Scale: Developing and testing a measurement instrument for control-based and commitment-based safety management approaches in hospitals",
abstract = "Background Nursing management is considered important for patient safety. Prior research has predominantly focused on charismatic leadership styles, although it is questionable whether these best characterise the role of nurse managers. Managerial control is also relevant. Therefore, we aimed to develop and test a measurement instrument for control-based and commitment-based safety management of nurse managers in clinical hospital departments.Methods A cross-sectional survey design was used to test the newly developed questionnaire in a sample of 2378 nurses working in clinical departments. The nurses were asked about their perceptions of the leadership behaviour and management practices of their direct supervisors. Psychometric properties were evaluated using confirmatory factor analysis and reliability estimates.Results The final 33-item questionnaire showed acceptable goodness-of-fit indices and internal consistency (Cronbach’s α of the subscales range: 0.59–0.90). The factor structure revealed three subdimensions for control-based safety management: (1) stressing the importance of safety rules and regulations; (2) monitoring compliance; and (3) providing employees with feedback. Commitment-based management consisted of four subdimensions: (1) showing role modelling behaviour; (2) creating safety awareness; (3) showing safety commitment; and (4) encouraging participation. Construct validity of the scale was supported by high factor loadings and provided preliminary evidence that control-based and commitment-based safety management are two distinct yet related constructs. The findings were reconfirmed in a cross-validation procedure.Conclusion The results provide initial support for the construct validity and reliability of our ConCom Safety Management Scale. Both management approaches were found to be relevant for managing patient safety in clinical hospital departments. The scale can be used to deepen our understanding of the influence of patient safety management on healthcare professionals’ safety behaviour as well as patient safety outcomes.",
keywords = "BEHAVIORAL INTEGRITY, CARE, CLIMATE, FIT INDEXES, NURSING LEADERSHIP, ORGANIZATIONS, OUTCOMES, PATIENT SAFETY, QUALITY, TRANSFORMATIONAL LEADERSHIP",
author = "C.W. Alingh and M.M.H. Strating and {van Wijngaarden}, J.D.H. and J. Paauwe and R. Huijsman",
year = "2018",
doi = "10.1136/bmjqs-2017-007162",
language = "English",
volume = "27",
journal = "BMJ Quality & Safety",
issn = "2044-5415",
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The ConCom Safety Management Scale : Developing and testing a measurement instrument for control-based and commitment-based safety management approaches in hospitals. / Alingh, C.W.; Strating, M.M.H.; van Wijngaarden, J.D.H.; Paauwe, J.; Huijsman, R.

In: BMJ Quality & Safety, Vol. 27, No. 10, 2018.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The ConCom Safety Management Scale

T2 - Developing and testing a measurement instrument for control-based and commitment-based safety management approaches in hospitals

AU - Alingh, C.W.

AU - Strating, M.M.H.

AU - van Wijngaarden, J.D.H.

AU - Paauwe, J.

AU - Huijsman, R.

PY - 2018

Y1 - 2018

N2 - Background Nursing management is considered important for patient safety. Prior research has predominantly focused on charismatic leadership styles, although it is questionable whether these best characterise the role of nurse managers. Managerial control is also relevant. Therefore, we aimed to develop and test a measurement instrument for control-based and commitment-based safety management of nurse managers in clinical hospital departments.Methods A cross-sectional survey design was used to test the newly developed questionnaire in a sample of 2378 nurses working in clinical departments. The nurses were asked about their perceptions of the leadership behaviour and management practices of their direct supervisors. Psychometric properties were evaluated using confirmatory factor analysis and reliability estimates.Results The final 33-item questionnaire showed acceptable goodness-of-fit indices and internal consistency (Cronbach’s α of the subscales range: 0.59–0.90). The factor structure revealed three subdimensions for control-based safety management: (1) stressing the importance of safety rules and regulations; (2) monitoring compliance; and (3) providing employees with feedback. Commitment-based management consisted of four subdimensions: (1) showing role modelling behaviour; (2) creating safety awareness; (3) showing safety commitment; and (4) encouraging participation. Construct validity of the scale was supported by high factor loadings and provided preliminary evidence that control-based and commitment-based safety management are two distinct yet related constructs. The findings were reconfirmed in a cross-validation procedure.Conclusion The results provide initial support for the construct validity and reliability of our ConCom Safety Management Scale. Both management approaches were found to be relevant for managing patient safety in clinical hospital departments. The scale can be used to deepen our understanding of the influence of patient safety management on healthcare professionals’ safety behaviour as well as patient safety outcomes.

AB - Background Nursing management is considered important for patient safety. Prior research has predominantly focused on charismatic leadership styles, although it is questionable whether these best characterise the role of nurse managers. Managerial control is also relevant. Therefore, we aimed to develop and test a measurement instrument for control-based and commitment-based safety management of nurse managers in clinical hospital departments.Methods A cross-sectional survey design was used to test the newly developed questionnaire in a sample of 2378 nurses working in clinical departments. The nurses were asked about their perceptions of the leadership behaviour and management practices of their direct supervisors. Psychometric properties were evaluated using confirmatory factor analysis and reliability estimates.Results The final 33-item questionnaire showed acceptable goodness-of-fit indices and internal consistency (Cronbach’s α of the subscales range: 0.59–0.90). The factor structure revealed three subdimensions for control-based safety management: (1) stressing the importance of safety rules and regulations; (2) monitoring compliance; and (3) providing employees with feedback. Commitment-based management consisted of four subdimensions: (1) showing role modelling behaviour; (2) creating safety awareness; (3) showing safety commitment; and (4) encouraging participation. Construct validity of the scale was supported by high factor loadings and provided preliminary evidence that control-based and commitment-based safety management are two distinct yet related constructs. The findings were reconfirmed in a cross-validation procedure.Conclusion The results provide initial support for the construct validity and reliability of our ConCom Safety Management Scale. Both management approaches were found to be relevant for managing patient safety in clinical hospital departments. The scale can be used to deepen our understanding of the influence of patient safety management on healthcare professionals’ safety behaviour as well as patient safety outcomes.

KW - BEHAVIORAL INTEGRITY

KW - CARE

KW - CLIMATE

KW - FIT INDEXES

KW - NURSING LEADERSHIP

KW - ORGANIZATIONS

KW - OUTCOMES

KW - PATIENT SAFETY

KW - QUALITY

KW - TRANSFORMATIONAL LEADERSHIP

U2 - 10.1136/bmjqs-2017-007162

DO - 10.1136/bmjqs-2017-007162

M3 - Article

VL - 27

JO - BMJ Quality & Safety

JF - BMJ Quality & Safety

SN - 2044-5415

IS - 10

ER -