Objectives. To describe a new survey tool for assessing medical group capability to improve care and to test the relationship between survey scores and other factors among 41 medical groups. Methods. The 30 factors and strategies that experienced quality improvement leaders ranked as most important for successful implementation were incorporated in a questionnaire. The scores from 41 medical directors on this Change Process Capability Questionnaire (CPCQ) in relation to depression improvement were correlated with organizational factors. Results. On a 5-point response scale, there was high variation on nearly all CPCQ items (standard deviation, 0.59-1.63) and for overall scores for factors and strategies. The total CPCQ score also correlated highly with organizational priority for depression improvement as well as with the presence of overall systems for depression care. Conclusions. This measure appears to distinguish among medical groups and to demonstrate an association with both change priorities and implemented systems for depression. (Am J Med Qual 2008; 23:193-200)
Institute of Medicine.Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.
2.
McGlynn EA, Asch SM, Adams J., et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635-2645.
3.
Schoen C., Davis K., How SK, Schoenbaum SCU.S. health system performance: a national scorecard [published online ahead of print September 20, 2006]. Health Aff (Millwood). 2006;25:w457-w475.
4.
Ingersoll GL , Kirsch JC, Merk SE, Lightfoot J.Relationship of organizational culture and readiness for change to employee commitment to the organization. J Nurs Adm. 2000;30:11-20.
5.
Solberg LIImproving medical practice: a conceptual framework. Ann Fam Med. 2007;5:251-256.
Flynn BB, Schroeder R., Sakakibara S.Determinants of quality performance in high- and low-quality plants. Qual Manage J. 1995;2:8-25.
8.
Larson PD, Sinha A.The TQM impact: a study of quality managers' perceptions. Qual Manage J. 1995;2:53-66.
9.
Tamimi N., Gershon M., Currall SCAssessing the psychometric properties of Deming's 14 principles. Qual Manage J. 1995;2:38-52.
10.
Davis HR, Salasin S.Readiness for organizational change: decision determinant analysis guide. In: Davidoff I, Guttentag M, Offutt J, eds. Evaluating Community Medical Health Services: Principles and Practice. Rockville, MD: National Institute of Mental Health, the Staff College; 1977:14-20.
11.
Hardison CDReadiness, action, and resolve for change: do health care leaders have what it takes?Qual Manage Health Care. 1998;6:44-51.
Moos RH, Finney JWAlcoholism program evaluations: the treatment domain. Drugs Soc (New York). 1988;2:31-51.
14.
West TDComparing change readiness, quality improvement, and cost management among Veterans Administration, for-profit, and nonprofit hospitals. J Health Care Finance. 1998; 25:46-58.
15.
Blazey MLInsights into organizational self-assessments. Qual Prog. 1998;31:47-52.
16.
Solberg LI, Brekke ML, Kottke TE, Steel RPContinuous quality improvement in primary care: what's happening? Med Care. 1998;36:625-635.
17.
Gustafson DH, Sainfort F., Eichler M., Adams L., Bisognano M., Steudel H.Developing and testing a model to predict outcomes of organizational change . Health Serv Res. 2003;38:751-776.
18.
Farley DO, Haims MC, Keyser DJ, Olmsted SS, Curry SV, Sorbero M.Regional Health Quality Improvement Coalitions: Lessons Across the Life Cycle . Santa Monica, CA: RAND Health ; 2003.
19.
Prochaska JM , Prochaska JO, Levesque DAA transtheoretical approach to changing organizations . Adm Policy Ment Health. 2001;28:247-261.
20.
Solberg LI, Brekke ML, Fazio CJ, et al. Lessons from experienced guideline implementers: attend to many factors and use multiple strategies. Jt Comm J Qual Improv . 2000;26:171-188.
21.
Amundson GM , Frederick J.Making quality measurement work. Minn Med. 2003;86:50-52.
22.
Ncqa.The State of Health Care Quality: 2006. Industry Trends and Analysis. Washington, DC: NCQA; 2006.
23.
Solberg LIRecruiting medical groups for research: relationships, reputation, requirements, rewards, reciprocity, resolution, and respect. Implement Sci . 2006;1:25.
24.
Scholle SH, Pawlson LG, Solberg LI, et al. Measurement of practice systems for chronic illness care: accuracy of self-reports from clinical personnel. Jt Comm J Qual Patient Saf. In press.
25.
Bodenheimer T., Wagner EH, Grumbach K.Improving primary care for patients with chronic illness. JAMA. 2002;288: 1775-1779.
26.
Margolis KL , Solberg LI, Asche SE, Whitebird RRUse of practice system tools by medical groups for depression and other chronic medical conditions. Am J Manag Care. In press.
27.
Kralewski J. , Dowd BE, Kaissi A., Curoe A., Rockwood T.Measuring the culture of medical group practices . Health Care Manage Rev. 2005;30(3):184-193.
28.
Kralewski JE , Dowd BE, Heaton A., Kaissi A.The influence of the structure and culture of medical group practices on prescription drug errors. Med Care. 2005;43:817-825.
