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Health Services Research & Development

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2008 HSR&D National Meeting Abstract

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National Meeting 2008

3071 — Creation of a High Involvement Work System Scale for Registered Nurses at the VA

Shane AC (HERC), Bartel AP (Columbia University), Stone PW (Columbia University), Phibbs CS (HERC)

Objectives:
A High Involvement Work System (HIWS) is an organizational structure that encourages a work environment characterized by high employee involvement. Many organizations that have implemented HIWS report decreased employee turnover, higher employee satisfaction, greater productivity, higher customer satisfaction, and increased profits. The primary objective of this study is to create an HIWS scale for registered nurses that is formulated from items on the 2004 and 2006 VA All Employee Survey.

Methods:
We identified seven items from the 2004 and 2006 All Employee Survey to formulate our HIWS scale. Using data from the VA Support Service Center (KLF Menu), we extracted the average scores of the seven items for registered nurses at the site level. The 2004 data contains information on 138 VA sites and 15,694 registered nurses, while the 2006 data includes 146 VA sites and 23,462 registered nurses. To test the internal reliability of our HIWS scale, we calculated the Cronbach’s alpha. Finally, we calculated an overall HIWS score per site.

Results:
The seven items we identified for our HIWS scale included the following traits: cooperation, innovation, rewards, opportunity, goal alignment, empowerment, and managerial support. The Cronbach’s alpha for our scale was 0.950 for 2004 and 0.933 for 2006. The maximum possible value for the overall HIWS scores was 35. The range of the overall HIWS scores for the 2004 data was 17.80 to 27.12 with a mean score of 23.06. The 2006 data yielded a range 18.49 to 29.10 with a mean score of 23.15.

Implications:
Using various items from the 2004 and 2006 All Employee Survey, we created an internally reliable scale that demonstrates registered nurses’ reports of the degree to which each VA hospital’s environment reflects the traits of a HIWS.

Impacts:
Our HIWS instrument is a reliable scale that may be used in longitudinal research in the VA setting. Having a reliable HIWS scale allows for the conduct of rigorous studies of how to best promote organizational structures that provide quality healthcare for veterans as well as positive work environments for the registered nurses.


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