Audit and feedback and clinical practice guideline adherence: Making feedback actionable

BACKGROUND: As a strategy for improving clinical practice guideline (CPG) adherence, audit and feedback (A&F) has been found to be variably effective, yet A&F research has not investigated the impact of feedback characteristics on its effectiveness. This paper explores how high performing facilities (HPF) and low performing facilities (LPF) differ in the way they use clinical audit data for feedback purposes. METHOD: Descriptive, qualitative, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low adherence to six CPGs, as measured by external chart review audits. One-hundred and two employees involved with outpatient CPG implementation across the six facilities participated in one-hour semi-structured interviews where they discussed strategies, facilitators and barriers to implementing CPGs. Interviews were analyzed using techniques from the grounded theory method. RESULTS: High performers provided timely, individualized, non-punitive feedback to providers, whereas low performers were more variable in their timeliness and non-punitiveness and relied on more standardized, facility-level reports. The concept of actionable feedback emerged as the core category from the data, around which timeliness, individualization, non-punitiveness, and customizability can be hierarchically ordered. CONCLUSION: Facilities with a successful record of guideline adherence tend to deliver more timely, individualized and non-punitive feedback to providers about their adherence than facilities with a poor record of guideline adherence. Consistent with findings from organizational research, feedback intervention characteristics may influence the feedback's effectiveness at changing desired behaviors

How Do Employees Perceive Corporate Responsibility? Development and Validation of a Multidimensional Corporate Stakeholder Responsibility Scale

Recent research on the microfoundations of corporate social responsibility (CSR) has highlighted the need for improved measures to evaluate how stakeholders perceive and subsequently react to CSR initiatives. Drawing on stakeholder theory and data from five samples of employees (N = 3,772), the authors develop and validate a new measure of corporate stakeholder responsibility (CStR), which refers to an organization’s context-specific actions and policies designed to enhance the welfare of various stakeholder groups by accounting for the triple bottom line of economic, social, and environmental performance; it is conceptualized as a superordinate, multidimensional construct. Results from exploratory factor analyses, first- and second-order confirmatory factor analyses, and structural equation modeling provide strong evidence of the convergent, discriminant, incremental, and criterion-related validities of the proposed CStR scale. Two-wave longitudinal studies further extend prior theory by demonstrating that the higher-order CStR construct relates positively and directly to organizational pride and perceived organizational support, as well as positively and indirectly to organizational identification, job satisfaction, and affective commitment, beyond the contribution of overall organizational justice, ethical climate, and prior measures of perceived CSR

Teachers as leaders: A moderator variable approach

A review of research on teachers as leaders shows that current approaches have produced unclear and inconsistent results. A new approach--viewing teachers in a situational context--is suggested. 155 students filled out 2 questionnaires; the 1st (administered during the 5th wk of class) contained measures of teacher leadership behavior and student role clarity, and the 2nd (administered during the 10th wk) measured overall student satisfaction with the class. Student performance was also assessed at the 10th wk. It was found that (a) student performance significantly correlated with teacher supportiveness and directiveness under low role clarity but not high role clarity, and (b) the differences in these correlations were statistically significant. (23 ref

The effect of leniency on leader behavior descriptions

This article reports the results from five studies designed to estimate the magnitude and effects of leniency on subordinate-provided descriptions of leader Consideration and Initiating Structure. Using a newly developed scale to measure leniency response bias (the tendency to describe others in favorable but probably untrue terms), the results of the studies indicate that subordinate reports of leader Initiating Structure are not particularly susceptible to the effects of leniency. The results for Consideration, however, showed that: (1) consideration items were not socially neutral and were susceptible to leniency; (2) consideration reflected an underlying leniency factor when applied in a field setting; (3) leniency explained a substantial proportion of the variation involved in Consideration-dependent variable correlations; and (4) this did not appear to result from conceptual overlap between Consideration and leniency, but rather from spurious correlation through the susceptibility of the measures to the effects of leniency. The importance of these findings for leadership research are discussed, and several alternatives for the control of leniency in leader behavior description are discussed

Assessing the Construct Validity of the Job Descriptive Index A Review and Meta-Analysis

The construct validity of the Job Descriptive Index (JDI) was investigated by using a meta-analysis to summarize previous empirical studies that examined antecedents, correlates, and consequences of job satisfaction. In total, 79 unique correlates with a combined total of 1,863 correlations were associated with the JDI subdimensions. The construct validity of the JDI was supported by (a) acceptable estimates of internal consistency and test-retest reliability, (b) results that conform to a nomological network of job satisfaction relationships, and (c) demonstrated convergent and discriminant validity. Contrasting results with previous meta-analytic findings offered further support for the JDI's construct validity. Limitations of the JDI and suggestions for future research are discussed