Design and psychometric properties of a questionnaire to assess quality management of health care services: a sequential exploratory study
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Keywords
Healthcare, Quality Management, Questionnaire
Abstract
Background: Quality management is one of the most effective programs for improving the performance of healthcare systems.
Aims: This study aimed to develop and assess the psychometric properties of a questionnaire to assess the quality management of healthcare services in Iranian hospitals.
Methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. This study was conducted in the two phases of identifying and designing the items and evaluating the psychometric properties of the instrument. In the preliminary phase, quality management models in healthcare systems were reviewed. In the second phase, the psychometric evaluation of the instrument was done using face and content validity, construct validity, and reliability.
Results: A total of 293 completed questionnaires were returned. Six main dimensions and 30 variables were identified according to the factor loadings. The dimensions of the final questionnaire included leadership, human resources, financial resources, planning, control, and process approach. Cronbach's alpha coefficients for each subscale were acceptable, ranging from 0.85 to 0.93, and for the total scale, it was 0.96. Confirmatory factor analysis by Amos software was performed afterwards to confirm the relationship between each of the variables and the main dimensions. Confirmatory factor analysis demonstrated a five-factor model, all of whose fit indices were acceptable, except for the goodness-of-fit index and normed fit index (Normed chi-square [χ2/df] = 2.35, RMSEA = 0.066, TLI = 0.907, CFI = 0.906, AGFI = 0.899).
Conclusion: The dimension of leadership has the greatest impact on the quality management of healthcare services in Iran. It seems that with continuous planning on the quality of management at the ministry level in the Iranian health system, this dimension can significantly contribute to improving the quality of healthcare services.
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