Table 5

Items Assessing Organizational Change Ability

Recognition Level
ItemOverall (N=249)Level 1, % (n=91)Level 3,a % (n=158)
The clinicians in our practice adhere to practice policies.83.382.283.9
The leaders of our efforts to improve care quality are enthusiastic about their task.b82.374.486.7
The clinicians in our practice espouse a shared mission and policies.79.875.882.1
The working environment in our practice is collaborative and cohesive, with a shared sense of purpose, cooperation, and willingness to contribute to the common good.77.476.977.1
When making changes at our practice, we choose new processes of care that are more advantageous than the old for everyone involved (patients, clinicians, and our entire practice).68.771.167.3
The thinking of our leadership is strongly oriented toward systems.
We have greatly improved the quality of care in the past year.67.361.170.9
We have many clinician and staff champions interested in leading the improvement of care quality.64.258.467.5
Most of the other health care resources in our community (hospitals, community groups, specialist offices) are supportive of the medical home concept.59.559.659.5
Our practice operations rely heavily on organized systems.b58.548.964.1
Our practice attaches more priority to quality of care than to finances.57.762.555.1
We have received feedback from patients that they have benefited from the changes we have made.56.553.358.2
Our practice is undergoing considerable stress as the result of internal changes. (reverse coded)41.947.238.9
Our resources (personnel, time, financial) are too tightly limited to improve care quality now. (reverse coded)b21.128.117.2
Overall score, mean (SD)b,c9.5 (3.0)9.0 (3.2)9.8 (2.8)
  • Note: Values are percentage that agree or strongly agree. Pearson χ2 test for categorical variables and independent samples t tests for continuous variables.

  • a Includes practices that entered the study at Level 3 and practices that advanced from Level 1 to Level 3 during

  • b P <.05, difference by level.

  • c Range: 1 to 14, with higher scores indicating greater change ability.