This form provides guidance in interpreting reports from the Readiness Assessment Tool database, assessing trends in your organization.
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The data collected through completion of the Readiness Assessment Tool can be entered into the Microsoft® Access database provided. This database can then be used to generate two data reports: an Item Response Report and a Score Report. Examples of these reports are provided at the end of this document.
This report provides information on the percentage of staff responding "strongly disagree," the percentage responding "disagree," etc. to each statement (referred to as an item) in the tool. The report also provides a mean, or average, score for each item. Mean scores indicate the average level of agreement with an item. The maximum possible mean score for each item is 5.0. Item mean scores between 4.0 and 5.0 are generally considered to be high. Item mean scores between 1.0 and 2.9 are generally considered to be low. Item mean scores between 3.0 and 3.9 are generally considered to be neutral or average.
The percentages and mean scores are calculated for all staff as well as for three staff subgroups: front-line staff (e.g., certified nurse assistants), middle management (e.g., charge nurses, unit nurses, front-line supervisors) and upper management (e.g., director of nursing, assistant director of nursing, director of staff development, department heads, administrator).
This report provides a mean, or average, score for the whole tool as well as for each of the domains and subdomains that comprise the tool. These mean scores indicate the overall level of agreement with all items in the tool or in a given domain or subdomain.
As with the item response report, the score report provides total mean scores for all staff as well as for the aforementioned three staff subgroups: front-line staff, middle management, and upper management.
The maximum possible mean score for the tool as a whole is 380.
The maximum possible mean scores for each domain and subdomain are as follows:
| Domain | Score |
|---|---|
| Philosophy Toward QI | 90 |
| Organizational Commitment to QI | 55 |
| Management Involvement in QI | 15 |
| Staff Involvement in QI | 20 |
| Information Culture | 55 |
| Documentation | 40 |
| Use of Information Technology | 15 |
| Work Environment | 235 |
| Work Design | 60 |
| Leadership Support | 40 |
| Worker-Supervisor Relationship | 40 |
| Teamwork | 30 |
| Communication/Information Sharing | 40 |
| Cultural Competence/Cultural Diversity | 25 |
At this stage in the development of the readiness assessment tool, there is not enough information to provide distinct ranges for what are "high" and "low" mean scores, either for the tool as a whole or for any given domain or subdomain. However, generally, if the maximum possible mean score is divided by 2, then any score below the resulting number can be considered a relatively low score and any score above the resulting number can be considered a high score. For example, the maximum possible mean score for the tool is 380. When 380 is divided by 2, the resultant number is 190. Thus, a mean score less than 190 can be considered relatively low, indicating a lesser degree of overall organizational readiness. A mean score greater than 190 can be considered relatively high, indicating a greater degree of overall organizational readiness.
A greater percentage of staff responding that they either "strongly agree" or "agree" with an item indicates a greater degree of organizational readiness in the area addressed by that particular item. However, it is important to keep in mind that the percentage of "strongly agree" and/or "agree" responses should not be examined in isolation but rather examined together with the percentage of each of the other responses. The importance of this can be illustrated through an example:
| Item | Strongly Disagree | Disagree | Neither Disagree nor Agree | Agree | Strongly Agree |
|---|---|---|---|---|---|
| Item X | 0% | 2% | 8% | 40% | 50% |
| Item Y | 0% | 40% | 0% | 0% | 60% |
In this example, 90 percent of staff responded either "strongly agree" or "agree" to Item X, indicating a strong overall level of agreement and readiness. However, for Item Y, 60 percent of staff said they "strongly agree" but the remaining 40 percent responded "disagree." Thus, although a majority responded "strongly agree" to Item Y, a large percentage disagreed with the item. This presents a much different picture–and a much different assessment of readiness–than does Item X. Not only is there a lesser percentage of staff who either "strongly agree" or "agree" with Item Y, there is also obvious discrepancy of staffs' viewpoints on this item. This discrepancy is indicative of a lesser degree of organizational readiness.
Higher mean scores for an item indicate a greater degree of readiness in the area addressed by this item. Unlike the response percentages, mean scores do not provide a breakdown of responses by response category. Thus, mean scores may be less informative than response percentages. However, mean scores can be extremely useful in examining change in scores over time, i.e., for examining trends within an organization.
A lower overall mean score indicates a lesser degree of organizational readiness for quality improvement activities. However, it is the domain and subdomain mean scores that will be most informative in determining the particular areas in which organizational readiness is lacking. Any domain or subdomain receiving a low mean score represents an area which an organization should address prior to and/or during its quality improvement activities.
It is possible for the overall mean score for the tool to be relatively high while one or more domain or subdomain mean scores remain low. Thus, it is extremely important that the overall mean score not be used as the only indicator of an organization's readiness for change. Domain and subdomain mean scores should always be examined in conjunction with the overall mean score.
It is crucial to the success of any quality improvement (QI) initiative that various subgroups of staff are in agreement as to the current state of readiness of an organization. Therefore, if the response percentages, item mean scores and/or total mean scores (overall and by domain and subdomain) of the various levels of staff (front-line, middle management, upper management) are not similar, this is an indication of a low degree of readiness. For example, upper management may score high on the domain of Work Environment while middle management and front-line staff score low, indicating that upper management's perceptions of the organization's work environment differ from those of middle management and front-line staff. If not addressed, these differing perceptions can be carried into the QI process and may present significant challenges in implementing QI activities, particularly activities that one group of staff deems necessary and important but that other groups of staff do not. Thus, it is essential that before and/or during the QI process, an organization addresses the specific areas where discrepancies exist between various levels of staff.
Current as of June 2007
Internet Citation:
Scoring Form. Generating and Interpreting Reports from the Readiness Assessment Tool. On-Time Quality Improvement for Long-Term Care. June 2007. Rockville, MD, Agency for Healthcare Research and Quality. http://www.ahrq.gov/research/ltc/puscoringform.htm
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