The Patient Care Ownership Scale: Development of an Instrument to Measure Patient Care Ownership Among Internal Medicine Trainees

Background Patient care ownership is essential to delivering high-quality medical care but appears to be eroding among trainees. The lack of an objective measure has limited the study of ownership in physicians. Objective To develop an instrument to measure psychological ownership of patient care. D...

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Veröffentlicht in:Journal of general internal medicine : JGIM 2019-08, Vol.34 (8), p.1530-1537
Hauptverfasser: Djulbegovic, Mia, Beckstead, Jason W., Fraenkel, Liana
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Sprache:eng
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Zusammenfassung:Background Patient care ownership is essential to delivering high-quality medical care but appears to be eroding among trainees. The lack of an objective measure has limited the study of ownership in physicians. Objective To develop an instrument to measure psychological ownership of patient care. Design Cross-sectional study. Participants Internal medicine trainees in a large, academic hospital completing an inpatient rotation. Main Measures Our scale prototype adapted an existing ownership scale (developed in the non-medical setting) based on themes identified in qualitative studies of patient care ownership. We conducted cognitive interviews to determine face validity of the scale items. Our finalized scale measures ownership’s key constructs: advocacy, responsibility, accountability, follow-through, knowledge, communication, initiative, continuity of care, autonomy, and perceived ownership. We distributed an online, anonymous, 46-question survey to 219 residents; 192 residents completed the survey; and 166 responses were included in the analysis. We calculated Cronbach’s α to determine the scale’s internal consistency. Exploratory factor analysis was used to explore possible subscales. We examined construct validity using bivariate and correlational analysis. Key Results The 15-item ownership scale demonstrated good internal consistency (Cronbach’s α  = 0.89). We identified three possible subscales corresponding to assertiveness, being the “go-to” person, and diligence. Training level and prior intensive care unit experience significantly predicted ownership ( p  
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-019-05066-8