Participation in Decision Making as a Property of Complex Adaptive Systems: Developing and Testing a Measure

Abstract

Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method. Study 1 was a mail survey of a single respondent (administrators or directors of nursing) in each of 197 nursing homes. Study 2 was a field study using random, proportionally stratified sampling procedure that included 195 organizations with 3,968 respondents. Analysis. In Study 1, we analyzed the data to reduce the number of scale items and establish initial reliability and validity. In Study 2, we strengthened the psychometric test using a large sample. Results. Results demonstrated validity and reliability of the participation in decision-making instrument (PDMI) while measuring participation of workers in two distinct job categories (RNs and CNAs). We established reliability at the organizational level aggregated items scores. We established validity of the multidimensional properties using convergent and discriminant validity and confirmatory factor analysis. Conclusions. Participation in decision making, when modeled as a systems-level property of organization, has multiple dimensions and is more complex than is being traditionally measured. Managers can use this model to form decision teams that maximize the depth and breadth of expertise needed and to foster connection among them.

Exploring the link between clinical managers involvement in budgeting and performance

“…It has been noted that involvement of clinical professionals in decision-making enhances their motivation, commitment, sense-making, and knowledge generation (e.g., Anderson et al, 2013;Ashmos, Duchon, McDaniel, & Huonker, 2002;Kash, Naufal, Dagher, & Johnson, 2010;Liu, 2008). Although the clinical manager role is highly complex and involves a broad set of tasks, literature has repeatedly stressed the beneficial effects of participative budgeting on influencing employee attitudes, motivation, and subsequent organizational behavior and performance (e.g., Covaleski, Evans, Luft, & Shields, 2003;Shields & Shields, 1998).…”

Complex adaptive systems and their relevance for nursing: An evolutionary concept analysis

“…Consequences are events or phenomena that follow an occurrence of the concept (Rodgers & Knafl, 2000, p.111). As for "CAS" identified in this study, consequences were cognitive diversities (Anderson et al, 2005;Lanham et al, 2009), decisional processes (Meagher-Stewart et al, 2010;Grol et al, 2007;Anderson et al, 2005;Agyepong et al, 2012;Bailey et al, 2012;Anderson et al, 2013), information flows (Arrow & Henry, 2010), and integrated cure (Grol et al, 2007;Tsasis et al, 2013;Reeve et al, 2013;Edgren, 2008;Best et al, 2012;Greenhalgh et al, 2012;Havig et al, 2013).…”

“…In a study conducted in Australia (Anderson et al, ), the CAS's key concepts were used to spread the dominant traditional languages and the concept of linearity in the comprehension of health care, of continuity of care and of the sociologic notions of boundary work and patient routes. The Australian researchers claimed that concepts linked to CASs increased the ability to comprehend the interdependent social processes in healthcare organizations (Anderson et al, ). The same scientists came to the conclusion that nursing is a CAS and that the nursing profession itself exhibits CAS characteristics.…”

Irrational use of antibiotics in Iran from the Perspective of Complex Adaptive Systems: redefining the challenge

“…Recently complexity science approach to health, settings and organizations has emerged as a promising approach which can provide a more thorough understanding of complex health issues [24][25][26][27][28][29]. Similarly, applying the Complex Adaptive Systems (CAS) theory, a derivative of complexity science to understand, explore, scale up, evaluate and research in health systems has become popular with researchers in recent years [22,[30][31][32][33].…”