%0 Journal Article
%T Participation in Decision Making as a Property of Complex Adaptive Systems: Developing and Testing a Measure
%A Ruth A. Anderson
%A Donde Plowman
%A Kirsten Corazzini
%A Pi-Ching Hsieh
%A Hui Fang Su
%A Lawrence R. Landerman
%A Reuben R. McDaniel
%J Nursing Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/706842
%X 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. 1. Introduction Participation in decision making (PDM) by workers, including all types of nurses, is recognized internationally as an important aspect of effective management in nursing and healthcare [1¨C5]. Prior researchers, however, have noted deficiencies in the conceptualization of PDM [5, 6]. Two factors, little consensus as to its specific meaning [7] and various definitions [8], contribute to inconsistent findings regarding outcomes of participation. These deficiencies may stem from a simplistic view of PDM [4, 5, 9¨C12], typically measured at the individual level, ignoring systems-level properties. Complexity science suggests that organizations are complex adaptive systems [13, 14] and as such PDM is an emerging property of the system. Emerging properties are generated by local interactions [15] and are particularly important for organizational adaption in complex, chaotic environments, such as the health care environment [16]. Participation emerges as nursing staff and managers of varying expertise and values interact at the local level through a variety of means (e.g., chance encounters, informal meetings, and committee structures) in making
%U http://www.hindawi.com/journals/nrp/2013/706842/