Development and validation of the measurement model of total quality management sustainability as perceived by professional nurses in accredited hospitals

Abstract

To develop a Total Quality Management Sustainability (TQMSS) and investigate its reliability and validity. This study was a non-experimental study and used multistage random sampling. The researcher applied both qualitative and quantitative methods. Initially, the scale was developed from integrating the literature reviews with individual interviews of 10 Thai experts and experiences of TQM in hospitals. Later, the steps of DeVellis(1991) were followed in order to construct the items of the scale. To assess content validity a panel of Thai experts evaluated the TQMSS developed by the researcher to be context appropriate. The questionnaire was then administered to 2,565 staff nurses randomly recruited from 13 accredited hospitals. Data analysis was conducted on the 2,165 usable returned questionnaires. The reliability of the instrument, calculated by the Cronbach Alpha Coefficient is 0.96. The content validity index of the TQMSS was 0.88. The data were analyzed by EFA and CFA. The results showed the eight components. For the components of the TQMSS, the eight factors consisted of 65 items and explained a total variance of 53.27%. The resulting eight factors included: (1) Education and training, (2) Leaderships, (3) Drivers, (4) Continuous quality improvement culture, (5) Support and recognition of organization, (6) Interaction and relationships among staff, (7) Cooperation and participation, and (8) Monitoring the results. The 8-factor model of the TQM Sustainability was also tested by confirmatory factor analysis. The model validation of the best-fitted model provided a chi-square goodness-of-fit test of the significant chi-square, was 985.387 (df =981), significant at 0.46 level, chi-square/df =1.00, GFI= 0.99, AGFI=0.97, and RMSEA=0.00. Cronbach’s alpha of large sample was computed to test internal consistency, 0.97.