Document Type


Publication Date


Date of Final Presentation


Committee Chair

Dr. Teresa Serratt

Committee Member

Dr. Pamela Gehrke

Coordinator/ Chair of DNP Program

Dr. Pamela Strohfus

Abstract/ Executive Summary

Background: Research shows that despite an increase in the number of organizational improvement initiatives there is a lack of consistent, sustained outcomes. Organizations struggle with how to reliably and accurately measure their readiness to drive and sustain outcomes. A search of the literature failed to identify a comprehensive, evidence-based tool that has been developed or evaluated to assess organizational improvement readiness. The objective of this project was to evaluate a newly developed Organizational Improvement Readiness Assessment (OIRA) Tool.

Project Design: Guided by two theoretical models, Delphi-Based Systems Architecting Framework (DB-SAF) and the Rogers Diffusion of Innovation Model, a 3-round, modified Delphi nominal group method was utilized. An evaluation panel of 13 organizational improvement subject matter experts (SMEs) was recruited, with 11 SMEs completing all 3 evaluation rounds. The relevancy and clarity of the OIRA Tool competencies was evaluated using an item-level content validity index (I-CVI) and a scale-level content validity index (S-CVI). Additionally, the tool was evaluated from a usability perspective using Google Analytics.

Results: The OIRA Tool was found to be clear, understandable, and relevant for organizations evaluating their readiness to drive and sustain outcomes improvements (S-CVI index of 0.92 and I-CVI indices ranging from 0.82 to 1.0). The final version of the tool included 22 competencies, modified based on expert consensus from the original 25. Usability test results confirmed the OIRA Tool, a web-based tool, is easy to use and well designed as measured by exit rates (15.44%), bounce rates (51.81%), and conversion rates (14%), all of which were significantly better than industry benchmarks.

Recommendations and Conclusions: Results of this project provide evidence of the content validity and usability of the OIRA Tool. The tool has the potential to help healthcare organizations assess their readiness to sustain organizational improvements and to identify gaps in leadership and culture, processes, technologies, and standards. The OIRA Tool provides the foundation for future analytics modeling and additional studies to test the theory and the advancement of outcomes improvement science.

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