The Culture of Care Barometer as a starting point for dialogue

A positive hospital work environment is very important for staff and patients. That does not only count for attracting and retaining employees, it is also a prerequisite for providing affordable, person-centered and safe care. Unfortunately, we observe that not all hospital employees experience their work environment as positive. To reliably measure these experiences, we were looking for a measurement tool that could provide more objective insight into this experience. Through a Delphi study and systematic literature search, we found the Culture of Care Barometer (CoCB), developed by Rafferty et al. (2017) in the United Kingdom.

This easy-to-fill instrument contains the key elements of the work environment and seemed to be well applicable to the Dutch situation and deserved a Dutch validation effort to the CoCB- NL.

Our research shows that the CoCB-NL is a valid and reliable instrument for identifying elements in the work environment that need improvement. And the instrument was found to be responsive and therefore useful for longitudinal evaluations of the work environment of healthcare workers.

Data collection for this study took place in two teaching hospitals in departments where management had an intrinsic motivation to improve the work environment. After measuring and reporting back the results, great conversations about the results started in these departments. The newly found factor structure proved to better facilitate this dialogue, according to the managers of the departments involved.

While insight only through numbers and graphs is objective, it does not guarantee improvement. We have learned through our studies that dialogue after measurement is very important and should be encouraged.

The CoCB-NL contains an open-ended question and participants' comments can be a beginning of dialogue. However, we also learned that employees do not always feel safe and doubt the anonymous treatment of their responses. It is important for researchers, managers and HR advisors to pay attention to this and treat open answers with value. How we can do this, we will explore in a follow-up study.

Read the latest study here: Measuring the work environment among healthcare professionals: Validation of the Dutch version of the Culture of Care Barometer | PLOS ONE

Maassen S, van Oostveen C, Weggelaar AM, Rafferty AM, Zegers M, et al. (2024) Measuring the work environment among healthcare professionals: Validation of the Dutch version of the Culture of Care Barometer. PLOS ONE 19(2): e0298391. https://doi.org/10.1371/journal.pone.0298391