Table 2.

Results of the Factor Analysis of the Clinician Staff Questionnaire

Factors and Items	Attribute Assessed
Adaptive reserve (items loading >.40 across all samples; Cronbach α =.97)
1. We regularly take time to consider ways to improve how we do things	Mindfulness
2. People in our practice actively seek new ways to improve how we do things	Mindfulness
3. People at all levels of this office openly talk about what is and isn’t working	Mindfulness
4. People are aware of how their actions affect others in this practice	Heedful interactions
5. Most people in this practice are willing to change how they do things in response to feedback from others	Respectful interaction
6. This practice encourages everyone (front office staff, clinical staff, nurses, and clinicians) to share ideas	Cognitive diversity
7. I can rely on the other people in this practice to do their jobs well	Trust
8. Difficult problems are solved through face-to-face discussions in this practice	Communication
9. We regularly take time to reflect on how we do things	Reflection
10. After trying something new, we take time to think about how it worked	Reflection
11. The practice leadership makes sure that we have the time and space necessary to discuss changes to improve care	Leadership
12. Leadership in this practice creates an environment where things can be accomplished	Leadership
13. Practice leadership promotes an environment that is an enjoyable place to work	Leadership
14. Leadership strongly supports practice change efforts	Leadership
15. This practice learns from its mistakes	Learning culture
16. It is hard to get things to change in our practice (reverse score)	Learning culture
17. Mistakes have led to positive changes here	Learning culture
18. People in this practice have the information that they need to do their jobs well	Sensemaking
19. When we experience a problem in the practice, we make a serious effort to figure out what’s really going on	Sensemaking
20. I have many opportunities to grow in my work	Teamwork (emergent property)
21. People in this practice operate as a real team	Teamwork (emergent property)
22. Most of the people who work in our practice seem to enjoy their work	Work environment (emergent property)
23. This practice is a place of joy and hope	Work environment (emergent property)
Community knowledge (items loading >.60 across all samples; Cronbach α =.82)	–
1. This practice works effectively together as a team with community organizations	–
2. This practice utilizes community resources to meet the health care needs of patients	–
3. This practice is aware of community resources that are accessible to patients	–
4. People in this practice are connected with community organizations that serve patients	–
Health information technology integration (items loading >.60 across all samples; Cronbach α =.73)	–
1. The electronic medical record is well integrated into the practice’s daily work flow	–
2. The use of the electronic medical record during patient visits interferes with the doctor-patient relationship	–
3. I have what I need to do my work well	–
4. The practice can easily identify patients with a particular disease or medication	–
Cultural sensitivity (items loading >.60 across all samples; Cronbach α =.68)	–
1. I am aware of my racial/ethnic/cultural stereotypes	–
2. I believe cultural issues are important in my interaction with health professional colleagues	–
3. I believe cultural issues are important in my interactions with patients	–
Patient safety culture (items loading >.60 across all samples; Cronbach α =.81)	–
1. Staff feel like their mistakes are held against them	–
2. It is just by chance that more serious mistakes don’t happen in our practice	–
3. Staff worry that mistakes they make are kept in their personal file	–
4. Staff are afraid to ask questions when something does not seem right	–
5. We tend to let setbacks and problems stop our change efforts	–