Supportive Organizational Context Research Articles

There is No End to Learning, but How Does it Begin? A Meta‐Analysis of the Team Learning Pathway

AbstractWe complete a meta‐analytic investigation across two phases to increase understanding about team learning, an important process that is a challenge for teams to enact. In the first phase, we create a meta‐analytic database of 198 independent samples (N = 15,536 teams) to summarize the strength of the relationships between learning and team antecedents and outcomes. Motivational emergent states (e.g., potency) exhibited the strongest relationship with learning, followed by affective (e.g., psychological safety) and cognitive (e.g., trust) emergent states. Our results also highlight the positive relationship between learning and various antecedents, including team structure, supportive organizational context, environmental uncertainty, cognitive diversity, and gender diversity. In the second phase, we create an additional meta‐analytic database with 53 independent samples (N = 4,468 teams) to test a serial mediation model, demonstrating that psychological safety and learning serially mediate the relationships between team learning orientation and salient team outcomes (i.e., performance and innovation).

The loyalty imperative: Understanding the link between organizational culture and employee commitment

Organizational commitment (EOC) and employee loyalty are two critical constructs that contribute to organizational success. Understanding the intricate relationship between these factors is essential for organizations seeking to cultivate a loyal and committed workforce. This study delves into the mediating effect of EOC on employee loyalty, examining the mechanisms through which organizational culture fosters a loyal workforce. To investigate the mediating role of EOC, a sample of 300 employees from the Indonesian Port Corporation was surveyed. Path analysis, a statistical technique that assesses the strength and direction of relationships between multiple variables, was employed to test the study’s hypothesis. The findings revealed a strong association between organizational culture, EOC, and employee loyalty. Organizational culture dimensions, particularly teamwork, respect for individuals, stability, attention to detail, and outcome orientation, were positively related to EOC and employee loyalty. Furthermore, EOC was found to mediate the relationship between organizational culture and employee loyalty, indicating that EOC plays a crucial role in shaping employee loyalty within a supportive organizational culture context. These findings underscore the importance of fostering EOC to enhance employee loyalty and organizational success. Organizations seeking to cultivate a loyal workforce should create a supportive organizational culture that promotes teamwork, respect for individuals, stability, attention to detail, and outcome orientation. By nurturing these cultural traits, organizations can foster a strong sense of EOC among their employees, increasing employee loyalty, productivity, and organizational growth.

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

BackgroundA well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource–constrained settings.MethodsWe designed a convergent mixed-methods study to understand the experiences of mentees, mentors, hospital leaders, and external stakeholders with the mentorship intervention. Quantitative data was collected through a survey (n = 25) and qualitative data through in-depth interviews (n = 26) in 2018 to gather information on (1) intervention characteristics including areas of mentorship, mentee-mentor relationships, and mentor characteristics, (2) organizational context including facilitators and barriers to implementation, (3) perceived impact, and (4) respondent characteristics. We analyzed the quantitative and qualitative data using frequency analysis and the constant comparison method, respectively; we integrated findings to identify themes.ResultsAll mentees (100%) experienced the intervention as positive. Participants perceived impact as: safer and more frequent surgical procedures, collegial bonds between mentees and mentors, empowerment among mentees, and a culture of continuous learning. Over 70% of all mentees reported their confidence and job satisfaction increased. Supportive intervention characteristics included a systems focus, psychologically safe mentee-mentor relationships, and mentor characteristics including generosity with time and knowledge, understanding of local context, and interpersonal skills. Supportive organizational context included a receptive implementation climate. Intervention challenges included insufficient clinical training, inadequate mentor support, and inadequate dose. Organizational context challenges included resource constraints and a lack of common understanding of the intervention.ConclusionWe offer lessons for intervention designers, policy makers, and practitioners about optimizing surgical mentorship interventions in resource-constrained settings. We attribute the intervention’s success to its holistic approach, a receptive climate, and effective mentee-mentor relationships. These qualities, along with policy support and adapting the intervention through user feedback are important for successful implementation.

An exploratory case study investigating the implementation of a novel knowledge translation strategy in a pandemic: the Pandemic Practice Champion

BackgroundThe clinical Pandemic Practice Champion (PPC) role was created in a large tertiary pediatric hospital as a knowledge translation (KT) strategy for implementing COVID-19 evidence-based knowledge. We aimed to describe the core components of the PPC role, the process of implementing the role, and the factors that hindered or facilitated role implementation.MethodsAn exploratory case study was undertaken. Semi-structured interviews were conducted virtually with stakeholders including PPC, managers, and front-line health care professionals (HCP). A directed approach to qualitative content analysis consistent with the Consolidated Framework for Implementation Research (CFIR) guided the analytic process. Inductive analyses and three stages of thematic synthesis were also conducted.ResultsFour PPC, 3 managers, and 6 HCP were interviewed. The core components of the PPC role consisted of (a) acting as knowledge experts and educators, (b) problem-solving for complex patient care issues, (c) conducting crisis management, and (d) acting as a resource to management, HCP, and families. Facilitators for successful implementation included access to external information, a supportive organizational context and culture, dedicated time and resources, and leadership support. Lack of clarity of role definition, insufficient time, pandemic uncertainty and fatigue, inability to change infrastructure, and access to external information hindered implementation.ConclusionThe PPC role was successfully implemented within a crisis context. Key barriers (role clarity, time, resources) and facilitators (organizational and leadership support) need to be considered when implementing the PPC role in practice. Future studies are needed to determine the intervention effectiveness of the champion role in changing HCP behavior and health outcomes and further examine implementation processes and mechanisms.

Defining a Supportive Organizational Context for IPC in Primary Care: A Mixed Methods Study

Health, Interprofessional Practice and Education is a peer-reviewed, open access journal dedicated to increasing the availability of high-quality evidence to inform patient care and practitioner education from an interprofessional perspective. HIPE is aimed at academics, practitioners and student-practitioners who seek to become more knowledgeable and skilled at working with providers in other health disciplines for the purpose of providing compassionate, quality, integrated care to diverse patient populations.HIPE is published by Pacific University Libraries | ISSN 2641-1148

Development of real world learning opportunities in community exercise prescription for healthcare professional programmes - \u2018Physio Hub\u2019

BackgroundGiven the challenge of chronic lifestyle diseases, the shift in healthcare focus to primary care and recognised importance of a preventive approach to health, including exercise prescription, the embedding of related learning in healthcare professional programmes is critical.MethodsIn response to these contemporary demands, a complex curriculum development project was undertaken at University College Dublin, employing a four dimensional curriculum framework for the development of health professional curricula, that focused on (1) future orientation of healthcare practices (the why?), (2) defining capabilities of graduates (the what?), (3) teaching, learning and assessment (the how?) and (4) organisation/institution delivery (the where)? The process was informed by latest exercise, health promotion, educational and health policy literature, alongside engagement with multiple internal university and external community stakeholders.ResultsHaving sufficient clinical education opportunity for translating exercise theory into practice was identified as a key need (the Why?). Development of strategies for health promotion and design and delivery of evidence based exercise programmes with inter-professional and inter-sectoral network building were some of the graduate capabilities identified as being critically important. (the what?) The resultant UCD Physio Hub model of clinical education combines ‘on campus’ and ‘community outreach’ activity to facilitate inter-sectoral ‘real world’ experiential student learning in health promotion and exercise prescription for both healthy and clinical populations. Underpinned by social constructivist educational theory, students are encouraged to be creative and to collaborate in responding to identified health needs of specific community groups by designing and delivering community services. (the how?) In developing new student learning opportunities to enhance curriculum, a supportive organisational culture and context was critical with UCD having excellent exercise infrastructure and the Physio Hub project aligning with a community engagement ethos articulated in the university’s strategy. (the where?)ConclusionThis paper provides an overview of Physio Hub, its services, educational practices and translational research ethos, all of which are combined to deliver a rich exercise and health promotion learning experience. Although developed for physiotherapy in this instance, the curriculum process and resultant education model could be applied across medical and other health professional programmes and to facilitate interdisciplinary learning.

Supportive Organizational Context for Teams: A Study of Construct Validity

Despite a call within scientific literature to better account for contextual factors in team studies, very little research has systematically analyzed the potentially critical role of such factors, thus limiting organizations’ ability to provide contextual conditions that would foster team effectiveness. The Supportive Organizational Context for Teams (SOCT) construct effectively captures some of these factors (rewards, information, education, and resource allocation). However, while the internal consistency of the SOCT has been analyzed, its multidimensional representation has never been tested. In this study, we address these limitations by assessing the factor structure of a measure proposed by Wageman et al. (2005) and of its distinctive nature in relation to Perceived Organizational Support. Using a sample of 235 participants and the newly developed bifactor-ESEM framework, this study supports the notion that a high-order model is superior to a first-order model, and SOCT and Perceived Organizational Support are distinct from one another.

Aligning Perspectives?—Comparison of Top and Middle-Level Managers’ Views on How Organization Influences Implementation of evidence-based practice

Abstract A supportive organizational context is important for successfully implementing evidence-based practice (EBP). Managers have an important role in creating organizational prerequisites for EBP. The present study compared how top- and middle-level managers describe the process of implementing EBP and the factors influencing this process. Data were collected through interviews with twenty-two managers in social services, and analysed with thematic deductive analysis based on the Theoretical Domains Framework (TDF) and the COM-B model. Findings showed that top-level managers focused more on strategic- and system-level issues, e.g. external comparisons, dialogue with authorities and creating support systems, while the middle managers focused on the operative implementation at staff level, i.e. motivating and involving staff. Furthermore, the two groups had different understandings of EBP. To conclude, there needs to be an alignment in the understanding of, and support for, EBP between the different levels of managers. To create a mutual understanding of what EBP entails and to clearly communicate how the organization applies the different steps of the EBP process could be crucial steps in enabling the implementation of EBP, and needs to be done in dialogue between middle- and top-level managers.

Collaborative capacity and patient-centered care in the Veterans' Health Administration Community Living Centers.

Previous research in acute care settings has shown that collaborative capacity, defined as the way providers collaborate as equal team members, can be improved by the ways in which an organization supports its staff and teams. This observational cross-sectional study examines the association between collaborative capacity and supportive organizational context, supervisory support, and person-centered care in nursing homes to determine if similar relationships exist. We adapted the Care Coordination Survey for nursing homes and administered it to clinical staff in 20 VA Community Living Centers. We used random effects models to examine the associations between supportive organizational context, supervisory support, and person-centered care with collaborative capacity outcomes including quality of staff interactions, task independence, and collaborative influence. A total of 723 Community Living Center clinical staff participated in the Care Coordination Survey resulting in a response rate of 29%. We found that teamwork and collaboration-measured as task interdependence, quality of interactions and collaborative influence-did not differ significantly between Community Living Centers but did differ significantly across occupational groups. Moreover, staff members' experiences of teamwork and collaboration were positively associated with supportive organizational context and person-centered care. Our findings suggest that elements of organizational context are important to facilitating collaborative capacity. Additionally, investing in staffing, rewards, and person-centered care may improve teamwork.

Beyond Formal Access: Organizational Context, Working From Home, and Work\u2013Family Conflict of Men and Women in European Workplaces

Working from home has become engraved in modern working life. Although advocated as a solution to combine work with family life, surprisingly little empirical evidence supports that it decreases work–family conflict. In this paper we examine the role of a supportive organizational context in making working from home facilitate the combination of work and family. Specifically, we address to what extent perceptions of managerial support, ideal worker culture, as well as the number of colleagues working from home influence how working from home relates to work–family conflict. By providing insight in the role of the organizational context, we move beyond existing research in its individualistic focus on the experience of the work–family interface. We explicitly address gender differences since women experience more work–family conflict than men. We use a unique, multilevel organizational survey, the European Sustainable Workforce Survey conducted in 259 organizations, 869 teams and 11,011 employees in nine countries (Bulgaria, Finland, Germany, Hungary, Netherlands, Portugal, Spain, Sweden, United Kingdom). Results show that an ideal worker culture amplifies the increase in work family conflict due to working from home, but equally for men and women. On the other hand, women are more sensitive to the proportion of colleagues working from home, and the more colleagues are working from home the less conflict they experience.

Unpacking the coexistence between improvement and innovation in world-class manufacturing: A dynamic capability approach

Recent contributions in management and organizational literature call for research to investigate how companies can simultaneously pursue initiatives of improvement and innovation. Questions also remain about the extent to which a commitment to continuous improvement hinders innovation. Blending organizational literature with lean management literature on Just in Time, we propose a model that shows how improvement and innovation can co-exist within the same manufacturing plant. We test our hypotheses on an international database using structural equation modelling. Findings show that improvement and innovation coexist within those plants that nurture a supportive organizational context and implement JIT at the same time. While a supportive organizational context is necessary for the coexistence of innovation and improvement, JIT acts as a catalyst that provides resources to innovation activities and incentivizes the firm to replace ill-designed products and processes. Our study offers original contributions that lie at the intersection of operations management and organizational literatures.

Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers

BackgroundOperating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood. We examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises.MethodsWe conducted a cross-sectional study using a Web-based survey of individuals who had downloaded OR cognitive aids from the websites of Ariadne Labs or Stanford University between January 2013 and January 2016. In this paper, we report on the experience of 368 respondents from US hospitals and ambulatory surgical centers. We analyzed the relationship of more successful implementation (measured as reported regular cognitive aid use during applicable clinical events) with organizational context and with participation in a multi-step implementation process. We used multivariable logistic regression to identify significant predictors of reported, regular OR cognitive aid use during OR crises.ResultsIn the multivariable logistic regression, small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation (p = 0.0092). Completing more implementation steps was also significantly associated with more successful implementation; each implementation step completed was associated with just over 50% higher odds of more successful implementation (p ≤ 0.0001). More successful implementation was associated with leadership support (p < 0.0001) and dedicated time to train staff (p = 0.0189). Less successful implementation was associated with resistance among clinical providers to using cognitive aids (p < 0.0001), absence of an implementation champion (p = 0.0126), and unsatisfactory content or design of the cognitive aid (p = 0.0112).ConclusionsSuccessful implementation of cognitive aids in ORs was associated with a supportive organizational context and following a multi-step implementation process. Building strong organizational support and following a well-planned multi-step implementation process will likely increase the use of OR cognitive aids during intraoperative crises, which may improve patient outcomes.

Introducing conflict as the microfoundation of organizational ambidexterity

This article contributes to our understanding of organizational ambidexterity by introducing conflict as its microfoundation. Existing research distinguishes between three approaches to how organizations can be ambidextrous, that is, engage in both exploitation and exploration. They may sequentially shift the strategic focus of the organization over time, they may establish structural arrangements enabling the simultaneous pursuit of being both exploitative and explorative, or they may provide a supportive organizational context for ambidextrous behavior. However, we know little about how exactly ambidexterity is accomplished and managed. We argue that ambidexterity is a dynamic and conflict-laden phenomenon, and we locate conflict at the level of individuals, units, and organizations. We develop the argument that conflicts in social interaction serve as the microfoundation to organizing ambidexterity, but that their function and type vary across the different approaches toward ambidexterity. The perspective developed in this article opens up promising research avenues to examine how organizations purposefully manage ambidexterity.

Ambidexterity of employees: the role of empowerment and knowledge sharing

PurposeThe aim of this study is to empirically test the link between employee ambidexterity and two supportive organizational cultures, namely, a perceived culture of empowerment and a knowledge-sharing culture. Furthermore, the paper addresses the mechanisms through which these supportive organizational cultures work to enable employees to engage in ambidextrous behaviour. Specifically, the role of intrinsic motivation is investigated.Design/methodology/approachData were obtained from 136 managers employed in the five main Belgian service sectors.FindingsThe findings indicate that a perceived culture of empowerment is positively related to intrinsic motivation, which in turn facilitates employee ambidexterity. Also, a moderating effect of extrinsic motivation on employee ambidextrous behaviour is found. At the same time, a perceived knowledge-sharing culture is having no effect on ambidexterity or intrinsic motivation.Research limitations/implicationsInsights into the roles of individuals in achieving ambidexterity help to advance the theoretical understanding of how a supportive organizational context may enhance employee ambidexterity.Originality/valueDespite the growing body of research on antecedents of ambidexterity, there is still lack of thorough understanding of how a supportive organizational context may enhance employee ambidexterity and the roles of individuals in achieving ambidexterity. This is one of the first studies that investigate these factors in relation to individual level ambidexterity (as opposed to organization level ambidexterity).

Personality and transformational leadership: The moderating effect of organizational context

Understanding the antecedents of transformational leadership is an important issue, given the potential benefits of this leadership style. Based on the trait activation model (Tett & Burnett, 2003), this study aimed at testing the moderating role of the organizational context on the relationship between personality and transformational leadership. Results from regression analyses on a sample of 89 leaders and their 643 followers show that leaders who have relationship-oriented personalities emerge as transformational leaders only when they evolve in a supportive organizational context. These results support the relevance of considering the effect of individual factors and contextual factors together to better understand the conditions that are conducive to the adoption of transformational leadership.

Testing a comprehensive model of implementation and sustained use for EBTs for PTSD: A national investigation in VA residential settings

The national roll-outs of evidence-based psychotherapies in the Department of Veterans Affairs (VA) afford an unusual opportunity to study both implementation and sustainability. Although unique in some aspects of management and resources, the VA also serves as an excellent laboratory to understand the implementation of best practices as it is a more organized and controlled environment, free of the barriers faced in other more fragmented segments of the U.S. health care system. In a two-year NIMH grant, we utilized a theory-based model to collect baseline data regarding the adoption of two evidence-based treatments for Posttraumatic Stress Disorder (PTSD), Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), in a national sample of 38 VA PTSD residential treatment programs with over 200 providers. In a subsequently funded NIMH R01, we are extending our investigation with the same population and model to see: (1) how well PE and CPT are sustained over time, (2) what organizational and individual factors influence sustainability, and (3) what effects implementation and sustained use of PE and CPT have on patient outcomes. Implications for implementation in and outside of the VA health care system will be discussed. Updates on measurement of a model of implementation for health care: advances toward a testable theory One comprehensive theoretical model for understanding implementation of innovations was initially developed by Rogers (1962) and elaborated on by others (Greenhalgh et al. 2005). This model construed implementation as a complex process influenced by five broad constructs: (a) perceived characteristics of innovation, (b) potential adopter characteristics, (c) communication and influence, (d) system antecedents and readiness, and (e) outer context. Although a considerable evidence-base was used to develop the model, the authors did not fully operationalize their model, making it difficult to test formally. Our group undertook a systematic review of the literature and, using an iterative process, we examined existing measures and utilized or adapted items. Where no one measure was deemed appropriate, we developed other items to measure the constructs through consensus. The review and iterative process of team consensus identified three types of data that could be used to operationalize the constructs in the model: survey items, interview questions and administrative data. Over three waves of data collection concerning the implementation of two evidence-based psychotherapies disseminated nationally within Department of Veterans Affairs, we have made changes to the quantitative measurement of aspects of this model including the exclusion of the measurement of some constructs (e.g., learning style, locus of control, tolerance of ambiguity) as well as refinement of others (e.g., needs, motivation, knowledge-seeking). This presentation will review these changes as well as psychometric properties of other constructs and their items. Testing the model using quantitative data for implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: outcomes for two yearly time points This study examined the implementation of two evidence-based psychotherapies, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), in the Department of Veterans Affairs (VA) residential Posttraumatic Stress Disorder treatment programs. The current analyses focused on continued implementation a year after an initial assessment of implementation and of provider and site variables thought to be related to implementation. Seventy-five providers from 38 programs provided complete quantitative data on both baseline and follow-up. At one year follow-up, there was continued effect of supportive organizational context (i.e., dedicated time and resources and incentives and mandates) on the implementation of both PE and CPT delivered in a group format. Unlike at baseline, effects of perceived characteristics of treatment on implementation of PE and of supportive organizational context on CPT delivered individually were no longer significant. Rather, social connections predicted a lower likelihood of implementation of CPT individually. These effects all remained, even after taking into account baseline levels of implementation. Implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: patient-level outcomes This presentation will discuss the effects of implementation of two EBTs for PTSD (PE and CPT) in the U.S. Department of Veterans Affairs (VA) residential treatment programs on patients' PTSD symptom severity, alcohol and drug use, and treatment satisfaction. The instruments were administered to patients upon admission and four months post-discharge. The short form of the Mississippi Scale for Combat-Related PTSD was used to measure PTSD and alcohol and drug abuse were measured using the composite indexes from the Addiction Severity Index. Controlling for length of stay and baseline symptoms, implementation of PE and CPT predicted improvement in PTSD symptom severity and alcohol use. The implications of these findings are that two EBTs for PTSD can be feasibly and effectively disseminated to routine clinical settings and implementation produces favorable patient outcomes.

Public Employees and Performance Appraisal

There is considerable agreement that organizations can benefit from using performance appraisal. Nevertheless, some studies find that both supervisors and employees have negative reactions to the process. This article addresses this contradiction by emphasizing the importance of cognitive aspects of performance appraisal. Without understanding individual employees’ reactions to performance appraisal and its supportive organizational context, it is less likely for performance appraisal to be used for its original objective, which is performance improvement. Given the importance of employee acceptance of a performance measurement system, this article attempts to identify key factors which can heighten employee acceptance of performance appraisal using data from the 2005 Merit Principles Survey. The findings indicate that the developmental use of performance appraisal, employee participation in performance standard setting, the quality of the relationship they have with their supervisors, and employee perceived empowerment are positively associated with employee acceptance of performance appraisal.

A Quantitative Test of an Implementation Framework in 38 VA Residential PTSD Programs.

This study examines the implementation of two evidence-based psychotherapies, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), in the Department of Veterans Affairs residential Posttraumatic Stress Disorder treatment programs. Two hundred and one providers from 38 programs completed an online survey concerning implementation of PE delivered on an individual basis and CPT delivered in individual and group formats. For PE, a supportive organizational context (dedicated time and resources, and incentives and mandates) and overall positive view of the treatment were related to its implementation. For both group and individual CPT, only the supportive organizational context was significantly associated with outcome. Implications for implementation efforts are discussed.

Identity, selfhood and dementia: messages for social work

Dementia has been identified as a policy priority area for the European Union (EU). Given projected figures on the global increase in dementia over the next few decades, working with people with dementia is likely to become an even more prominent area of activity for social workers in older people's services. Recent research has begun to engage with the subjective experiences of people with dementia and there is considerable focus within nursing literature on their active efforts to maintain identity and selfhood. However, these issues have received little attention within the domain of social work. This paper reviews recent research on the subjective experiences of people with dementia and discusses the implications for social work in relation to: early intervention; communication and assessment, and support arrangements. Based on experience in England, it is argued that the current policy and practice context constrains social work's ability to respond to these issues and that a supportive organisational context, as well as high levels of skill, time and commitment, are required if concepts of personhood and citizenship are to have meaning in practice.

An Exploration of the Factor Structure of the Nursing Work Index

The nurse shortage is increasing in the developed world. Organisational context is important in determining issues associated with nurse shortages, such as retention, recruitment, and job satisfaction. Recent research has utilised the Nursing Work Index-Revised (NWI-R) as a measure of organisational context traits. Within the NWI-R a four-factor model has been reported as being important in determining good organisational context, yet researchers have recently questioned the stability of the four-factor structure. No known study has attempted to replicate the four-factor structure reported in the NWI-R. The aim of this research is to examine the factor structure of the 15 items that comprise the four factors of the NWI-R. The NWI-R is an instrument that is focused on capturing organisational attributes that characterise professional nursing environments. A random sample of 172 (50%) acute care hospital nurses completed the NWI-R as part of a larger research project. The sample was diverse concerning nursing grade and specialty. Data were analysed using SPSS.11.0 to extract factors' structures (principal component and maximum likelihood), measures of homogeneity and descriptive statistics were generated from the findings. The four-factor structure of the NWI-R was not replicated in the data analysis. Instead a modified three-factor structure was identified accounting for 57% of the variance. Measures of internal consistency were acceptable. Previous research utilised the four factors of the NWI-R as a method to identify supportive organisational context and practice. The three-factor model raises questions regarding the stability of the findings using the NWI-R. This research shows the synthesis of the two models in light of previous findings. The findings might have far reaching implications for research that has utilised the NWI-R as a measure of organisational context. Further research is required to examine this study's findings and literature.