Table 1 Final exploratory factor analysis loadings and factor eigenvalues

Eigenvalue

q09. Across my hospital/clinic, leaders at all levels create a safe environment for exposing problems.

0.705

q10. Across my hospital/clinic, senior leaders practice humble inquiry when interacting with employees at all levels of the organization.

0.794

q11. Across my hospital/clinic, leaders at all levels engage employees where the work happens.

0.686

q13. Across my hospital/clinic, leaders at all levels create and sustain an environment of continuous improvement and continuous learning.

0.767

q16. In my unit/department, senior leaders have made an explicit commitment to patient-centered care.

0.576

q29. In my unit/department, senior leaders follow a process for strategy definition and deployment that provides focus at all levels.

0.754

q36. Across my hospital/clinic, leaders at all levels coach to ensure a clear connection between purpose and the work being performed.

0.744

q37. Across my hospital/clinic, leaders at all levels provide employees and staff regular feedback.

0.63

q40. In my unit/department, senior leaders make data driven decisions.

0.621

q43. Across my hospital/clinic, successes gained and failures are shared.

0.538

q02. In my unit/department, management staff use PDSA thinking with the operational units they lead.

0.643

q06. In my unit/department, management staff are committed to lean.

0.774

q07. In my unit/department, physicians are committed to lean.

0.677

q12. Lean has a sponsor/champion and clinical and management staff who demonstrate visible, active, public commitment and support of lean.

0.816

q14. In my unit/department, management staff practice A3 thinking.

0.751

q21. In my unit/department, use of standard work is monitored for compliance.

0.753

q22. In my unit/department, clinical staff use standard work.

0.8

q24. In my unit/department, senior leaders use standard work.

0.78

q25. In my unit/department, work processes are standardized.

0.675

q26. In my unit/department, those who provide care to patients/customers communicate with each other.

0.672

q27. In my unit/department, the communication that occurs among those who provide care to patients/customers is focused on problem-solving rather than blaming each other or others.

0.68

q28. In my unit/department, those who provide care to patients/customers share common goals.

0.751

q32. In my unit/department, clinical staff attend daily huddles.

0.75

q33. In my unit/department, management staff attend daily huddles.

0.642

q38. In my unit/department, a daily management system (e.g., daily huddles, gemba walks, etc) is used.

0.656