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Nurs Outlook. 2015 Nov-Dec;63(6):691-702. doi: 10.1016/j.outlook.2015.05.007. Epub 2015 Jun 11.

Guiding health care transformation: A next-generation, diagnostic remediation tool for leveraging polarities.

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Elsevier/CPM Resource Center, Grand Rapids, MI. Electronic address:
Center for Public Policy and Administration, University of Utah, Salt Lake City, UT; Allscripts, Chicago, IL.



Health care reform is optimized through the Polarity Thinking Model to achieve and sustain improvements in cost, safety, quality, and efficiency. Traditional problem-solving "fix-it" approaches have histories of inadequacy and failure in addressing the multiple polarities inherent in health care transformation. The Polarity Thinking Model is reviewed followed by a study conducted to establish validity and reliability for diagnostic assessment and remediation through leveraging polarities.


Thirteen common health care polarities were identified by an International Consortium, each needing to be leveraged or managed within an organization engaged in health care transformation. A Web-based survey tool was designed to provide leaders with readily interpretable diagnostic information for organizational evaluation regarding how well each polarity is being managed. Four hundred ninety-seven volunteers from two American and two Canadian acute care organizations participated.


Content and context validity were established, and statistically significant reliabilities for the survey instrument were verified. Interpretations of study findings verify the assessment accuracy and interpretive value of the information for leading organizational optimization.


Employing the Polarity Thinking Model and tools to evaluate how well organizations are managing polarities will enhance the organization's ability to self-diagnose and then succeed in achieving transformation toward sustainable desired outcomes.


Assessing polarities; Greater purpose; Leveraging polarities; Sustainable outcomes; The Polarity Thinking Model

[Indexed for MEDLINE]

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