Psychometric analysis of the leadership environment scale (LENS): Outcome from the Oregon research initiative on the organisation of nursing (ORION)

Aim: The purpose of this study was to establish the psychometric properties of the new 16-item leadership environment scale. Background: The leadership environment scale was based on complexity science concepts relevant to complex adaptive health care systems. Methods: A workforce survey of direct-care nurses was conducted (n = 1,443) in Oregon. Confirmatory factor analysis, exploratory factor analysis, concordant validity test and reliability tests were conducted to establish the structure and internal consistency of the leadership environment scale. Results: Confirmatory factor analysis indices approached acceptable thresholds of fit with a single factor solution. Exploratory factor analysis showed improved fit with a two-factor model solution; the factors were labelled ‘influencing relationships’ and ‘interdependent system supports’. Moderate to strong convergent validity was observed between the leadership environment scale/subscales and both the nursing workforce index and the safety organising scale. Reliability of the leadership environment scale and subscales was strong, with all alphas ≥.85. Conclusions: The leadership environment scale is structurally sound and reliable. Implications for Nursing Management: Nursing management can employ adaptive complexity leadership attributes, measure their influence on the leadership environment, subsequently modify system supports and relationships and improve the quality of health care systems. The leadership environment scale is an innovative fit to complex adaptive systems and how nurses act as leaders within these systems.