The ADAPTER-health questionnaire: a tool for measuring team resilience in healthcare.

Aim
A resilient healthcare team is essential in providing high-quality care. Therefore our goal is to gain insight in the factors contributing to resilient team performance in Dutch hospitals. To do so we want to validate the ADAPTER-Health questionnaire in the healthcare setting and investigate relevant moderating factors.

Methods
The ADAPTER-Health questionnaire was developed and then administered on 42 wards across 15 Dutch hospitals, resulting in 622 responses. Confirmatory Factor Analysis was used for validation. ANOVAs were used to analyse the data followed by post hoc comparisons. Several moderators were examined: hospital type, medical specialty, profession, patient interaction, and work experience.

Results
Confirmatory factor analysis provided sufficient justification for validation of the ADAPTER-Health. The subscales responding, shared leadership, learning, anticipating, monitoring, cooperation with other departments and heedful interrelating, showed positive correlations with team resilience, ranging from moderate to strong. Respondents were generally positive (3.7 out of 5) about team resilience on their ward. Cooperation with other departments and learning scored lowest and responding and monitoring highest. Hospital type was the only consistent moderating factor on team resilience. Affiliation with medical specialty, profession and work experience gave more inconsistent results on subscale levels.

Conclusions
The ADAPTER-Health questionnaire can be used for monitoring and strengthening team resilience. The subscales can be used as starting points for learning about and improving a teams’ resilient performance. To make the outcomes of the questionnaire more valuable for practice and to test effect generalisability, the ADAPTER-Health needs to be administered across different healthcare settings.