145 The CREATE-tool: A self-evaluation tool for a Challenging Rehabilitation Environment To convert the rating per statement into a cluster rating, all PDCA elements were treated as ordinal data, in which Plan represents a value of 1, Do a value of 2, Act a value of 3, and Check a value of 4. The standardized cluster rating is calculated as the sum of the actual ratings divided by the maximum obtainable score per cluster. Therefore, the standardized score varies between 0.25 and 1.00. This standardized score is shown in a 5-axis radar chart, of which each axis represents one cluster. To combine the individual results in team results per ward, the median and range per statement were determined. The median ratings were used to calculate the standardized team cluster ratings, which were visualized in a 5-axis radar chart. Rating phase All participants were invited by email to individually fill in the CREATE-tool based on the current situation on their ward. They received a link to a form hosted by Castor Electronic Data Capture, a secure, cloud-based electronic data capture platform. (17) Participants received a reminder after two weeks if they had not completed the tool. According to the protocol, the individual ratings in Castor were converted to Excel, in order to calculate the individual and team standardized scores for the five clusters. The scores were not used to study the psychometric properties of the CREATE-tool, but to visualize the ratings of the professionals and teams. Team discussion phase On each ward a team meeting of two hours was organized. At the start of the meeting, all participants received their individual results (PDCA rating and radar chart) and the team results (median and range PDCA and radar chart) concerning the CREATE-tool. The team meeting was chaired by a researcher (LT) who was in possession of all individual results and the team results. During the team meeting the team members were invited to discuss the results for each consecutive cluster. Points of discussion could be: deviations between individual and team rating, team ratings which were considered debatable, state6
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