Exploring the use of social network analysis methods in process improvement within healthcare organizations: a scoping review.

BACKGROUND: Communication breakdowns among healthcare providers have been identified as a significant cause of preventable adverse events, including harm to patients. A large proportion of studies investigating communication in healthcare organizations lack the necessary understanding of social networks to make meaningful improvements. Process Improvement in healthcare (systematic approach of identifying, analyzing, and enhancing workflows) is needed to improve quality and patient safety. This review aimed to characterize the use of SNA methods in Process Improvement within healthcare organizations. METHODS: Relevant studies were identified through a systematic search of seven databases from inception - October 2022. No limits were placed on study design or language. The reviewers independently charted data from eligible full-text studies using a standardized data abstraction form and resolved discrepancies by consensus. The abstracted information was synthesized quantitatively and narratively. RESULTS: Upon full-text review, 38 unique articles were included. Most studies were published between 2015 and 2021 (26, 68%). Studies focused primarily on physicians and nursing staff. The majority of identified studies were descriptive and cross-sectional, with 5 studies using longitudinal experimental study designs. SNA studies in healthcare focusing on process improvement spanned three themes: Organizational structure (e.g., hierarchical structures, professional boundaries, geographical dispersion, technology limitations that impact communication and collaboration), team performance (e.g., communication patterns and information flow among providers., and influential actors (e.g., key individuals or roles within healthcare teams who serve as central connectors or influencers in communication and decision-making processes). CONCLUSIONS: SNA methods can characterize Process Improvement through mapping, quantifying, and visualizing social relations, revealing inefficiencies, which can then be targeted to develop interventions to enhance communication, foster collaboration, and improve patient safety.

Estructura organizativa para el Club de Boxeo Mas Holding, Sri Lanka

En el Club de Boxeo MAS Holding, en Sri Lanka, se constatan insuficiencias en las relaciones entre las áreas organizativas de la estructura actual y con ello, poca coherencia de acciones estratégicas para el logro de los objetivos de la institución deportiva; ello se manifiesta en la poca estabilidad de los resultados competitivos nacional e internacionalmente, lo anterior asociado a que la estructura organizativa responde a criterios muy pragmáticos y utilitarios, resulta insuficiente y se ha convertido en una barrera que impide asumir, creadoramente, los cambios del entorno. La investigación tiene como objetivo determinar los componentes de una estructura para la gestión deportiva del Club de Boxeo MAS Holding, Sri Lanka. El resultado está en la concepción teórica de la estructura organizacional para el Club de Boxeo Mas Holding que responde a los fundamentos jurídicos, políticos y administrativos del país, y da respuesta a las exigencias de cambios para el desarrollo de la actividad deportiva. Se sostiene dicha estructura en principios como la eficiencia, el carácter dinámico, flexible e innovador y sujeta a cambios, según los escenarios que se presenten al boxeo.

No MAS Holding Boxing Club, Sri Lanka, existem insuficiências nas relações entre as áreas organizacionais da estrutura atual e, com isso, pouca coerência de ações estratégicas para a consecução dos objetivos da instituição esportiva; isso se manifesta na pouca estabilidade dos resultados competitivos nacionais e internacionais, isso associado ao fato de que a estrutura organizacional responde a critérios muito pragmáticos e utilitários, é insuficiente e se tornou uma barreira que a impede de assumir, criativamente, as mudanças do ambiente. A pesquisa tem como objetivo determinar os componentes de uma estrutura para a gestão esportiva do MAS Holding Boxing Club, Sri Lanka. O resultado é a concepção teórica da estrutura organizacional do Mas Holding Boxing Club que atende aos fundamentos legais, políticos e administrativos do país e responde às demandas de mudança para o desenvolvimento da atividade esportiva. Essa estrutura se baseia em princípios como eficiência, caráter dinâmico, flexível e inovador e está sujeita a mudanças, de acordo com os cenários que surgem no boxe.

In the MAS Holding Boxing Club, in Sri Lanka, there are insufficiencies in the relationships between the organizational areas of the current structure and with it, little coherence of strategic actions to achieve the objectives of the sports institution; this is manifested in the poor stability of competitive results nationally and internationally, the above, associated with the fact that the organizational structure responds to very pragmatic and utilitarian criteria, is insufficient and has become a barrier that prevents creatively assuming the changes in the environment. The research aims to determine the components of a structure for the sports management of the MAS Holding Boxing Club, Sri Lanka. The result is in the theoretical conception of the organizational structure for the Mas Holding Boxing Club that responds to the legal, political and administrative foundations of the country, and responds to the demands for changes for the development of sporting activity. This structure is supported by principles such as efficiency, dynamic, flexible and innovative character and subject to change, depending on the scenarios presented to boxing.

Organizational structure, agility, and public value-driven innovation performance in the UAE public services.

Existing public sector management literature requires an empirical examination of the relationship between change readiness, organizational agility, and public value-driven innovation performance. Moreover, how organizational structure moderates these relationships in the public sector context is still being determined. This study aims to address this gap by collecting data from 421 top management respondents working in public services in the United Arab Emirates. The hypotheses are tested using a structural equation model. The study's findings confirm that change readiness positively influences organizational agility and reveals the positive effects of organizational agility on public value-driven innovation performance in public service organizations. Additionally, this study highlights that change readiness directly affects public value-driven innovation performance. Simultaneously, organizational structure (formalization and centralization) affects the relationships between change readiness and public value-driven innovation performance, and organizational agility and public value-driven innovation performance. Finally, this study shows that organizational structure (centralized and formalized) impacts the relationship between change readiness and organizational agility. This study contributes substantially to the existing knowledge on the relationships between change readiness, organizational agility, organizational structure, and public value-driven innovation performance.

Properties of Multistranded Twisted Graphene Fibers and Their Application in Flexible Light-Emitting Devices.

As a typical carbon-based material electrode, graphene fiber exhibits many advantages, such as good electrical conductivity, lightweight, and strong structural designability. Its demand is increasing in the wearable display field. With the help of fine denier fiber spinning combined with multistranded graphene fibers prepared via twisting and drafting, their petal-like twisted structure endows the fibers with a high specific surface area, enabling them to complete dye adsorption within 30 min. Simultaneously, compared with that of a single fiber with the same thickness, the volume specific resistance of a multistranded twisted graphene fiber is reduced by 2.4 times. During force sensing, the twisted structure of multistranded fibers exhibits varying simultaneity of fiber fracture with excellent resistance sensitivity reaching up to 55%. The multistranded twisted flexible graphene fibers demonstrate excellent robustness. Electroluminescent flexible devices prepared with graphene fibers and fiber braided fabrics with different organizational structures as electrodes emit highly saturated short-wave blue light during long-term multiple use. Therefore, multistranded twisted graphene fibers exhibit considerable potential for future applications in wearable multicolor smart displays and flexible optical signal electronics.

Understanding the Landscape of Consultation Liaison Psychologists in Academic Medical Centers.

Current literature lacks data related to the role of psychologists on consultation-liaison (CL) services; previous data indicates only 4% of CL services are run by psychologists, while 32% of liaison mental health services include a psychologist. As CL psychologists' roles within hospitals grow, it is critical to identify clinical strategies and organizational structures of CL services across hospital systems. The current study seeks to provide a deeper understanding of CL psychologists' scope of work. Participants (N = 77) (15% response rate) completed a measure developed for this study, exploring psychologist roles, clinical practice, and departmental structures. Thirty-two percent of respondents were in Psychiatry Departments, 58% were in academic medical centers, almost half had training programs and the most frequently utilized billing code was: Given the limited data available, this study provided a contemporary and foundational understanding of the CL psychologist roles as well as future avenues of empirical inquiry such as discrete organization and structural characteristics.

Lessons learned from nursing crisis meetings: Qualitative study to evaluate nurses' experiences and needs.

AIMS: The aim of this study is to evaluate the nurses' experiences with the Nursing Crisis Meetings and to identify nurses' needs regarding the future governance structure. DESIGN: Qualitative study. METHODS: Two focus groups were conducted in February 2022 with participants of the Nursing Crisis Meetings (N = 15). We used thematic analysis to describe themes. RESULTS: We identified five themes: opportunity to speak up, call for nursing leadership, call for control over practice and autonomy, development of a governance infrastructure and development of the professional nurse role. CONCLUSION: Nurses experienced the Nursing Crisis Meetings to be a positive and empowering infrastructure, which facilitates the unique opportunity to speak up and share experiences and concerns. This new infrastructure is a promising strategy to engage nurses during a pandemic and to build on a professional governance structure. IMPACT: This paper highlights the need for nurses to speak up and be engaged during the COVID-19 pandemic and gives a practical example of how to put this infrastructure into practice.

Neonatal intensive care nurses' accounts of care for mothers/families with substance-exposed pregnancies: A critical discourse analysis.

AIMS: To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance-exposed pregnancy (SEP). DESIGN: This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship-building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique. METHOD: Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty-one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery. RESULTS: Study findings revealed nurses experienced challenges providing high-quality, family-centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care. CONCLUSION: The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high-quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments. IMPACT: This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high-quality care in stressful healthcare environments. REPORTING METHOD: EQUATOR guidelines were followed, using the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: NICU nurses were interviewed about their care-provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data.

The Effects of Contextual Factors on Hospital Chaplains: A Qualitative Study.

Critical questions arise about how contextual factors affect hospital chaplains. We interviewed 23 chaplains in-depth. Hospitals' religious or other institutional affiliation, geography, and leadership can influence chaplains both explicitly/directly and implicitly/indirectly-for example, in types/amounts of support chaplains receive, scope of chaplains' roles/activities, amounts/types of chaplains' interactions, chaplains' views of their roles and freedom to innovate, and patients', families' and other providers' perceptions/expectations regarding spiritual care. These data have critical implications for research, practice, and education.

Content and process: organizational conflict and decision making.

The foundational work in the Carnegie perspective established conflict as endemic to organizations and a driver of organizing behavior and decision making. Organizations as a system of coordinated action among interdependent individuals and groups with different preferences, interests, information, or knowledge create the potential for pervasive and ongoing latent goal conflict. At the same time, extant psychology research has devoted considerable attention to identifying the content and intensity of conflict, focusing on the relationship between different types of conflict and their impact on group outcomes. The Carnegie perspective also assumes that the need for joint decision-making and the differences in goals or perception of reality are never fully resolved. As a result, it has paid attention to the processes through which conflict is addressed - by attending sequentially to goals, decentralizing information, accumulating excess resources, and forming coalitions rather than formal mediating procedures. The assessment of the psychology and organizational theory research also suggests that future work focusing on organizational conflict as latent, situated, and dynamic would enable greater clarity on how organizations make decisions.

Influence of knowledge management infrastructure on knowledge creation processes. A study in the primary sector.

Under the theoretical approaches of the resource-based view of the firm, the dynamic capabilities and the knowledge-based view of the firm, the purpose of this paper is to analyze the influence that the knowledge management infrastructure has on knowledge creation processes in primary sector companies, specifically, the aquaculture sector. For the empirical analysis, the SEM-PLS approach was used on a sample of 186 shrimp farms in Ecuador. Results confirm that the environment and organizational structure, and culture influence knowledge creation, while technological resources are not significant. This can be explained by the characteristics of the central activities of the shrimp companies and the assignment of functions. From a theoretical point of view, this paper links the knowledge-based view of the firm with the activities of the primary sector. Specifically, a theoretical model is developed in which the variables that can influence the knowledge creation processes of shrimp farms are studied. Existing works in the scientific literature that analyze both perspectives are practically nil. From a managerial perspective, given the importance of the creation and renewal of knowledge to develop organizational capabilities in the face of the dynamism of the market, the findings of this study can guide managers to understand how the combination of resources can help increase stocks of knowledge useful to business objectives.

Measuring midwives' perceptions of their practice climate across racial-ethnic identities: An invariance analysis of the Midwifery Practice Climate Scale.

Diversification of the midwifery workforce is key to addressing disparities in maternal health in the United States. Midwives who feel supported in their practice environments report less burnout and turnover; therefore, creating positive practice environments for midwives of color is an essential component of growing and retaining midwives of color in the workforce. The Midwifery Practice Climate Scale (MPCS) is a 10-item instrument developed through multiphase empirical analysis to measure midwives' practice environments, yet the MPCS had not been independently tested with midwives of color. We conducted invariance analyses to test whether latent means can be compared between midwives of color and non-Hispanic White samples. A step-up approach applied a series of increasingly stringent constraints to model estimations with multiple group confirmatory factor analyses with two pooled samples. A configural model was estimated as the basis of multiple group comparisons where all parameters were allowed to freely vary. Metric invariance was estimated by constraining item factor loadings to be equal. Scalar invariance was estimated by constraining intercepts of indicators to be equal. Each model was compared to the baseline model. The findings supported scalar invariance of MPCS across midwives of color and non-Hispanic White midwives, indicating that the MPCS is measuring the same intended construct across groups, and that differences in scores between these two groups reflect true group differences and are not related to measurement error. Additionally, in this sample, there was no statistically significant difference in perceptions of the practice environments across midwives of color and non-Hispanic White midwives (p > 0.05).

Place and the Structuring of Cross-Sector Partnerships: The Moral and Material Conflicts Over Healthcare and Homelessness.

Local places, such as communities, cities, and towns, host many cross-cross sector partnerships, many geared primarily toward alleviating local social and environmental issues. Yet, existing literatures focus predominantly on largescale systemic impact and global challenges such as climate change, paying scant attention to the role of local, geographically bounded dynamics in shaping these partnerships. In this article, I conceptualize places as geographic locations imbued with specific meaning systems and material resources to unpack how local embeddedness shape the structure of cross-sector partnerships. Specifically, I investigate how place-based conflict, arising from tensions between the moral and material aspects of a partnership, can shape formalized aspects of organizational structure. These include the scope of operations, partners' roles, and shared resources. I unpack these relationships using a case study of Occupy Medical, a local partnership between the civic society and the local government in Eugene, Oregon, tackling the problem of providing healthcare to the homeless and other marginalized and disenfranchised communities. The analysis covers the nine-year period of 2011-2020 and spans three major restructurings of the organization, the latest prompted by the onset of the COVID-19 pandemic in March 2020. I theorize two forms of structural arrangements for cross-sector partnerships, confined and leveraged, and further elaborate on the role of cross-sector partnerships in crises response on the local level.

Centralization and integration of public health systems: Perspectives of public health leaders on factors facilitating and impeding COVID-19 responses in three Canadian provinces.

The extent to which power, resources, and responsibilities for public health are centralized or decentralized within a jurisdiction and how public health functions are integrated or coordinated with health care services may shape pandemic responses. However, little is known about the impacts of centralization and integration on public health system responses to the COVID-19 pandemic. We examine how public health leaders perceive centralization and integration facilitated and impeded effective COVID-19 responses in three Canadian provinces. We conducted a comparative case study involving semi-structured interviews with 58 public health system leaders in three Canadian provinces with varying degrees of centralization and integration. Greater public health system centralization and integration was seen by public health leaders to facilitate more rapidly initiated and well-coordinated provincial COVID-19 responses. Decentralization may have enabled locally tailored responses in the context of limited provincial leadership. Opacity in provincial decision-making processes, jurisdictional ambiguity impacting Indigenous communities, and ineffectual public health investments were impediments across jurisdictions and thus appear to be less impacted by centralization and integration. Our study generates novel insights about potential structural facilitators and impediments of effective COVID-19 pandemic responses during the second year of the pandemic. Findings highlight key areas for future research to inform system design that support leaders to manage large-scale public health emergencies.

The contribution of organizational culture, structure, and leadership factors in the digital transformation of SMEs: a mixed-methods approach.

Contributing to the scarce literature on how companies can deal with their business model of digital transition, this work explores the digital transformation (DT) process in small and medium enterprises (SME), investigating how organizational culture, structure, and leadership influence it. While such three factors are deemed essential components to facilitate DT, how they operate and how they relate to each other are still not very well-defined issues in need of in-depth investigation. This study employed a mixed-methods approach, following an exploratory sequential design. First, a conceptual model was developed based on qualitative data collected from expert interviews and analyzed through grounded theory. This stage uncovered 25 first-order concepts about culture, structure, and leadership, further organized into 6 constructs and hypothesis paths. Then, with a sample of 192 SMEs, the structural model was measured and validated using exploratory factor analysis and PLS-SEM. As a result, our study offers robust and timely research, whose conceptual model condenses a knowledge corpus that future research can benefit from, and it provides statistical extrapolations about how and how much those factors relate to each other in SME context; moreover, given the traditional scarce resources and lack of flexibility in SMEs, it provides orientation and guidelines to managers facing DT and needing to understand the organizational factors they should be aware of, where to focus energy, and what to expect as results. From a large-scale perspective, this study carries an impactful contribution to the many countries where SMEs play a major economic and social role.

Nursing management for temporary lodging facilities in Japan in the early stages of the COVID-19 pandemic: A multiple-case study.

AIM: Temporary lodging facilities which were non-medical facilities were established to secure beds for severely and moderately ill patients with COVID-19, as well as for isolation, non-contact observation, and care of mildly ill and asymptomatic patients in Japan. This study aims to understand nursing management practices adopted in these facilities by examining cases of their establishment and operation. METHODS: A multiple-case study design was used. Interviews for qualitative data collection were conducted from August to October 2020. After analyzing the nursing management practices in four temporary lodging facilities, common points were collated and integrated. RESULTS: For the establishment and operation of temporary lodging facilities, a three-layer structure based on disaster management methods was adopted: headquarters at the helm as overseers, field supervisors in the middle, and frontline nursing staff at the base. The structure had clear roles, facilitated information exchange, and provided efficient and effective nursing care. Field supervisors mainly provided psychological and clinical support for staff and served as information and interprofessional hubs. CONCLUSION: It is recommended that temporary lodging facilities should be organized based on principles of the division of labor. The workforce should comprise nursing staff, and experienced nursing professionals should be recruited to the higher echelons.

Factors affecting faculty conformity in South China universities.

Based on social contagion theory, this study examines the mediating role of formalization of organizational structure between organizational identification and faculty conformity. It also analyzes the moderating role of conflict management style between organizational identification and faculty conformity, and formalization of organizational structure and faculty conformity in universities in Hunan province, China. Convenience sampling was employed to select the subjects, and 1,024 Chinese faculty members including teaching staff and administrative staff were surveyed online with the questionnaire consist of organizational identification scale, organizational formalization scale, conflict management style scale, and faculty conformity scale. 1,000 valid respondents were collected and SPSS was used to analyze the data through descriptive analysis, analysis of variance, correlation analysis, and hierarchical multiple regression. The results showed that faculty members' organizational identification had a positive effect on faculty conformity; formalization of organizational structure partially mediated the relationship between organizational identification and faculty conformity; and conflict management style positively moderated the relationship between organizational identification and faculty conformity and between formalization of organizational structure and faculty conformity. University administrators are often the initiators of conformity as they are responsible for formulating internal regulations. Therefore, they must monitor and coordinate workplace conflicts, resolve and guide faculty conformity, promote individual faculty members' self-improvement, and foster steady organizational development.

It's Time We Looked Under the Hood: An In-Depth Examination of Five Public California Area Agencies on Aging.

BACKGROUND AND OBJECTIVES: As the older adult population grows, it is important to understand the effectiveness of service delivery systems that support aging in place. Studying service delivery processes and organizational structures of Area Agencies on Aging (AAAs) is essential for future efforts to understand service delivery outcomes and innovations. RESEARCH DESIGN AND METHODS: We conducted site visits with 5 government-run California AAAs. We used a template and constant comparative analysis to analyze transcripts from site visits and focus groups with key informants. RESULTS: AAA representatives discussed how their organizational structure was related to (a) which services and programs they provided; (b) administrative cost savings and access to funding sources; (c) inter- and intra-agency coordination; and (d) visibility among clients and community partners. DISCUSSION AND IMPLICATIONS: These findings can be used to guide decisions surrounding how changes in AAA structure may affect funding, coordination, service delivery, and visibility, among other factors. Consolidating the AAA with other departments and programs facilitates coordination and shared administrative costs, yet consolidation may reduce standalone AAAs' visibility and ability to innovate. AAA structure should be tailored to fit community resources, local government organization, and the needs of older residents.

Networked Organizational Structure of Enterprise Information Security Management Based on Digital Transformation and Genetic Algorithm.

With the rapid development of society and economy, enterprises have also started digital transformation in order to follow the pace. Now-a-days, the development of enterprises is also faced with the risk of improper management of enterprise information security, so it is very necessary to study the networked organizational structure of enterprise information security management. The purpose of this paper is to study how to analyze the network organization structure of enterprise information security management based on genetic algorithm. This paper puts forward the difficult problems faced by enterprise information security, and how to prevent and solve the risks encountered in information security. In the experimental part of this paper, it can be seen that with the increase of the number of experiments, the work efficiency of the traditional network organization structure has increased from about 4.6 to about 17%. The work efficiency of the network organization structure based on genetic algorithm has risen from about 10 to about 50%. It shows that the work efficiency of the network organization structure based on genetic algorithm is much higher than that of the traditional network organization structure. It can be seen that the advantage percentage of enterprise information security management networked organizational structure with strong room for growth is 79-84%, and the percentage of cost savings is 75-82%. It can be seen that there are still many advantages of the networked organizational structure of enterprise information security management. The network organization structure based on genetic algorithm can not only improve the work efficiency of enterprises, but also improve the information security. Therefore, the network organization structure based on genetic algorithm is of great significance to the enterprise information security.

The Intersection Between Heart Failure and Critical Care Cardiology: An International Perspective on Structure, Staffing, and Design Considerations.

The overall patient population in contemporary cardiac intensive care units (CICUs) has only increased with respect to patient acuity, complexity, and illness severity. The current population has more cardiac and noncardiac comorbidities, a higher prevalence of multiorgan injury, and consumes more critical care resources than previously. Patients with heart failure (HF) now occupy a large portion of contemporary tertiary or quaternary care CICU beds around the world. In this review, we discuss the core issues that relate to the care of critically ill patients with HF, including global perspectives on the organization, designation, and collaboration of CICUs regionally and across institutions, as well as unique models for provisioning care for patients with HF within a health care setting. The latter includes a discussion of traditional and emerging models, specialized HF units, the makeup and implementation of multidisciplinary team-based decision-making, and cardiac critical care admission and triage practices. This article illustrates the ways in which critically ill patients with HF have helped to shape contemporary CICUs throughout the world and explores how these very patients will similarly help to inform the future maturation of these specialized critical care units. Finally, we will critically examine broad, contemporary, international models of HF and cardiac critical care delivery in North America, Europe, South America, and Asia, and conclude with opportunities for the further investigation and generation of evidence for care delivery.

Measuring moral distress in nurses during a pandemic: Development and validation of the COVID-MDS.

The COVID-19 pandemic created novel patient care circumstances that may have increased nurses' moral distress, including COVID-19 transmission risk and end-of-life care without family present. Well-established moral distress instruments do not capture these novel aspects of pandemic nursing care. The purpose of this study was to develop and evaluate the psychometric properties of the COVID-19 Moral Distress Scale (COVID-MDS), which was designed to provide a short MDS that includes both general and COVID-19-specific content. Researcher-developed COVID-19 items were evaluated for content validity by six nurse ethicist experts. This study comprised a pilot phase and a validation phase. The pilot sample comprised 329 respondents from inpatient practice settings and the emergency department in two academic medical centers. Exploratory factor analysis (EFA) was conducted with the pilot data. The EFA results were tested in a confirmatory factor analysis (CFA) using the validation data. The validation sample comprised 5042 nurses in 107 hospitals throughout the United States. Construct validity was evaluated through CFA and known groups comparisons. Reliability was assessed by the omega coefficient from the CFA and Cronbach's alpha. A two-factor CFA model had good model fit and strong loadings, providing evidence of a COVID-19-specific dimension of moral distress. Reliability for both the general and COVID-19-specific moral distress subscales was satisfactory. Known groups comparisons identified statistically significant correlations as theorized. The COVID-MDS is a valid and reliable short tool for measuring moral distress in nurses including both broad systemic sources and COVID-19 specific sources.