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Positive professional practice environments have repeatedly been correlated to better patient and organizational outcomes, thus evaluating and measuring the environment is imperative.  The Revised Professional Practice Environment (RPPE) Scale is intended to measure staff perception of eight components of the professional clinical practice environment in the acute care setting.  Each subscale has been validated as a stand alone measure and together they provide a clear picture of staff perceptions of the environment in which they practice.  The eight components of the RPPE are:

  • leadership and autonomy over practice
  • staff relationships with physicians
  • control over practice
  • communication about patients
  • teamwork
  • handling disagreement and conflict
  • internal work motivation
  • cultural sensitivity

The RPPE has been translated into multiple languages, adapted (with MGH permissions) for use in several different settings, across all care delivery disciplines and has been used extensively throughout the world.  Use of the Revised Professional Practice Environment instrument and related tools provides insights to organizational successes and opportunities for improvement (Ives Erickson, Duffy, Ditomassi & Jones, 2008).  It can be used by superiors, peers and subordinates as a measure of executive performance (Adams, Ives Erickson, Jones & Paulo, 2009). 

Such information can help to identify specific aspects of the environment that may require change, aid in design and/or help to improve various components of individual unit or department practice settings as well as provide evaluative feedback about whether such changes have made a difference in practice.  At MGH, PCS management and staff have used PPE and RPPE item data in this way since the early 1990s. They report that the RPPE subscale and item scores provide valuable data describing an effective professional practice environment.


Adams, JM, Ives Erickson, J., Jones, D.A. & Paulo, L. (2009) An Evidence Based Structure for Transformative Nurse Executive Practice: The Model of the Interrelationship of Leadership, Environments & Outcomes for Nurse Executives (MILE ONE) Nursing Administration Quarterly 33(4): 280-287.

Ives Erickson (in press) 200 Years of Nursing - A Chief Nurse’s Reflections on Practice, Theory, Policy, Education, and Research. JONA

Ives Erickson, J, Duffy, M, Ditomassi, M, Jones, D. (2009) Psychometric evaluation of the revised professional practice environment (RPPE) Scale, JONA, 39(5): 236-243.


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