Penetration Instruments

Penetration refers to ‘the integration of a practice within a service setting and its subsystems’. Commonly used terms: Level of institutionalisation; Spread; Service access. Proctor et al, 2011

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Penetration Instruments	Psychometric quality (ConPsyCL)	Validity (COSMIN)	Reliability (COSMIN)	Responsiveness (COSMIN)	Usability
A measure of clinical information technology sophistication in hospitals	3	Not assessed	Poor	Not assessed	Adequate
A measurement instrument for spread of quality improvement in healthcare	4	Poor	Fair	Not assessed	Good
The Prevention and Control of Antimicrobial resistance (PACAR) scale	6	Fair	Poor	Not assessed	Good
The Scaling Integrated Care in Context (SCIROCCO) tool	5	Good	Good	Not assessed	Good