Measuring red tape in a hospital setting: A survey experiment

Public administration research is actively exploring alternatives for the General Red Tape (GRT) scale to measure red tape. Owing to increasing criticism on the GRT scale, scholars proposed the Three-Item Red Tape (TIRT) scale as an alternative. Using a repeated cross-sectional design, this article tests both scales in a before–after analysis of a major change in the organization of administration in a hospital. The results indicate that the GRT scale does not capture the resulting major change in red tape, which raises questions on the instrument's validity in a bottom-up research design within one organization. The TIRT scale, however, which measures red tape at the work environment level, does reflect the change in red tape but shows empirical weaknesses in its design. Additionally, by randomly assigning respondents to substantially different red tape definitions, this article shows that the red tape definition does not significantly impact respondents’ GRT ratings. The predominantly used GRT scale is not able to capture an increase in red tape in a bottom-up intraorganizational research design in a hospital, which raises questions on the instrument's validity. A more recent alternative for the GRT scale, more specifically the TIRT scale, captures the increase in red tape but shows empirical weaknesses. The wording of the red tape definition does not impact respondents’ answers on the GRT scale.