title: Development of the continuous quality improvement questionnaire (CQIQ).
abstract: OBJECTIVE
  Increasingly, hospitals are engaging in continuous quality improvement (CQI) endeavors, aimed at optimizing patient care. Physician involvement is critical to the success of such initiatives. Little is known about any mediating factors that affect physician participation in these projects, though such knowledge may be potentially important for targeting approaches to maximize physician involvement. The purpose of this study was to develop a reliable and valid instrument to assess physicians' knowledge of and attitudes toward CQI.
  
  
  METHODS
  Items for the questionnaire were generated by using interviews and literature re-view and covered areas of knowledge, attitude, and facilitators and barriers to involvement in CQI projects. Five physicians participated in the interviews, 64 participated in the survey, and 9 participated in the assessment of test-retest reliability. Main outcomes were reliability and validity.
  
  
  RESULTS
  The CQI questionnaire (CQIQ) had acceptable internal consistency and Cronbach's alpha correlation coefficient exceeded.70 for all scales. Item-total correlation ranged from.30 to.63 for all scales except for 1 item. Pearson's correlation coefficient for test-retest reliability was 0.85 (P =.02). A 76% response rate was achieved.
  
  
  CONCLUSIONS
  There appears to be complex interactions among psychologic and environmental mediators that influence physician participation in hospital quality initiatives. The CQIQ shows reasonable measurement properties and our findings should be generalizable to physicians in other academic institutions. The CQIQ provides additional information on the implementation of programs and processes that should be validated in other institutional settings to enhance the interpretability of the instrument.
authors.affiliation: Critical Care Research Network, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Hill
authors.forename: F
authors.initials: F
authors.lastname: Gwadry-Sridhar
authors.forename: T
authors.initials: T
authors.lastname: Armstrong
authors.forename: W J
authors.initials: WJ
authors.lastname: Sibbald
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002170:Canada; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D017749:Total Quality Management