title: Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
abstract: OBJECTIVE
  Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies. QI approaches are diverse and differ from clinical interventions. Widely used critical appraisal instruments do not take unique QI features into account and existing QI tools (eg, Standards for QI Reporting Excellence) are intended for publication guidance rather than critical appraisal. This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of QI publications.
  
  
  METHODS
  Approaches to developing the tool and ensuring validity included a literature review, in-person and online survey expert panel input, and application to empirical examples. We investigated psychometric properties in a set of diverse QI publications (N=54) by analysing reliability measures and item endorsement rates and explored sources of disagreement between reviewers.
  
  
  RESULTS
  The QI-MQCS includes 16 content domains to evaluate QI intervention publications: Organisational Motivation, Intervention Rationale, Intervention Description, Organisational Characteristics, Implementation, Study Design, Comparator Description, Data Sources, Timing, Adherence/Fidelity, Health Outcomes, Organisational Readiness, Penetration/Reach, Sustainability, Spread and Limitations. Median inter-rater agreement for QI-MQCS items was κ 0.57 (83% agreement). Item statistics indicated sufficient ability to differentiate between publications (median quality criteria met 67%). Internal consistency measures indicated coherence without excessive conceptual overlap (absolute mean interitem correlation=0.19). The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look and How to rate.
  
  
  CONCLUSIONS
  We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for continuing refinement.
authors: RAND Corporation, Santa Monica, California, USA.
authors: Susanne
authors: S
authors: Hempel
authors: RAND Corporation, Santa Monica, California, USA Veterans Affairs West Los Angeles Medical Center, Los Angeles, California, USA.
authors: Paul G
authors: PG
authors: Shekelle
authors: RAND Corporation, Santa Monica, California, USA.
authors: Jodi L
authors: JL
authors: Liu
authors: RAND Corporation, Santa Monica, California, USA Veterans Affairs Greater Los Angeles, North Hills, California, USA.
authors: Margie
authors: M
authors: Sherwood Danz
authors: University of Leeds, Leeds Institute of Health Sciences, Leeds, UK.
authors: Robbie
authors: R
authors: Foy
authors: National University of Singapore, Saw Swee Hock School of Public Health, Singapore.
authors: Yee-Wei
authors: YW
authors: Lim
authors: RAND Corporation, Santa Monica, California, USA.
authors: Aneesa
authors: A
authors: Motala
authors: RAND Corporation, Santa Monica, California, USA Veterans Affairs Greater Los Angeles, North Hills, California, USA University of California, Department of Medicine, Los Angeles, California, USA.
authors: Lisa V
authors: LV
authors: Rubenstein
mesh_terms: D006302:Health Services Research / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D010506:Periodicals as Topic / Q000592:standards*; D011594:Psychometrics; D011643:Publishing / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D015203:Reproducibility of Results
keywords: Evaluation methodology; Evidence-based medicine; Healthcare quality improvement; Quality improvement; Quality improvement methodologies