Critiquing a Quality Improvement Report

Quality improvement (QI) reports often assess processes of care in order to determine causes for clinical outcomes. Currently, there is a lack of standardization and consistency in quality of these efforts. Criteria to evaluate the integrity of a report may include the following (Davidoff & Batalden, 2005):

The nature and severity of the problem that prompted the effort was described, and the purpose of the proposed practice change was clearly described.

Process of the quality improvement effort is explicit - How were outcomes selected? How were data collected? How was a number of records/patients determined? Who in the organization participated in the process? Were data collectors trained appropriately? Was there bias inherent in methods used?

Determination of optimal outcomes - Were thresholds identified for patient care outcomes? How? If thresholds were not met, what steps did the QI process follow to elucidate potential process problems?

Evidence base - Did the QI effort involve any sort of literature review? How were benchmarks determined?

What were the key findings, and were they similar or different from the results of others reported in the literature? What lessons were learned during the process? What is done with the findings of the QI effort? Is dissemination done without bias? How will the change be maintained, and what are the planned next steps?

 Continue to Step 4 - Summarize the Evidence