The RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90401, USA.;
Int J Qual Health Care. 2014 Feb;26(1):6-15. doi: 10.1093/intqhc/mzt085. Epub 2013 Dec 4.
Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI.
Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process.
Primarily United States and Canada.
119 QI experts randomly assigned into four on-line panels.
Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features.
/st> Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features 'systematic data guided activities,' 'designing with local conditions in mind' and 'iterative development and testing' met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI.
We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as 'CQI.' All three features are needed as a minimum standard for recognizing CQI methods.
持续质量改进（CQI）方法是改善医疗服务提供的基础方法。然而，使用术语 CQI 的出版物在方法上存在异质性，并且使用其他标签来表示相关方法。基于其关键方法特征来识别 CQI 使用的标准可以使质量改进（QI）工作更有效地学习。目的是确定识别 CQI 的基本方法特征。
以前与 12 名国际专家组成的小组进行的工作确定了可靠提取的 CQI 方法特征。我们使用三轮在线改良 Delphi 过程测试了哪些特征符合严格的先验标准，作为 CQI 的基本特征。
主要在美国和加拿大。
119 名 QI 专家随机分配到四个在线小组。
参与者对 CQI 特征进行评分，并使用在线、匿名和异步讨论板讨论他们的答案。我们对评分进行了定量分析，并对讨论线程进行了定性分析。
小组对定义性 CQI 特征的共识。
/st>79 名（66%）小组成员完成了该过程。33 名完成者自认为是 QI 研究人员，18 名是 QI 实践者，28 名是两者同等重要。特征“系统数据指导活动”、“设计时考虑当地条件”和“迭代开发和测试”符合先验标准，是 CQI 的基本特征。定性分析显示，交叉主题集中在 QI 和 CQI 之间的差异。
我们在广泛的 CQI 研究人员和实践者中达成了共识，认为三个特征是将 QI 工作更具体地识别为“CQI”的基本特征。这三个特征是识别 CQI 方法的最低标准。
