What is the value and impact of the adaptation process on quality indicators for local use? A scoping review

Quality indicators (QIs) are designed for improving quality of care, but the development of QIs is resource intensive and time consuming.

To describe and identify the impact and potential attributes of the adaptation process for the local use of existing QIs.

EMBASE, MEDLINE, CINAHL and grey literature were searched.

Literatures operationalizing or implementing QIs that were developed in a different jurisdiction from the place where the QIs were included.

Of 7704 citations identified, 10 out of 33 articles were included. Our results revealed a lack of definition and conceptualization for an adaptation process in which an existing set of QIs was applied. Four out of ten studies involved a consensus process (e.g., Delphi or RAND process) to determine the suitability of QIs for local use. QIs for chronic conditions in primary and secondary settings were mostly used for adaptation. Of the ones that underwent a consensus process, 56.3 to 85.7% of original QIs were considered valid for local use, and 2 to 21.8% of proposed QIs were newly added. Four attributes should be considered in the adaptation: 1) identifying areas/conditions; 2) a consensus process; 3) proposing adapted QIs; 4) operationalization and evaluation.

The existing QIs, although serving as a good starting point, were not adequately adapted before for use in a different jurisdiction from their origin. Adaptation of QIs under a systematic approach is critical for informing future research planning for QIs adaptation and potentially establishing a new pathway for healthcare improvement.