Background Quality standards describe high-priority areas for quality improvement in a defined area.

Objectives To describe the processes by which areas for quality improvement are identified for quality standards.

Methods A topic overview, which describes core elements of the standard, such as the population and condition or services to be covered, is published on our website at the beginning of development. We then request written submissions from specialists and registered stakeholders asking them to i identify key areas for quality improvement ii provide examples of published information on current practice (such as, reports of variation in care, evaluations of guidance compliance, or patient experience) to support the identified areas. We also undertake a focused literature search for published current practice information (such as descriptions of practice variation) and identify national audits.

Results To date, we have undertaken at least 10 such reviews. We will present the types of information we receive, challenges (with a specific focus on quality of information and certainty of decisions made). We will also present how this information was used to identify area for improvement, and whether these decisions were valid.

Discussion We consider this a novel and practical approach to identifying improvement areas, bringing together views from a diverse audience, supplemented with published information.

Implications for Guideline Developers/Users Guideline developers could use similar methods to identify areas where evidence based recommendations could be focused, to define and guide best practice.