Marjon Borgert

77 A flowchart for building evidence-based care bundles Quality assessment For nine studies the checklist of Downs and Black was used. In 56% (5/9), studies scored between 15-19 points and were classi ed as ‘fair’. One study scored 24 points and was classi ed as‘good’. 28 Studies were classi ed as‘poor’quality in 33% (3/9) (Supplementary File 2, Table 1). In six studies the AGREE II was used. Quality scores were calculated per domain 13 (Supplementary File 2, Table 2). For Domain 1, all six studies were classi ed as ‘good’, which means that the scope and purpose of the bundle were clearly explained. Six studies were classi ed as ‘fair’ for Domain 2, i.e. stakeholder involvement and for Domain 4, i.e. clarity of presentation. For three studies it was not possible to assess their quality, because narrative reports were written about care bundles in general and no assessment tools were available. Flowchart for bundle design The expert team created a owchart containing all process steps to design new care bundles. The outline of the owchart is shown in Figure 2. Three evaluations were added to the owchart. These moments can be used to assess if the bundle conditions are met or to identify risks or problems prospectively. 2 Reported methods for bundle design The methods identi ed by the review were placed in either one of the main process steps. Table 2 shows all methods per process step. The table is complementary to Figure 2. In four process steps no other methods than the IHI methods were found.