The Development of the Tool for Rating the qUality of Services Tandards (TRUST)

Background This study aimed to develop a preliminary framework for the systematic, multi‐dimensional evaluation of service standards, the Tool for Rating the qUality of Service sTandards (TRUST), to address the heterogeneity and quality‐related deficiencies in existing standards and to provide a preliminary evidence‐informed basis for evaluating, optimizing, and promoting the quality of service standards. Methods TRUST was developed through an evidence based multi‐step process. First, a TRUST Working Group, consisting of a drafting team, an expert panel, and a steering committee, was established. A pool of candidate items was then constructed through a systematic literature review that identified 16 existing standard evaluation frameworks, followed by a group discussion. Subsequently, a structured online expert survey was conducted to assess expert agreement on the preliminary set of items. Item weights were calculated using the Precedence Chart method. Finally, we conducted a pilot study and calculated the inter‐rater reliability coefficients applying TRUST to a sample of 51 published standards. Results TRUST comprises 17 items across five distinct dimensions: collaboration (28.0%), scope and purpose (7.6%), quality management (39.1%), implementation and updates (15.6%) and social impact (9.7%). Inter‐rater reliability (intraclass correlation coefficient [ICC] (A,1)) across items ranged from 0.502 to 0.860, and the total score showed excellent reliability (ICC (A,1) = 0.832, 95% CI: 0.723–0.901). Conclusion TRUST offers an initial evidence‐based architecture to guide the future development of assessment instruments for standards, laying the groundwork for theoretical and practical support in optimizing and refining standards.