The proposed scoping review will be conducted in accordance with the framework proposed by Arksey and O’Malley [17] and the JBI methodology for scoping reviews [18]. The methodological framework proposed by Arksey and O’Malley [17] comprises 5 stages for conducting a scoping review. The first 2 stages of this protocol have already commenced, namely, the development of the search strategy and preliminary searches. The remaining stages of the scoping review will be carried out as outlined in this protocol.

The search strategy identified documents from 3 databases: PubMed, Scopus, and Embase (Multimedia Appendix 1), which were specifically selected to comprehensively capture clinical, managerial, and international health care policy literature. The main concepts used to develop a customized keyword search were organized around 2 core domains: health care quality professionals and QI competencies. For each database, preliminary searches of document titles and abstracts were conducted to identify key terms related to these 2 core domains. Due to the lack of standardized global nomenclature for health care quality professionals, broad and potentially ambiguous keywords (eg, “quality manager,” “professional competence,” or “continuous improvement”) were deliberately included. This strategy maximized search sensitivity and ensured that relevant literature using alternative or generalized terminology was not excluded. The initial keywords were then adapted to the specific syntax, wildcards, and controlled vocabularies of each database (eg, mapped to Medical Subject Headings [MeSH] terms in PubMed, Emtree in Embase, and using TITLE-ABS-KEY limiters in Scopus). This search strategy was tested and refined as needed to ensure its suitability for the selected databases and keywords. All reviewers evaluated the piloted search strategy and provided feedback for revision, and the proposed search strategy was validated by searching the selected databases. The first 100 search results were reviewed to ensure the validity of the search strategy. The reference lists of all included sources of evidence were screened for additional documents.

This review also included gray literature and related documents that were not available as published documents or in international databases. For example, several official documents such as manuals and reports were available online, with the government official websites serving as useful resources for locating such documents, as only a few published documents exist related to quality competencies of health care professionals. Gray literature was sourced from the targeted MOH websites from the Organization for Economic Co-operation and Development countries, countries that had developed their own National Quality Policy and Strategy based on the World Health Organization regions, and using the Google search engine (Multimedia Appendix 2). The selection of targeted websites was based on the fact that these nations have made significant progress in developing guidelines or strategies to enhance the competence of health care professionals in QI [19,20]. The use of the Google search engine was considered supplementary because not all guidelines or documents have been disseminated through scientific journals, and screening at least the first 200 to 300 results relevant to the study scope was considered [21-23]. The authors acknowledge the Google search engine as a limitation, even though the steps to reduce the filter bubble effect were taken due to the search algorithms’ invisibility. To minimize the potential influence of personalized search results, Google searches were conducted using the incognito or private browsing mode, with no active user login, cleared browsing history, and standardized search settings across reviewers. This is because the technology has been used, hiding the complexity of the search algorithms and not revealing the additional information on which the filtering is based [22,24].

Stages 1 and 2 are already underway, while stage 3 has yet to commence and will be carried out as described in this protocol. The documents retrieved from the search strategy will be collated and uploaded into Excel, with duplicates removed. Three independent reviewers will screen the titles and abstracts of the documents to identify potentially eligible documents. In case of differences in opinion, discussion will be taken to establish agreement on each document. If consensus is not achieved, a fourth reviewer will be consulted. Three reviewers will independently assess the full texts of the documents against the inclusion and exclusion criteria using piloted screening questions (Table 1). Any disagreements among reviewers will be resolved through discussions or by involving a fourth reviewer. All documents that fail to fulfill the inclusion criteria will be excluded.

The inclusion and exclusion criteria for the selected documents are shown in Table 2 and Textbox 2, respectively. The document selection process will exclude newspaper articles, presentation slides, conference proceedings, social media content, unofficial web pages, comments, editorial papers, and opinion papers, as these types of documents may lack the methodological rigor and empirical data required for this study’s “descriptive-analytic” approach. Review articles and protocols are excluded to avoid duplication of evidence, as this scoping review focuses on mapping primary sources. However, to ensure that relevant competency frameworks and conceptual guidance are not overlooked, the reference lists of relevant review articles will be screened to identify additional eligible primary documents. Additionally, peer-reviewed documents focusing on teaching and learning activities, for example, QI competencies for nursing and medical students, will be excluded as these documents do not show the exact competencies required by health care quality professionals. Only documents published in English will be included because English is the universal language understood by all the reviewers and will facilitate a consistent and coherent analysis by the research team. As this study is not funded, the team will face financial barriers when hiring a translator. Using an online translation service may not accurately reflect the technical meaning of the documents; a limitation acknowledged by the authors. While some targeted regions for gray literature are non-English speaking, only documents available in English will be included. Where English translations of relevant documents are available, they will be incorporated. This approach will allow the study to capture key gray literature while remaining consistent with the English-language inclusion criteria and acknowledging practical limitations of financial and translation resources. No time limit will be applied to the published documents, as the authors aim to include as many documents related to the research question as possible.

The search results and the study inclusion process will be reported in full in the final scoping review and presented in a PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) flow diagram [25].

Data for all documents that meet the inclusion criteria will be extracted using a customized data extraction form. The data extraction template is created to guide the data extraction, including document identifiers such as author, document year, document title, document sources (database or gray literature), origin, aim, study design, target population, and health care setting. In addition to the identifying data, the researchers will focus on extracting the domains and subdomains for the QI competencies (Multimedia Appendix 3). To ensure suitability in capturing the data of interest and establish data extraction consistency, the data extraction form will be piloted on at least 5 to 10 eligible documents. Two independent reviewers will extract data from each included document using the data extraction form, which will be modified and revised as necessary throughout the extraction process. The specific revisions will be outlined in the scoping review. Any reviewer disagreement will be addressed through discussion or by involving an additional reviewer. When necessary (and time permits), the documents’ authors will be contacted to solicit any missing or further data.

Given the current lack of clarity regarding the extent of the data available, it is not feasible to anticipate the most effective approach for organizing and disseminating the study findings. However, the data will be analyzed descriptively to obtain a numerical summary of the included documents. This summary will include information such as the total number of documents, the main objective of each document, the type of document, the target population, the year of publication, the country of origin of the document, and the health care settings where competencies are most commonly found. Data regarding the domains and subdomains of QI competencies will be analyzed using an inductive thematic approach [26]. The unit of analysis will be specific textual segments such as sentences or paragraphs that describe knowledge, skills or attitudes, and competencies related to QI. To ensure rigor during the coding process, 2 reviewers will independently perform line-by-line coding of the extracted text. Any disagreement in coding or theme generation will be resolved through discussions or by involving a third reviewer. Codes with similar characteristics will be grouped to generate initial themes. These themes will capture recurring patterns or common characteristics in the data on the domains and subdomains of QI competencies. Themes will be refined and revised as needed to ensure they accurately represent the relevant QI competency domains and subdomains. This inductive thematic synthesis is a highly iterative process, requiring researchers to continuously move back and forth between the raw data, emerging codes, and overarching themes to build an accurate competency framework. The 12-week duration allocated accommodates this rigorous, cyclical process of coding, reviewing, and refining. Subsequently, the final compilation of themes will be defined and tabulated. A narrative synthesis will complement the diagrammatic or tabulated results, describing how the findings relate to the objective and research questions of the review. The study timeline is described in Table 3.

Patients and/or the public will not be involved in the design, conduct, reporting, or dissemination of this research.

Incorporating recognized QI competencies into the practice of health care quality professionals can lead to several beneficial outcomes. Integrating these competencies may standardize QI practices across health care quality professionals, thereby promoting consistency in health care quality practices. The findings of this analysis, along with the suggested QI competencies, may lead to improved engagement and facilitate collaboration among health care quality professionals and policymakers. These competencies can guide the design of both foundational and ongoing educational programs, supporting the professional development of health care quality professionals. Integrating the identified QI competencies into job descriptions and performance evaluations can provide direct and tangible benefits for both health care outcomes and professional development. These recognized QI competencies may serve as a foundation for developing effective interventions and strategies to enhance QI initiatives within the health care sector. Furthermore, comprehending these essential competencies may empower individuals to assess their readiness to actively participate in QI teams.

This scoping review will not assess the identified QI competencies, nor will it critically evaluate the effectiveness of interventions or strategies aimed at developing or improving those competencies. The review is intended to provide a descriptive overview of the existing evidence on QI competency domains and subdomains among health care quality professionals. Furthermore, as scoping reviews do not include a formal quality appraisal of the included papers, the assurance and credibility of the findings may be limited. Nonetheless, the descriptive overview may still inform future research, policy development, and the design of competency frameworks.

A key strength of this review is that it will provide updated evidence on QI competencies from 3 online databases, supplemented by gray literature sources, to facilitate the identification of a comprehensive range of competency areas. Nevertheless, several limitations are anticipated. First, this review will include only publications in English, which may exclude relevant documents in other languages. Second, using specific search terms such as “quality improvement,” “competencies,” and “health care professionals,” primarily within titles and abstracts, may result in missing publications related to QI competencies. The inclusion of gray literature may also be considered a methodological limitation. Although it will enhance comprehensiveness of the review and address publication bias, identifying, locating, and accessing gray literature remains challenging. This is due to its decentralized and nonindexed nature, resulting in a less systematic process of identifying and retrieving gray literature, thus making it more difficult to standardize and reproduce.