SQUIRE Reporting Guidelines for Quality Improvement Studies

Abstract

The science of quality and safety is different from traditional science in so many ways that early attempts to define improvement work as science often generated tremendous debate and even contempt in the scientific community. Further, initial efforts to share findings and disseminate knowledge in the field by way of scholarly publication were limited by an inability to conform to traditional templates used when publishing scientific findings based on hypothesis testing. In 1999, the Quality Improvement Report Guidelines 1 were published to guide manuscript preparation for studies on local quality improvement. In response to continued confusion on how to format these manuscripts in a structured, meaningful fashion, the Standards for Quality Improvement Reporting Excellence (SQUIRE) reporting guideline was released in 2008 and revised in 2015 (SQUIRE 2.0). 2 SQUIRE 2.0 was developed using a combination of semistructured interviews and focus groups with end users, expert engagement in the interpretation of the interviews, and pilot testing. The guideline provides direction on how to report systematic efforts in health care improvement regardless of the specific approach used. A summary of the guideline is presented in the Box. While SQUIRE is less frequently used than other frameworks (eg, Consolidated Standards of Reporting Trials [CONSORT]), we hope this article helps elevate its use in the field of surgery. One reason for its limited use may be the lack of requirement for its use by many journals. ensure uniformity of language and avoid confusion associated with the multiplicity of terms. The Explanation and Elaboration document 8 provides supplemental instructions about each element, and other authors have published on the nuts and bolts of how best to write a quality and safety manuscript. 9

Improving Acute Orthopaedic Admission Note Documentation Standards at a Tertiary Centre Through Proforma Introduction: A Quality Improvement Initiative

“…This quality improvement project was performed with respect to Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines [ 13 ] at a regional trauma and tertiary referral centre in the West of Ireland [ 14 ]. First, a retrospective review of 50 consecutive unscripted admission notes was conducted independently by three authors, Conor O'Driscoll, Ross Condell, and David O'Sullivan.…”

Implementation of a standardized voiding protocol after minimally invasive surgery: A quality improvement initiative

“…Following the SQUIRE guidelines, 4 informed by best available evidence 5 and advice from quality improvement experts, we designed a quality improvement initiative to reduce the rate of UTI after minimally invasive hysterectomy for gynecologic malignancies (Figure 1). This list of interventions 6 included: (1) education sessions with house staff and nursing staff about appropriate Foley catheter management, (2) aseptic Foley catheter insertion technique at time of surgery, (3) use of new catheter for every insertion attempt, (4) proper positioning of catheter bag below the level of the bladder during surgery, (5) catheter removal immediately after surgery in the operating room, (6) implementing a formal trial of void protocol (Figure 2), and (7) limiting repeat catheterizations for urinary retention.…”

Totally Excited about Moving Mobility and Exercise (TEAM Me): A Successful Multidisciplinary Exercise Quality Improvement Initiative for Pediatric and Young Adult Oncology and Stem Cell Transplant Inpatients

“…We utilized a Plan-Do-Study-Act (PDSA) model to study the impact of this quality improvement program on the physical activity of children receiving cancer/stem cell therapy and on staff perceptions of patients’ physical activity. We report our findings in accordance with the Standards for Reporting Quality Improvement Excellence (SQUIRE) guidelines for reporting quality improvement studies [ 6 ].…”