Three Questions … A Quick Glimpse Into WHO is Using SQUIRE and WHY
Sarah Frazer, BA, BSc, MIHM, FRSA
Dr. Frazer is well known in healthcare for her work on how good practice spreads, how improvements can be made at practitioner level and how organizations and teams can best work together. She is a speaker and workshop presenter and has written numerous papers, articles and guides around the topics of the spread of better practice, complex systems, culture and behavior in organizations, breakthrough collaborative and improvement methodologies, and is the author of "Undressing the Elephant; Why Good Practice Doesn't Spread in Healthcare"
1. What have you found most interesting about SQUIRE
SQUIRE is perhaps not only for writing up completed improvement work. We've been using the guidelines in two proactive ways. One method is at the start of a project to use SQUIRE like a meeting agenda and to work through the topics. The headings enable a comprehensive discussion and more detailed planning than before. They work as excellent reminders for all aspects of improvement project implementation. Another way is to use them as a midway project review. In this case we use them to draft a case study as though the project was completed and we are writing some time after the end. In this way we check progress and do future planning that is more implementation orientated. The process provides insight into work still to be completed if the intended
outcomes are to be achieved.
2. How have the guidelines been helpful in writing about your improvement work?
They provide a comprehensive list of what can be covered. We do have a fair amount of discussion on some items and disagreement as to whether they should be included in the write-up. This is interesting in itself and we usually end up adding the section in after the debate! Where context, history and funding is concerned the guidelines are an excellent step forward in helping those who read the write-ups to understand how applicable the results may be to their own situation. There is some evidence of some projects not wishing to use the guidelines because they appear too onerous. My feeling is this is precisely what the guidelines are intending to resolve - the quick write up that lacks fidelity.
3. Have the SQUIRE guidelines influenced how you plan for future work?
Yes. We use them as a guidelines for improvement project planning. It can be frustrating to get to the end of the project and realize some effort at the start on, for example, addressing ethical issues, would have meant a more efficient and effective process and better outcome. For me personally I am a lot more critical of what I read. I use the guidelines as my benchmark. If improvement reports leave out many of the headings then I ask myself, and others, why the omission and what impact does this have on the result and its generalizability.
“Outstanding SQUIRE Presentation”
Greg Ogrinc, MD, MS, and Kathryn Kirkland, MD, presented Medicine Grand Rounds at Dartmouth-Hitchcock Medical Center on Friday, September 11, 2009. The presentation contained an overview of the need for and the development of the SQUIRE guidelines along with an in depth example of using the guidelines to write a paper. The video stream for the presentation is available here: http://www.dhslides.org/mgr/mgr091109f/f.htm
Three Questions … A Quick Glimpse Into WHO is Using SQUIRE and WHY
Neesha Naik Choma, MD
Dr. Choma is a member of the Department of Medicine, Division of General Internal Medicine and Public Health at the Vanderbilt University Medical Center and on staff at the Department of Veterans Affairs in Nashville, TN. Dr. Choma recently had a QI paper accepted by Cardiovascular Quality and Outcomes. Here is what she has to say about SQUIRE.
1. What have you found most interesting about SQUIRE?
I like the way SQUIRE guidelines seamlessly merge the elements unique to quality improvement (QI) research with current scientific literary practice. Quality improvement in healthcare is receiving heightened attention as an important practice in care delivery today, yet the intricacies and subtitles of QI research remain unfamiliar to many practicing providers and administrators. As it disseminates and becomes incorporated into the medical community at large, SQUIRE guidelines will help to increase awareness and change general familiarity with QI.
2. How have the guidelines been helpful in writing about your improvement work?
I primarily used SQUIRE guidelines as a checklist. I actually started writing my manuscript before I was aware of SQUIRE and had to resort to extracting recurrent "themes" from existing QI literature to formulate a paper outline. I found out about SQUIRE prior to manuscript submission and used it to refine my paper and ensure that it was thorough and met scientific rigor.
3. Have the SQUIRE Guidelines influenced how you plan for future improvement work?
Definitely. It is extremely helpful to have a set of scientifically based guidelines to refer to as I continue to plan QI work and generate manuscripts. Now that I am aware and familiar with the guidelines, I will use SQUIRE as a starting point when planning QI projects. It will be helpful to ensure various key QI elements are considered, designed, and included early on before unrolling actual interventions.
SPINE Journal Adopts SQUIRE Guidelines
SPINE has joined the leaders in healthcare journals by adopting the SQUIRE Guidelines in their Instructions for Authors. Recognized internationally as the leading subspecialty journal for the treatment of spinal disorders, Spine is a peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. Spine request in their Instruction for Authors that all manuscripts describing quality improvement studies to follow the Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines.
Canadian Journal of Diabetes Endorse SQUIRE
In the Editor's Note, of V32,#4 of the Canadian Journal of Diabetes, Heather J. Dean, MD, FRCPC, Editor-in-Chief stated "The Canadian Journal of Diabetes is proud to be one of the international journals supporting these important new publishing guidelines". She goes on to state "these guidelines will substantially enhance scholarship in the field of QI." Dr. Dean then summarizes her editorial with "The Canadian Journal of Diabetes eagerly awaits authors who submit manuscripts and comply with the SQUIRE Guidelines and, even more fundamentally, who use the guidelines to inform the design of the QUI project they undertake." With that the journal also published the "Development of the SQUIRE Publication Guidelines" in the same journal publication showing their commitment to SQUIRE.
Willkommen SQUIRE!
SQUIRE Guidelines Make International Debut at the 2009 International Forum on Quality and Safety in Berlin Germany
Over 125 interprofessional delegates from around the world participated in a workshop session on the SQUIRE Guidelines. The workshop focused on the development of the guidelines; the details of describing the context of improvement projects; and featured an audience review of a section of a manuscript. This hands-on learning approach to SQUIRE was well received by the participants and felt to be very helpful even ... Wundervoll!