HiQuiPs: Preparing a QI Manuscript – the SQUIRE 2.0 Guidelines

Updated: Feb 28

Authors: Matthew Hacker Teper, Shawn Mondoux, Ahmed Taher


You are planning to conduct a quality improvement project and your project supervisor has advocated that you download a copy of the SQUIRE 2.0 QI reporting guidelines before you begin. This is confusing, as it seemed to you that reporting guidelines governed how a manuscript should be drafted rather than how a project should be conducted. You decide to take a deeper dive into the SQUIRE 2.0 guidelines.


Squire logo. Standards for Quality Improvement Reporting Excellence (source: SQUIRE)

Do I NEED to follow the SQUIRE 2.0 guidelines?

You do not. Although SQUIRE represents best practices for publishing in QI and likely yield the most consumable and “spreadable” manuscript, most quality improvement articles that are featured in prominent journals do not yet follow the SQUIRE 2.0 guidelines. BMJ Quality and Safety, for example, allows authors to submit both Original Research (which should follow the respective reporting standard) and Quality Improvement Reports (which are to follow the SQUIRE 2.0 guidelines). This represents an acknowledgement that a significant number of research interventions that use other methodologies - for example, randomized trials with CONSORT guidelines,​(1)​ observational trials with STROBE guidelines​ (2​) - still may have important findings that should be relayed to a larger audience. Despite the fact that CONSORT and STROBE are not primarily designed for QI, the clear adherence to their tenets and their incorporation into a research team’s processes typically generates a high-quality manuscript.


The trouble is when research teams do not incorporate the tenants of any reporting guideline and then look to “adapt” a manuscript after the intervention has been completed to suit the requirements of a reporting guideline. This generally leads to clear gaps in adherence to the reporting standard. These are most often noticed by editorial teams and become difficult limitations to circumvent.


Summing up: guidelines for more than just writing

In the end, it turns out the reporting standards are the result of the combined knowledge of individuals with significant expertise in writing manuscripts and conducting projects of a specific subtype. Although they are meant to guide writing, they are often insightful documents that may drive a research project from its inception, long before a manuscript is ever drafted.


After reviewing the SQUIRE 2.0 guidelines, you realize that there is value in incorporating and thinking about the manuscript and how it will be drafted even though you are still in the planning stage of the QI project. You decide to work this into your QI project early on so that the transition into more formal QI reporting will be less challenging.


That's it! We hope this helps introduce the reader to the SQUIRE 2.0 QI reporting guidelines. We would encourage all readers to incorporate these reporting guidelines into the foundational documents and guidance of any research project.


This post was copyedited by: Matthew Hacker Teper


References

  1. Schulz K, Altman D, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152(11):726-732. doi:10.7326/0003-4819-152-11-201006010-00232

  2. von E, Altman D, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495-1499. doi:10.1016/j.ijsu.2014.07.013

  3. Moher D, Liberati A, Tetzlaff J, Altman D, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097

  4. Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. Squire 2.0 (Standards for Quality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. Am J Crit Care. 2015;24(6):466-473. doi:10.4037/ajcc2015455

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