The SQUIRE Guidelines: an evaluation from the field, 5 years post release.

Area of Science:

• Healthcare Quality Improvement
• Medical Writing Standards
• Research Reporting

Background:

• The Standards for Quality Improvement Reporting Excellence (SQUIRE) Guidelines were established in 2008 to enhance the reporting of healthcare quality improvement initiatives.
• The field of healthcare improvement has evolved significantly since the initial publication of the SQUIRE Guidelines.
• A comprehensive evaluation of the existing SQUIRE Guidelines was undertaken to inform their revision.

Purpose of the Study:

• To evaluate the utility and identify areas for improvement in the original SQUIRE Guidelines.
• To gather end-user and expert feedback to guide the revision process for the SQUIRE Guidelines.
• To enhance the clarity and completeness of reporting for healthcare improvement projects.

Main Methods:

• An evaluative design incorporating focus groups and semi-structured interviews.
• Involved 29 end-users and 18 advisory group members representing diverse expertise and experience in healthcare improvement and research.
• Purposive sampling ensured variation in participants' work settings, geographic locations, and experience levels.

Main Results:

• Participants found the SQUIRE Guidelines useful for planning healthcare improvement projects but encountered challenges during the writing phase due to redundancies and lack of clarity.
• Specific items, such as "planning the study of the intervention" and the mechanism of change, were difficult for participants to interpret consistently.
• Disagreement existed regarding the reporting of intervention iterations, with experience and evolving terminology hypothesized as contributing factors.

Conclusions:

• The current SQUIRE Guidelines are beneficial for planning but present complexities and ambiguities in the writing process.
• Revision efforts will focus on clarifying identified areas of conflict and defining essential components for comprehensive reporting of improvement work.
• The revised SQUIRE Guidelines aim to improve the precision, accuracy, and completeness of published healthcare improvement reports.