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Review and Application of the Standards for Quality Improvement Reporting Excellence Guidelines in Korea

의료 질 개선 활동 보고지침(SQUIRE) 소개와 적용

  • Seong-Hi Park (School of Nursing, Soonchunhyang University) ;
  • Young-Kyung Do (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Yoo-Sam Chung (Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine)
  • 박성희 (순천향대학교 간호학과) ;
  • 도영경 (서울대학교 의과대학 의료관리학교실) ;
  • 정유삼 (울산대학교 의과대학 서울아산병원 이비인후과)
  • Received : 2023.04.10
  • Accepted : 2023.05.31
  • Published : 2023.06.30

Abstract

Globally, quality improvement (QI) activities are conducted in most health care institutions; however, results of QI activities are shared and communicated rather informally and often only among frontline practitioners. Unless QI activities, a cumulative experiential learning process in each healthcare institution, are shared widely through academic publication, scientific understanding in the QI field will remain a challenge. It was against this backdrop that in 2008 the Standards for QUality Improvement Reporting Excellence (SQUIRE) 1.0 was developed as a guideline for converting cases of QI activities to academic publications. Modifications and further developments in subsequent years led to a revised SQUIRE 2.0 in 2015. This review provides an overview of the development process of the SQUIRE 2.0 and the 18 major items, along with relevant examples for more concrete understanding. The SQUIRE 2.0 highlights the three basic elements involved in systematic efforts to improve quality of care, patient safety, and value: why a certain QI activity was conducted, what was found, and what was learned from it. The SQUIRE 2.0 is a guideline for reporting diverse methods used in QI activities that can be complex and multidimensional. Given that a large number of QI activities are reported in Korea each year in academic conferences, held by the Korean Society for Quality in Health Care and other professional societies, it is our hope that, by introducing the SQUIRE 2.0, this review can serve as a catalyst for converting QI activities to research studies and thereby for disseminating results of QI activities to a wider audience.

Keywords

References

  1. Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ. 2013;347:f6753.
  2. Djulbegovic B. A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice. 2014;10(3):200-2. https://doi.org/10.1200/JOP.2013.001364
  3. Likosky DS. Developing and executing quality improvement projects (concept, methods, and evaluation). Journal of Extra-Corporeal Technology. 2014;46(1):38-44. https://doi.org/10.1051/ject/201446038
  4. Batalden PB, Davidoff F. What is "quality improvement" and how can it transform healthcare? Quality & Safety in Health Care. 2007;16(1):2-3. https://doi.org/10.1136/qshc.2006.022046
  5. Davidoff F, Batalden P. Toward stronger evidence on quality improvement. Draft publication guidelines: the beginning of a consensus project. Quality & Safety in Health Care. 2005;14(5):319-25. https://doi.org/10.1136/qshc.2005.014787
  6. Goodman SN. Toward evidence-based statistics 1. The P value fallacy. Annals of Internal Medicine. 1999;130(12):995-1004. https://doi.org/10.7326/0003-4819-130-12-199906150-00008
  7. Portela MC, Pronovost PJ, Woodcock T, Carter P, Dixon-Woods M. How to study improvement interventions: a brief overview of possible study types. BMJ Quality & Safety. 2015;24(5):325-36. https://doi.org/10.1136/bmjqs-2014-003620
  8. Berwick DM. The science of improvement. JAMA. 2008;299:1182-4. https://doi.org/10.1001/jama.299.10.1182
  9. Taylor MJ, McNicholas C, Nicolay C, Darzi A, Bell D, Reed JE. Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety. 2014;23(4):290-8. https://doi.org/10.1136/bmjqs-2013-001862
  10. Perla RJ, Provost LP, Parry GJ. Seven propositions of the science of improvement: exploring foundations. Quality Management in Health Care. 2013;22(3):170-86. https://doi.org/10.1097/QMH.0b013e31829a6a15
  11. Alexander JA, Hearld LR. The science of quality improvement implementation: developing capacity to make a difference. Medical Care. 2011;49(Suppl):S6-S20. https://doi.org/10.1097/MLR.0b013e3181e1709c
  12. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276(8):637-9. https://doi.org/10.1001/jama.1996.03540080059030
  13. Davidoff F. News from the International Committee of Medical Journal Editors. Annals of Internal Medicine. 2000;133(3):229-31. https://doi.org/10.7326/0003-4819-133-3-200008010-00017
  14. Jung H-I, Kim H-E. Consolidated Standards of Reporting Trials: the reporting guideline for randomized controlled trials. Journal of Dental Hygiene Science. 2014;14(3):269-75. https://doi.org/10.17135/jdhs.2014.14.3.269
  15. Shin C, Han C-S, Pae C-U, Patkar A. Tools for quality evaluation of clinical research reports. Clinical Pharmacology and Neuroscience. 2011;22(2):67-72.
  16. Simera I, Moher D, Hirst A, Hoey J, Schulz KF, Altman DG. Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network. BMC Medicine. 2010;8:24.
  17. Equator Network. Enhancing the quality and transparency of health research. [Internet]. London, UK: The UK EQUATOR Centre; 2023 [cited 2023 Feb 10]. Available from: http://www.equator-network.org.
  18. Davies L, Batalden P, Davidoff F, Stevens D, Ogrinc G.The SQUIRE Guidelines: an evaluation from the field, 5 years post release. BMJ Quality & Safety. 2015;24(12):769-75. https://doi.org/10.1136/bmjqs-2015-004116
  19. 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. BMJ Quality & Safety. 2016;25(12):986-92. https://doi.org/10.1136/bmjqs-2015-004411
  20. Korean Society for Quality in Health Care. Submission guidelines for authors: how we do it. [Internet]. Seoul, Korea: Korean Society for Quality in Health Care; 2022 [cited 2023 Feb 10]. Available from: http://www.kosqua.net/index.php?hCode=-JOURNAL_04_02.
  21. Grol RP, Bosch MC, Hulscher ME, Eccles MP, Wensing M. Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Quarterly. 2007;85(1):93-138. https://doi.org/10.1111/j.1468-0009.2007.00478.x
  22. Rubenstein LV, Hempel S, Farmer MM, Asch SM, Yano EM, Dougherty D, et al. Finding order in heterogeneity: types of quality-improvement intervention publications. Quality & Safety in Health Care. 2008;17(6):403-8. https://doi.org/10.1136/qshc.2008.028423
  23. Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Affairs (Project Hope). 2002;21(5):103-11. https://doi.org/10.1377/hlthaff.21.5.103
  24. Cronenwett L, Sherwood G, Barnsteiner J, Disch J, Johnson J, Mitchell P, et al. Quality and Safety Education for Nurses. Nursing Outlook. 2007;55(3):122-31. https://doi.org/10.1016/j.outlook.2007.02.006
  25. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney S; SQUIRE Development Group. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Quality & Safety in Health Care. 2008;17(Suppl 1):i3-i9. https://doi.org/10.1136/qshc.2008.029066
  26. Day RA. The origins of the scientific paper: the IMRAD format. American Medical Writers Association Journal. 1989;4:16-8.
  27. Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0: standard per l'eccellenza nel reporting degli studi di miglioramento della qualita Revisione delle linee guida dopo un rigoroso processo di consenso. Evidence. 2015;7(9):e1000119.
  28. Dyrkorn OA, Kristoffersen M, Walberg M. Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic. BMJ Quality & Safety 2012;21(3):206-10. https://doi.org/10.1136/bmjqs-2011-000316
  29. Benning A, Ghaleb M, Suokas A, Dixon-Woods M, Dawson J, Barber N, et al. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation. BMJ (Clinical research ed.), 2011;342:d195.
  30. Reavey DA, Haney BM, Atchison L, Anderson B, Sandritter T, Pallotto EK. Improving pain assessment in the NICU: a quality improvement project. Advances in Neonatal Care. 2014; 14(3):144-53. https://doi.org/10.1097/ANC.0000000000000034
  31. Feldman-Winter L, Ustianov J, Anastasio J, Butts-Dion S, Heinrich P, Merewood A, et al. Best fed beginnings: a Nationwide Quality Improvement Initiative to Increase Breastfeeding. Pediatrics. 2017;140(1):e20163121.
  32. Xing W, Zhang Y, Gu C, Lizarondo L. Pelvic floor muscle training for the prevention of urinary incontinence in antenatal and postnatal women: a best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports. 2017;15(2):567-83. https://doi.org/10.11124/JBISRIR-2016-003277
  33. Geerlinks AV, Digout C, Bernstein M, Chan A, MacPhee S, Pambrun C, et al. Improving time to antibiotics for pediatric oncology patients with fever and suspected neutropenia by applying lean principles. Pediatric Emergency Care. 2020;36(11):509-14. https://doi.org/10.1097/PEC.0000000000001557
  34. Jobson M, Sandrof M, Valeriote T, Liberty AL, Walsh-Kelly C, Jackson C. Decreasing time to antibiotics in febrile patients with central lines in the emergency department. Pediatrics. 2014;135(1):e187-e95. https://doi.org/10.1542/peds.2014-1192
  35. Lesselroth BJ, Yang J, McConnachie J, Brenk T, Winterbottom L. Addressing the sociotechnical drivers of quality improvement: a case study of post-operative DVT prophylaxis computerised decision support. BMJ Quality & Safety. 2011;20(5):381-9. https://doi.org/10.1136/bmjqs.2010.042689
  36. Zubkoff L, Neily J, Mills PD, Borzecki A, Shin M, Lynn MM, et al. Using a virtual breakthrough series collaborative to reduce postoperative respiratory failure in 16 Veterans Health Administration hospitals. Joint Commission Journal on Quality and Patient Safety. 2014;40(1):11-20. https://doi.org/10.1016/S1553-7250(14)40002-3
  37. Dandoy CE, Davies SM, Flesch L, Hayward M, Koons C, Coleman K, et al. A team-based approach to reducing cardiac monitor alarms. Pediatrics 2014;134(6):e1686-e94. https://doi.org/10.1542/peds.2014-1162
  38. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.
  39. Srigley JA, Furness CD, Baker GR, Gardam M. Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ Quality & Safety. 2014;23(12):974-80. https://doi.org/10.1136/bmjqs-2014-003080
  40. Okumura MJ, Ong T, Dawson D, Nielson D, Lewis N, Richards M, et al. Improving transition from paediatric to adult cystic fibrosis care: programme implementation and evaluation. BMJ Quality & Safety. 2014;23(Suppl 1):i64-i72. https://doi.org/10.1136/bmjqs-2013-002364
  41. Harvey G, Jas P, Walshe K, Skelcher C. Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement. BMJ Quality & Safety. 2014;24(1):48-55. https://doi.org/10.1136/bmjqs-2014-002928
  42. Brady PW, Zix J, Brilli R, Wheeler DS, Griffith K, Giaccone MJ, et al. Developing and evaluating the success of a family activated medical emergency team: a quality improvement report. BMJ Quality & Safety 2014;24(3):203-11. https://doi.org/10.1136/bmjqs-2014-003001
  43. Hands C, Reid E, Meredith P, Smith GB, Prytherch DR, Schmidt PE, et al. Patterns in the recording of vital signs and early warning scores: compliance with a clinical escalation protocol. BMJ Quality & Safety 2013;22(9):719-26. https://doi.org/10.1136/bmjqs-2013-001954
  44. Davidoff F, Dixon-Woods M, Leviton L, Michie S. Demystifying theory and its use in improvement. BMJ Quality & Safety. 2015;24(3):228-38. https://doi.org/10.1136/bmjqs-2014-003627
  45. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Science. 2011;6:42.
  46. Dainty KN, Scales DC, Sinuff T, Zwarenstein M. Competition in collaborative clothing: a qualitative case study of influences on collaborative quality improvement in the ICU. BMJ Quality & Safety. 2013;22(4):317-23. https://doi.org/10.1136/bmjqs-2012-001166
  47. Donahue KE, Halladay JR, Wise A, Reiter K, Lee SY, Ward K, et al. Facilitators of Transforming Primary Care: A Look Under the Hood at Practice Leadership. Annals of Family Medicine. 2013;11(Suppl 1):S27-S33. https://doi.org/10.1370/afm.1492
  48. Guse SE, Neuman MI, O'Brien M, Alexander ME, Berry M, Monuteaux MC, et al. Implementing a Guideline to Improve Management of Syncope in the Emergency Department. Pediatrics. 2014;134(5):e1413-e21. https://doi.org/10.1542/peds.2013-3833
  49. Berlinski A, Chambers MJ, Willis L, Homa K, Com G. Redesigning care to meet national recommendation of four or more yearly clinic visits in patients with cystic fibrosis. BMJ Quality & Safety 2014;23(Suppl 1):i42-i9. https://doi.org/10.1136/bmjqs-2013-002345
  50. Dhalla IA, O'Brien T, Morra D, Thorpe KE, Wong BM, Mehta R, et al. Effect of a Postdischarge Virtual Ward on Readmission or Death for High-Risk Patients. JAMA. 2014;312(13):1305-12. https://doi.org/10.1001/jama.2014.11492