Checklist for reporting a quality improvement in health care

This checklist is relevant to reports that describe system level work to improve the quality, safety, and value of healthcare, and is based on the SQUIRE statement.  Read more


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Instructions

Complete this checklist by entering the page numbers from your manuscript where readers will find each of the items listed below.

Your article may not currently address all the items on the checklist. Please modify your text to include the missing information. If you are certain that an item does not apply, please write "n/a" and provide a short explanation.

Download your completed checklist and include it as an extra file when you submit to a journal.

Title

1.

Indicate that the manuscript concerns an initiative to improve healthcare (broadly defined to include the quality, safety, effectiveness, patientcenteredness, timeliness, cost, efficiency, and equity of healthcare).

Abstract

02a

Provide adequate information to aid in searching and indexing.

02b

Summarize all key information from various sections of the text using the abstract format of the intended publication or a structured summary such as: background, local problem, methods, interventions, results, conclusions.

Introduction

3.

Problem description

Nature and significance of the local problem.

4.

Available knowledge

Summary of what is currently known about the problem, including relevant previous studies.

5.

Rationale

Informal or formal frameworks, models, concepts, and / or theories used to explain the problem, any reasons or assumptions that were used to develop the intervention(s), and reasons why the intervention(s) was expected to work.

6.

Specific aims

Purpose of the project and of this report.

Methods

7.

Context

Contextual elements considered important at the outset of introducing the intervention(s).

08a

Intervention(s)

Description of the intervention(s) in sufficient detail that others could reproduce it.

08b

Intervention(s)

Specifics of the team involved in the work.

09a

Study of the Intervention(s)

Approach chosen for assessing the impact of the intervention(s).

09b

Study of the Intervention(s)

Approach used to establish whether the observed outcomes were due to the intervention(s).

10a

Measures

Measures chosen for studying processes and outcomes of the intervention(s), including rationale for choosing them, their operational definitions, and their validity and reliability.

10b

Measures

Description of the approach to the ongoing assessment of contextual elements that contributed to the success, failure, efficiency, and cost.

10c

Measures

Methods employed for assessing completeness and accuracy of data.

11a

Analysis

Qualitative and quantitative methods used to draw inferences from the data.

11b

Analysis

Methods for understanding variation within the data, including the effects of time as a variable.

12.

Ethical considerations

Ethical aspects of implementing and studying the intervention(s) and how they were addressed, including, but not limited to, formal ethics review and potential conflict(s) of interest.

Results

13a

Initial steps of the intervention(s) and their evolution over time (e.g., time-line diagram, flow chart, or table), including modifications made to the intervention during the project.

13b

Details of the process measures and outcome.

13c

Contextual elements that interacted with the intervention(s).

13d

Observed associations between outcomes, interventions, and relevant contextual elements.

13e

Unintended consequences such as unexpected benefits, problems, failures, or costs associated with the intervention(s).

13f

Details about missing data.

Discussion

14a

Summary

Key findings, including relevance to the rationale and specific aims.

14b

Summary

Particular strengths of the project.

15a

Interpretation

Nature of the association between the intervention(s) and the outcomes.

15b

Interpretation

Comparison of results with findings from other publications.

15c

Interpretation

Impact of the project on people and systems.

15d

Interpretation

Reasons for any differences between observed and anticipated outcomes, including the influence of context.

15e

Interpretation

Costs and strategic trade-offs, including opportunity costs.

16a

Limitations

Limits to the generalizability of the work.

16b

Limitations

Factors that might have limited internal validity such as confounding, bias, or imprecision in the design, methods, measurement, or analysis.

16c

Limitations

Efforts made to minimize and adjust for limitations.

17a

Conclusion

Usefulness of the work.

17b

Conclusion

Sustainability.

17c

Conclusion

Potential for spread to other contexts.

17d

Conclusion

Implications for practice and for further study in the field.

17e

Conclusion

Suggested next steps.

Other information

18.

Funding

Sources of funding that supported this work. Role, if any, of the funding organization in the design, implementation, interpretation, and reporting.


To acknowledge this checklist in your methods, please state "We used the SQUIRE checklist when writing our report [citation]". Then cite this checklist as 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.


The SQUIRE 2.0 checklist is distributed under the terms of the Creative Commons Attribution License CC BY-NC 4.0