Getting It Right: Putting the ‘QI’ in Quality Improvement Reports

Towards a Safer Health System

Ever since the famous report To Err is Human: Building a Safer Health System was issued by the Institute of Medicine (now the National Academies of Sciences, Engineering, and Medicine) in 1999, health care institutions have been pushed towards reducing errors and increasing safety.

Changes have been spurred by accrediting and government organizations like the Joint Commission and the Centers for Medicare and Medicaid Services, by independent and professional initiatives like the Institute for Healthcare Improvement and the Magnet Recognition Program, and by consumer advocacy groups like the The Leapfrog Group and the National Patient Safety Foundation.

Nursing Education and Quality Improvement

Nursing, as the largest department in hospitals and the one tasked with shepherding patients through the system, is a key player in any system redesign and many nursing departments are playing an active role in improving the safety and quality of care.

Nursing education has also embraced the QI movement, adopting the Quality and Safety in Nursing (QSEN) program in many curriculums and also making it a hallmark of its doctor of nursing practice (DNP) programs. Developing and implementing QI projects is frequently a requirement for completing these programs.

Many have gone further and require students to submit their reports for publication. That can be a good thing, if the projects are done well and provide evidence to show either what works or what doesn’t work and why. However, even if the projects are done well, often the reports are done poorly.

Don’t Ignore the Easy-to-Follow Guidelines

In the September editorial, Jane Barnsteiner, AJN’s editor for research and QI, and I write about the problems we see in the many reports we receive (and which we know many other editors receive and are equally dismayed). Many reports don’t follow the SQUIRE Guidelines (Standards for QUality Improvement Reporting Excellence) and therefore lack the details that would make the report valuable and useful to others.

As we note, “No amount of good writing can fix a fatally flawed project.” Students need faculty to be knowledgeable about and guide them in using the SQUIRE guidelines. (Note: there is a SQUIRE writing conference coming up in November, but the guidelines and checklist of the new SQUIRE 2.0 version are easy to follow!)