About SQUIRE

Writing is part of quality and safety work.

Writing about and sharing your work it is important because it:

  • Forces you to clarify your thinking, verify your observations, and justify your inferences.
  • Hastens the spread of important and useful innovations.
  • Reduces the waste scarce of resources in confirming findings that are already firmly established.
  • Makes it possible to confirm uncertain findings.
  • Keeps people from repeating mistakes unnecesarily.
  • Contributes to the “collective memory,” which provides the context for interpreting new findings properly.
  • Returns something of value for the time, effort, inconvenience, and funds that people put into the work.
  • Holds you publicly accountable for your efforts.

For more on these issues, see: Davidoff F, Batalden P. Toward stronger evidence on quality improvement. Draft publication guidelines: the beginning of a consensue project. Qual Saf. Health Care 2005;14:319-25

Improvement efforts focus primarily on making care better at local sites, rather than on generating new, generalizable scientific knowledge. Despite its local focus, improvement frequently generates important new generalizable knowledge about systems of care and about how best to change those systems.  Whether improvement interventions are small or large, simple or complex, the Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines provide an explicit framework for sharing the knowledge acquired by examining those interventions closely, carefully, and in detail.

As you read and use these guidelines and the Explanation and Elaboration (E&E), you may have questions or comments about individual items in the guidelines, about examples that were chosen, about the guidelines, or the E&E as a whole.  We intend this E&E as a starting point for ongoing dialogue about the implementation and evaluation of the SQUIRE guidelines.  Please comment on an individual E&E item (found at the bottom of each web page) or contact the SQUIRE group with any questions or comments.

If you are submitting a manuscript to a journal that does not explicitly endorse the SQUIRE guidelines, we encourage you to refer the editor(s) and reviewers to this website so that they may become familiar with these guidelines.

The planning, implementation, analysis, and reporting of improvement work continue to evolve. The E&E provides a snapshot of existing examples that help to illustrate the many important and nuanced issues in doing, studying, and reporting QI work.  Ideally, these examples will be supplanted by hundreds of additional ones in the coming months and years, as the SQUIRE guidelines are used widely throughout the improvement community.