SQUIRE History
Development of the SQUIRE Guidelines and the Example and Explanation (E&E) Document
The SQUIRE guidelines were refined through a systematic vetting process with input from an expert panel and through public feedback. Specific details are provided elsewhere (Davidoff et al., Publication Guidelines for Quality Improvement in Health Care: Evolution of the SQUIRE Project, Qual Saf Health Care, 2008). Additionally, a table (PDF) is available that summarizes changes from the initial draft guidelines to the current SQUIRE guidelines. In brief, the development process involved:
- initial publication of draft guidelines in September 2005;
- a period of open, public feedback;
- a consensus conference in April 2007; and
- an asynchronous, email feedback loop leading to this current publication.
The Explanation and Elaboration (E&E) document, uses the current SQUIRE guidelines and identifies exemplary examples from existing literature to show how each guideline item can be addressed. This E&E document is designed to aid authors as they embark on an effort to share their work through publication using the SQUIRE guidelines.
We formed an author group for the E&E document by inviting individuals whose published work concentrated on specific areas of improvement and assigned a SQUIRE guideline item to each author. The author identified one or more articles that exemplified the components of that item. He or she then wrote a commentary expanding on the item’s content and linking the example article to the contents of the guideline item. A few of the articles chosen as examples in this paper were written using the initial SQUIRE guidelines[8], but most were not.
The E&E document demonstrates how it is possible to clearly write about improvement work using the SQUIRE guidelines. Also, many E&E sections include descriptions of what could have been added to enhance the example. Some may also link the contents of one section to another (e.g., Study Questions (Item #6) and Summary (Item #14)).