SQUIRE Blog

Talking and Teaching about SQUIRE

Kathy Kirkland

Topic: Miscellaneous

I've now had 2 opportunities to present my experience using SQUIRE as part of a presentation with Greg Ogrinc.  He gives the basic overview of how and why SQUIRE was created, and I get to talk about actually using the guidelines as I work to write up my quality improvement work in hand hygiene. 

The audiences were different.  In August we presented at Dept of Medicine grand rounds to what I would have characterized going in as a somewhat skeptical audience.  The words "Quality Improvement" don't necessarily bring the words "academic rigor" to many people's minds.  My sense, though, was that seeing the peer review process that went into developing the guidelines, and the prestige of the people involved, and the journal editors that have endorsed them spoke to some of the more traditional academics in the audience.  The real-life example of turning messy QI work into a publishable work I think appealed to those in the audience who have tried to improve their work (as required by the ABIM) and were prompted to see the work as potentially an academic "product."  Several people came up to me afterwards and said they had been inspired to pull out such projects and use the guidelines to try to make sense of them in this way.

The second audience was a group of MPH students at the Dartmouth Institute for Health Policy and Clinical Practice.  They are learning how to improve healthcare, and probably already "drinking the koolaid."  They asked great questions like "How do you know when in a project to start writing?" or "How do you separate out the improvement related to your interventions from the larger context of people improving healthcare (as we hope everyone at our medical center is doing)?"  I'm not sure I had answers but it seems to me that the latter question really gets at the need to measure how well you implement your intended interventions, and the need to embrace variation in order to understand what works where and why.

Presenting again today is inspiring me to get back on the horse and try to get this manuscript finished before the end of 2009.  I've been letting other things get in the way of finding the "writing space" in my life: like H1N1, and figuring out how to brine a turkey.  I'll be getting back to blogging as I turn again to my manuscript for what I hope will be the final leg of this journey.  Maybe the next version of the SQUIRE guidelines should include a suggested timeline for completion--something less than 5 years maybe!

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