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The fits and starts of writing

Kathy Kirkland

Here I go again.

 It's not that I haven't been writing; I just haven't been writing the hand hygiene piece.  I allow myself to agree to other writing tasks and then I postpone the writing task that doesn't have an external deadline.  But I have a renewed interest in getting this manuscript finished.

 I spent the last week at "summer camp" for grownups committed to improving healthcare.  I gained some new insights on my hand hygiene work from a criminologist.  Yes, it seems there are parallels between my work and crime prevention!  (How that never dawned on me before may be the stranger realization.)  In any event, I have some good, new ideas about how to approach the next set of learning.  But first, I absolutely must finish telling the current story. (It helped that the leader of our writing collaborative was also at summer camp.  One look from him, and I squirm.)

So--this afternoon, between other things, and with a pile of things on my desk, I opened up my draft manuscript and started writing again, this time in the Results section.  The way I see it (interpreting the Squire guidelines as they relate to my work)  the task in this section is to answer two questions:

     1) Did we do what we said we would do (in the methods)? (how well?)

     2) Did it work? (ie, did hand hygiene improve, and did we have fewer infections?)

Obviously, the second question is easier to write the answer to--and is the stuff of "normal" scholarly manuscripts.  The first question is the messy work of quality improvement, and of course the answer is no, not exactly--ie, we approximated what we set out to do, but there were deviations from the plan that are probably important to understand if you want to understand what about what we did worked.

 I only got about a paragraph written, but I think the important part was figuring out that questions 1 and 2 need to be answered.  It was helpful that back at the beginning of the project I laid out a 3 page document that outlined who was to be involved, in what role, and what the various workgroups were charged with.  It helps to see that in writing so I can reflect on what did and didn't happen according to plan.

 The SQUIRE guidelines continue to be helpful as signposts for me.  It may become second nature to write this kind of paper...later.

 Reading Sue's entries, I have to say that I feel pretty lucky to write in an environment where I can access the literature with a few keystrokes, and am surrounded by people who find my scholarly work familiar, at least on the surface.

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