SQUIRE Blog

Who, what, why? Introduction to me, my project, and this blog

Kathy Kirkland

I'm Kathy Kirkland.  I'm an infectous disease physician and the hospital epidemiologist at Dartmouth-Hitchcock Medical Center in Lebanon, NH.  I also coach residents and fellows in our Leadership Preventive Medicine Residency.  Quality improvement, systems thinking, reflecting on what works when and why--these ways of thinking thread through my entire professional life, and I even find it informing my home life, much to my children's eye-rolling.

Until recently much of the type of work I do hasn't really had a place in the medical literature.  The typical journal article would tell readers "how much" a QI intervention improved outcomes, and whether it was statistically significant, but rarely could you find out "how" the intervention was done, even by reading the methods section.  As anyone doing QI work or wanting to duplicate the successes of other knows, the meat is really in the how.

So, now the SQUIRE guidelines have come on the scene, legitimizing and providing a standard approach to the publication of the "hows" of quality improvement work.  And,now, there's no reason not to put pen to paper, or fingers to keyboard to try them out.

I am going to write a manuscript that captures the hows of some work we have done on improving hand hygiene at our hospital.  I also intend to write up the "how much" aspect of the work (ie how much did increasing hand hygiene to 88% reduce the rate of healthcare-associated infections).  But, using the SQUIRE guidelines, I'm going to try to recreate the steps we took to improving hand hygiene, and provide enough detail about them and the context within which we work, to allow others to build on the work in their own institutions.  And I'm going to try to get the manuscript published.

As I embark on this journey, I will use this Blog to reflect on how easy or hard it is to do this kind of writing, how helpful the SQUIRE guidelines actually are...and I hope interact with others who are undertaking similar projects.  I'm hoping it will force me to keep writing regularly, but today is Saturday and the first words are going to have to wait until another day.