Explanation & Elaboration

14. Summary

1. Summarizes the most important successes and difficulties in implementing intervention components, and main changes observed in care delivery and clinical outcomes
2. Highlights the study’s particular strength

Example

“The new PSMMC [patient safety morbidity and mortality conference] provides a constructive venue for residents, fellows and faculty to express concerns about the healthcare system. Although altering the popular traditional MMC [morbidity and mortality conference] had inherent risk, the successfully executed transition has enhanced the overall experience for staff and faculty. The conference has remained a popular educational forum, with increased participation as measured by attendance. The growth in attendance noted seems to represent both higher levels of interest among medical residents as well as increased frequency of attendance by other healthcare professionals who are invited to participate in interprofessional care discussions. The response of the medicine residents and fellows has shown that they are capable and often enthusiastic about generating ideas for needed changes in systems of care. The attitudes of residents and fellows improved in key areas following the change, including the belief that positive departmental changes were likely to result from the analyses of medical errors and subsequent improvement actions.” [37]

Elaboration

In this example, the main improvements and outcomes are clearly summarized. The tension between the value of a brief summary of key findings versus a thorough restatement of all the findings in the study is demonstrated. The conscientious reader will digest the entire results and discussion sections for a more nuanced understanding of the outcome. This example was taken from a report of a single-institution study that employed multiple cycles of changes to an educational conference, and this summary flows logically from 6. Study question, 8. Setting, 9. Planning the intervention, 10. Planning the study of the intervention, 13a. Outcomes and 13b. Outcomes.  The results section has tables and text to describe the details of the clinical and educational outcomes of this project. This level of detail is correctly placed in those sections and does not need to be repeated in the summary. The summary above focuses on the important strengths and outcomes (growth in attendance, attendance by non-physician health care professionals, and increased resident physician attitudes), so authors must choose which are most important to share and which need to be left out.

References

37. Bechtold M, Scott S, Nelson K, Cox K, Dellsperger K, Hall L. Educational quality improvement report: Outcomes from a revised morbidity and mortality format that emphasized patient safety. Qual Saf Health Care. 2007;16:422-427.

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