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1. SIQINS : strengthening quality improvement intervention reporting in Surgery

Author

Jones, Emma Leanne and Martin, Graham

Subjects
617.9
Abstract

Background: Surgical quality improvement (QI) research has been conducted with promising results, but translating learning into practice is complicated by incomplete reporting. This research aimed to identify which reporting items are most frequently incomplete, and why incomplete reporting occurs. Methods: A systematic review aimed to identify the current standard of reporting in the surgical QI literature. MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Articles were scored against a modified Template for Intervention Description and Replication (TIDieR) checklist. A qualitative interview study was conducted. QI authors, consumers (those who apply QI research in practice), editors and reporting guideline authors were interviewed to identify why reporting is hard. An author checking exercise involved asking the interview participants to describe how they would replicate an intervention described in a QI article. The article’s authors checked whether their intervention matched the participants’ interpretation. Data was analysed using the constant comparative method. Results: The systematic review identified 100 relevant articles. Reporting of fidelity was absent in 74% of articles; and modifications were absent in 73%. Participants (42) in the qualitative study included: 15 authors, 12 consumers, 11 journal editors and four reporting guideline authors. Of these, 28 were clinicians. Reporting QI is hard because: QI is an emerging field; features of hospitals and journals create tensions for reporting; context is hard to describe; publications are not always intended to be used for exact replication. Discussion and conclusion: QI is a youthful field but stakeholders have well developed aspirations for QI reporting. As the field matures, those involved in QI reporting place value on describing context, identifying active ingredients, and recognising how QI publications are to be used in practice. This research is relevant to an international audience and could help galvanise a renewed sense of importance for reporting.

Published
2017

3. Why is reporting quality improvement so hard? A qualitative study in perioperative care

Author

Jones, Emma Leanne, Dixon-Woods, Mary, Martin, Graham P, Jones, Emma Leanne [0000-0003-4318-9555], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, reporting, publishing, qualitative, Humans, Female, Middle Aged, Public Reporting of Healthcare Data, Delivery of Health Care, Quality Improvement, Qualitative Research, Perioperative Care
Abstract

OBJECTIVES: Quality improvement (QI) may help to avert or mitigate the risks of suboptimal care, but it is often poorly reported in the healthcare literature. We aimed to identify the influences on reporting QI in the area of perioperative care, with a view to informing improvements in reporting QI across healthcare. DESIGN: Qualitative interview study. SETTING: Healthcare and academic organisations in Australia, Europe and North America. PARTICIPANTS: Stakeholders involved in or influencing the publication, writing or consumption of reports of QI studies in perioperative care. RESULTS: Forty-two participants from six countries took part in the study. Participants included 15 authors (those who write QI reports), 12 consumers of QI reports (practitioners who apply QI research in practice), 11 journal editors and 4 authors of reporting guidelines. Participants identified three principal challenges in achieving high-quality QI reporting. First, the broad scope of QI reporting-ranging from small local projects to multisite research across different disciplines-causes uncertainty about where QI work should be published. Second, context is fundamental to the success of a QI intervention but is difficult to report in ways that support replication and development. Third, reporting is adversely affected by both proximal influences (such as lack of time to write up QI) and more distal, structural influences (such as norms about the format and content of biomedical research reporting), leading to incomplete reporting of QI findings. CONCLUSIONS: Divergent terminology and understandings of QI, along with existing reporting norms and the challenges of capturing context adequately yet succinctly, make for challenges in reporting QI. We offer suggestions for improvement.

Published
2019
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