title: The SQUIRE Guidelines: an evaluation from the field, 5 years post release.
abstract: BACKGROUND
  The Standards for Quality Improvement Reporting Excellence (SQUIRE) Guidelines were published in 2008 to increase the completeness, precision and accuracy of published reports of systematic efforts to improve the quality, value and safety of healthcare. Since that time, the field has expanded. We asked people from the field to evaluate the Guidelines, a novel approach to a first step in revision.
  
  
  METHODS
  Evaluative design using focus groups and semi-structured interviews with 29 end users and an advisory group of 18 thinkers in the field. Sampling of end users was purposive to achieve variation in work setting, geographic location, area of expertise, manuscript writing experience, healthcare improvement and research experience.
  
  
  RESULTS
  Study participants reported that SQUIRE was useful in planning a healthcare improvement project, but not as helpful during writing because of redundancies, uncertainty about what was important to include and lack of clarity in items. The concept "planning the study of the intervention" (item 10) was hard for many participants to understand. Participants varied in their interpretation of the meaning of item 10b "the concept of the mechanism by which changes were expected to occur". Participants disagreed about whether iterations of an intervention should be reported. Level of experience in writing, knowledge of the science of improvement and the evolving meaning of some terms in the field are hypothesised as the reasons for these findings.
  
  
  CONCLUSIONS
  The original SQUIRE Guidelines help with planning healthcare improvement work, but are perceived as complicated and unclear during writing. Key goals of the revision will be to clarify items where conflict was identified and outline the key components necessary for complete reporting of improvement work.
authors.affiliation: VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT Department of Surgery - Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, NH The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH.
authors.forename: Louise
authors.initials: L
authors.lastname: Davies
authors.affiliation: The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH.
authors.forename: Paul
authors.initials: P
authors.lastname: Batalden
authors.affiliation: The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH.
authors.forename: Frank
authors.initials: F
authors.lastname: Davidoff
authors.affiliation: The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH.
authors.forename: David
authors.initials: D
authors.lastname: Stevens
authors.affiliation: The Geisel School of Medicine at Dartmouth, Hanover, NH, USA Department of Veterans Affairs Medical Center, White River Junction, VT, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Ogrinc
mesh_terms: D006302:Health Services Research / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D010506:Periodicals as Topic / Q000592:standards*; D011643:Publishing / Q000592:standards*; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D014956:Writing / Q000592:standards*
keywords: Healthcare quality improvement; Qualitative research; Quality improvement