Publication Guidelines for Quality Improvement Studies in Healthcare: Evolution of the SQUIRE Project

ABSTRACT In 2005, we published draft guidelines for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. The current article contains the full revised version of the guidelines, which we refer to as Standards for QUality Improvement Reporting Excellence (SQUIRE). We also describe the consensus process, which included informal feedback from authors, editors and peer reviewers who used the guidelines; formal written commentaries; input from a group of publication guideline developers; ongoing review of the literature on the epistemology of improvement and methods for evaluating complex social programs; a 2-day meeting of stakeholders for critical discussion and debate of the guidelines' content and wording; and commentary on sequential versions of the guidelines from an expert consultant group. Finally, we consider major differences between SQUIRE and the initial draft guidelines; limitations of and unresolved questions about SQUIRE; ancillary supporting documents and alternative versions that are under development; and plans for the dissemination, testing and further development of SQUIRE.