The quality of clinician and student quality improvement reports: An analysis of 8 years of submissions

Introduction

Many papers reporting on QI projects are not publishable for a variety of reasons. We compared manuscripts submitted as QI reports between June 2014 and June 2016 (prior to publication of the revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) with papers submitted to the American Journal of Nursing between July 2016 and December 2022). The aim was to evaluate any changes in the quality of manuscripts and identify problems that led to rejection; we also compared the quality of students with non-student submissions.

Methods

We conducted a non-randomized descriptive study to evaluate 349 papers submitted as QI project reports between June 2014 and December 2022 using screening templates based on the SQUIRE 2.0 checklist and findings of the INANE Working Group on Student Papers.

Results

Manuscripts designated as QI reports accepted for publication increased from 4% during 2014–2016 (T1) to 14% during 2016–2022 (T2); one student submission was accepted. There was a slight decrease in submissions designated as QI that were not QI: 36% of student submissions during T1 and 31% of student submissions during T2. Among clinician submissions, 44% in T1 designated as QI reports were not QI versus 31% submitted during T2. There was a decrease in student submissions that followed the SQUIRE guidelines (36% during T1 to 24% during T2).

Conclusions

Findings demonstrate that by following the SQUIRE 2.0 guidelines, authors submit more complete manuscripts with fewer missing components. However, there are still misconceptions about what constitutes QI versus research and how to report QI initiatives. After comparing the findings from both periods, it is noteworthy that there is essentially the same level of inaccuracy and lack of acceptable manuscripts.

Clinical Relevance

Sharing findings from QI activities through presentations and publications is a vital way of helping spread the learnings from these projects and improve health care for a wider audience. Clinicians, academicians, and students must understand the elements of the SQUIRE guidelines and ensure that this framework is used for both designing and submitting QI projects for publication.