How to Publish Your Quality Improvement Work

Publishing quality improvement work advances the field, enhances your professional reputation, and helps other organizations learn from your experience. However, writing up QI work for publication requires a different approach than traditional research manuscripts.

The SQUIRE Guidelines

The Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) provide a framework for reporting QI work. SQUIRE guidelines include 18 items organized under title, abstract, introduction, methods, results, and discussion. Key elements unique to QI reporting include describing the context in which the work was done, the intervention and its rationale, the study of the intervention, and ethical considerations. Following SQUIRE guidelines increases the likelihood that your manuscript will be accepted and useful to readers.

Choosing the Right Journal

Several journals focus specifically on healthcare quality improvement. BMJ Quality and Safety, the Joint Commission Journal on Quality and Patient Safety, and the Journal for Healthcare Quality are well-known options. Consider also specialty-specific journals if your work is relevant to a particular clinical area. Review recent issues of your target journal to understand the types of QI work they publish and their formatting requirements.

Structuring Your Manuscript

QI manuscripts should clearly describe the problem you addressed, the context of your organization, the specific changes you implemented, the measures you used, and the results you achieved. Include enough detail about your methods that readers at other organizations could adapt your approach. Discuss both successes and failures, as the quality improvement community values honest reporting of what did and did not work.

Data Presentation for Publication

Use run charts or control charts to display your results over time, as these are the standard visualization tools in QI literature. Include baseline and post-intervention data. Report both process measures and outcome measures when available. Statistical analysis should be appropriate to your study design; many QI projects use time-series analysis or before-and-after comparisons rather than randomized controlled trial methods.

Navigating the Review Process

Peer review for QI manuscripts often focuses on the rigor of your methods, the strength of your evidence for improvement, and the generalizability of your findings. Be prepared to revise your manuscript based on reviewer feedback. Common revision requests include providing more context about your setting, strengthening your discussion of limitations, and clarifying the sustainability of your results.