SQUIRE arrives--with a plan for its own improvement

The increased focus on the epistemology—the theory of knowledge—that underlies both healthcare improvement and patient safety has brought a fresh vitality to the scholarly healthcare improvement literature.1 Into this discussion of epistemology come the newly revised guidelines for publication of healthcare improvement reports, SQUIRE (Standards for QUality Improvement Reporting Excellence).2 SQUIRE was originally promulgated by Davidoff and Batalden in Quality and Safety in Health Care in 2005 as draft guidelines to advance the scholarship of improvement and to address the underlying theory of experiential learning that is central to much of healthcare improvement research.3 Subsequently, with financial support from the Robert Wood Johnson Foundation, a consensus conference of editors and improvement scholars was conducted in Boston in April 2007, and the original draft document was revised following the conference deliberations. That revision was then circulated among some 50 colleagues for opinions and advice. After three cycles of review, the resulting document is now published in this special QSHC supplement.2 Colleagues who labour daily at improving health care in their clinical and institutional settings do not necessarily have incentives or the inclination to publish their original improvement work. Indeed, healthcare improvement is often its own reward. Academics, on the other hand, have strong incentives to publish their original work because …