Quality improvement (QI) activities have become an integral component of surgical care, involving all levels of stakeholders from trainees up to hospital administrators. While programs such as the American College of Surgeons National Surgical Quality Improvement Program can provide the necessary data and tools for these efforts, there remains a gap between measuring and improving quality. Furthermore, surgeons may experience a struggle between the need to improve care rapidly and the desire to obtain rigorous data to support effective change. The burgeoning disciplines of improvement and implementation science may help to address these challenges. These sciences apply theories, models, and frameworks to plan and understand QI efforts, and use advanced methods such as hybrid effectiveness-implementation study designs to facilitate translation of evidence into routine practice. However, improvement and implementation research differ from traditional research in that: (1) the interventions may be complex, multifaceted, and context-dependent; (2) the details of the implementation (ie, who, what, how) may be more important than the results themselves; and (3) the methods often involve iterative changes based on repeated measurements rather than on prestated hypotheses and planned stopping points. Therefore, conventional methods of reporting study methods and results may not be appropriate.
Mueck KM, Putnam LR, Kao LS. Improving the Quality of Quality Improvement Reporting: Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 Guidelines. JAMA Surg. 2016;151(4):311–312. doi:10.1001/jamasurg.2015.4719
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