Clinical Trials Unit, University of Warwick, Coventry, UK.
Orthopaedic Directorate, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
BMJ Open. 2019 Jul 24;9(7):e030269. doi: 10.1136/bmjopen-2019-030269.
Quality improvement (QI) may help to avert or mitigate the risks of suboptimal care, but it is often poorly reported in the healthcare literature. We aimed to identify the influences on reporting QI in the area of perioperative care, with a view to informing improvements in reporting QI across healthcare.
Qualitative interview study.
Healthcare and academic organisations in Australia, Europe and North America.
Stakeholders involved in or influencing the publication, writing or consumption of reports of QI studies in perioperative care.
Forty-two participants from six countries took part in the study. Participants included 15 authors (those who write QI reports), 12 consumers of QI reports (practitioners who apply QI research in practice), 11 journal editors and 4 authors of reporting guidelines. Participants identified three principal challenges in achieving high-quality QI reporting. First, the broad scope of QI reporting-ranging from small local projects to multisite research across different disciplines-causes uncertainty about where QI work should be published. Second, context is fundamental to the success of a QI intervention but is difficult to report in ways that support replication and development. Third, reporting is adversely affected by both proximal influences (such as lack of time to write up QI) and more distal, structural influences (such as norms about the format and content of biomedical research reporting), leading to incomplete reporting of QI findings.
Divergent terminology and understandings of QI, along with existing reporting norms and the challenges of capturing context adequately yet succinctly, make for challenges in reporting QI. We offer suggestions for improvement.
质量改进（QI）可能有助于避免或减轻护理效果不佳的风险，但在医疗保健文献中，QI 的报道往往很差。我们旨在确定影响围手术期护理领域 QI 报告的因素，以期为改善整个医疗保健领域的 QI 报告提供信息。
定性访谈研究。
澳大利亚、欧洲和北美的医疗保健和学术组织。
参与或影响围手术期护理中 QI 研究报告的发布、撰写或使用的利益相关者。
来自六个国家的 42 名参与者参加了这项研究。参与者包括 15 名作者（撰写 QI 报告的人）、12 名 QI 报告的使用者（将 QI 研究应用于实践的从业者）、11 名期刊编辑和 4 名报告指南作者。参与者确定了实现高质量 QI 报告的三个主要挑战。首先，QI 报告的范围很广，从小型本地项目到不同学科的多地点研究，导致对 QI 工作应该在哪里发表存在不确定性。其次，背景对于 QI 干预的成功至关重要，但很难以支持复制和发展的方式报告。第三，报告受到近端影响（例如缺乏时间撰写 QI）和更远端结构影响（例如关于生物医学研究报告格式和内容的规范）的不利影响，导致 QI 结果的不完全报告。
术语和对 QI 的理解存在差异，以及现有的报告规范和充分但简洁地捕捉背景的挑战，使得 QI 的报告具有挑战性。我们提供了改进的建议。
