SIQINS - Strengthening Quality Improvement Intervention reporting in Surgery

Background: Surgical quality improvement (QI) research has been conducted with promising results, but translating learning into practice is complicated by incomplete reporting. This research aimed to identify which reporting items are most frequently incomplete, and why incomplete reporting occurs. Methods: A systematic review aimed to identify the current standard of reporting in the surgical QI literature. MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Articles were scored against a modified Template for Intervention Description and Replication (TIDieR) checklist. A qualitative interview study was conducted. QI authors, consumers (those who apply QI research in practice), editors and reporting guideline authors were interviewed to identify why reporting is hard. An author checking exercise involved asking the interview participants to describe how they would replicate an intervention described in a QI article. The article’s authors checked whether their intervention matched the participants’ interpretation. Data was analysed using the constant comparative method. Results: The systematic review identified 100 relevant articles. Reporting of fidelity was absent in 74% of articles; and modifications were absent in 73%. Participants (42) in the qualitative study included: 15 authors, 12 consumers, 11 journal editors and four reporting guideline authors. Of these, 28 were clinicians. Reporting QI is hard because: QI is an emerging field; features of hospitals and journals create tensions for reporting; context is hard to describe; publications are not always intended to be used for exact replication. Discussion and conclusion: QI is a youthful field but stakeholders have well developed aspirations for QI reporting. As the field matures, those involved in QI reporting place value on describing context, identifying active ingredients, and recognising how QI publications are to be used in practice. This research is relevant to an international audience and could help galvanise a renewed sense of importance for reporting.