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In 1999, the Institute of Medicine (IOM) unveiled the dire need to make healthcare safer.1 In an effort to reduce harm, improve performance and minimise cost, quality improvement (QI) methodology was identified as an ideal approach to closing the quality gap.1–3 In the years that followed, the dissemination of publications using QI methods increased significantly.4 By 2008, the first edition of the Standards for Quality Improvement Reporting Excellence (SQUIRE) Guidelines was published in an effort to support the breadth, usability and rigour of scholarly healthcare improvement work.5 Seven years later, the modified SQUIRE 2.0 Guidelines bolstered the thorough, theory-driven reporting of interventions and improvement efforts to spread generalisable and actionable knowledge.6 Furthermore, the advent of learning health systems, defined by the IOM as a system ‘designed to generate and apply the best evidence for the collaborative healthcare choices for each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care’, has brought the value of healthcare improvement work to the forefront in academic centres.7 8
Incorporating continuous improvement and data-driven learning with traditional research methodology and routine care delivery is now common and encouraged. Consequently, the difference between classic human subject research (traditionally separate from routine clinical care) and QI research is increasingly blurred. Newer scientific fields such as implementation science focus on how to implement and disseminate evidence-based practices.9 QI research uses a different framework of improvement science to understand the effects of an intervention on important quality problems.10 While these related fields focus on what gets done in clinical care (compared with what is known), their definitions may differ at local, national and international levels. Regardless, the fact remains that scholarly dissemination of …
Contributors All authors conceptualised this essay and substantially contributed to the design of the publication. KP drafted the initial essay, and MLR and EC critically revised it. All authors agreed to the final essay prior to submission.
Funding This study was funded by National Center for Advancing Translational Sciences (Grant number: UL1TR001073) and Agency for Healthcare Research and Quality (Grant number: K12HS026396).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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