Editor’s Notebook: Peer Reviewed After All


January / February 2009
Editor’s Notebook

Peer Reviewed After All

When asked, I say that PSQH is not peer reviewed, but that’s not entirely accurate. I’ve always looked to members of our Editorial Advisory Board for direction and, increasingly, for peer reviews of manuscripts submitted for publication. Their comments help me select articles for publication and help authors improve their manuscripts. But I wouldn’t call PSQH a peer-reviewed journal — a label that usually indicates something different from what we present.

In PSQH, we cover a broad range of reports, case studies, research, events, news, and opinions in a style and format that’s intended to be accessible to a multidisciplinary audience. We are supported by a diverse group of sponsoring organizations (currently five), place paid advertising throughout each issue, use color and images wherever appropriate, and accept submissions from product manufacturers and service providers, so long as they adhere to our guidelines and fully disclose their commercial affiliations. The result is a publication with a more practical, less academic approach than traditional peer-reviewed journals.

When readers and prospective authors ask me if PSQH is peer reviewed, they often are trying to gauge our legitimacy. Legitimacy is a complex question, with which the academic, peer-reviewed publications also wrestle. As I mentioned in an earlier column (2008), the quality and safety community has not yet reached consensus about how to evaluate improvement projects. The debate about criteria and evidence — legitimacy — also applies to evaluation of manuscripts for publication and has contributed to a dearth of quality-improvement (QI) articles in medical journals. Most QI projects don’t conform to traditional guidelines for medical research and expectations about what constitutes a worthy manuscript.

The editors of the BMJ journal Quality & Safety in Health Care noted this gap in 1999 and introduced Quality Improvement Report (QIR) guidelines as a structure for reporting on QI projects and for manuscript review. Those now have spawned the SQUIRE Guidelines, which were published in a supplement to QSHC in October 2008 and discussed in a workshop I attended at IHI’s National Forum in December. SQUIRE (Standards for Quality Improvement Reporting Excellence) began with a draft version by Davidoff and Batalden published in QSHC in 2005. The final version was developed (with financial support from the Robert Wood Johnson Foundation) at a consensus conference in April 2007.

The SQUIRE guidelines are complex and intended for the most robust, generalizable QI research, while the original QIR guidelines are far simpler. In the QSHC supplement, Thomson and Moss say that QIR provides “a basis for sharing experience and learning,” appropriate for “smaller local projects.” QIR is relevant and helpful more often than SQUIRE for reviewing manuscripts submitted to PSQH, but I am indebted to IHI, the workshop presenters, and all who have participated in the discussion of guidelines. Those tools, plus thoughtful reviews by our Adivsory Board, continuously improve my decisions about the wealth and diversity of material submitted for publication in PSQH.


Carr, S. (2008) Evidence and criteria. Patient Safety & Quality Healthcare, 5(5), 4. Available at http://www.psqh.com/sepoct08/editor.html

SQUIRE: Standard for Quality Improvement Reporting Excellence. (2008). Quality & Safety in Health Care, 17(Supplement 1). Available at http://qshc.bmj.com/content/vol17/Suppl_1/

Moss, F., & Thompson, R. (1999, June). A new structure for quality improvement reports. Quality in Health Care, 9, 76.