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Pediatrics. 2011 Sep;128(3):e678-86. doi: 10.1542/peds.2010-0809. Epub 2011 Aug 15.

Strategies for addressing barriers to publishing pediatric quality improvement research.

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Center for Child and Adolescent Health Policy, Mass General Hospital for Children, Boston, Massachusetts 02114, USA.



Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication.


To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work.


We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop.


We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work.


Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

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