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How to write an abstract. Fiona Moss and Duncan Neuhauser. Paris April 2014. Background:1. There is a lot of good QI work “out there” It might help if shared/communicated Writing is way of communication Publication would help others

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How to write an abstract

How to write an abstract.

Fiona Moss and Duncan Neuhauser

Paris April 2014


Background 1
Background:1

  • There is a lot of good QI work “out there”

  • It might help if shared/communicated

  • Writing is way of communication

  • Publication would help others

  • Much of what is written up as “audit” is boring and uninformative


Aims of this session
Aims of this session

  • Describe Quality Improvement “in action” through using a structure for writing about QI

  • To show that writing can help your thinking

  • Learn how to translate achievements into words


Objectives of this session
Objectives of this Session

  • To understand some of the basics of QI

  • To encourage you to plan and complete your QI project

  • To learn a process for writing about your work

  • To encourage you to “write it up” for publication


Why bother to write well
Why bother to write well?

  • Writing is one of the communication skills.

  • To communicate your message with clarity and accuracy

  • To engage and stimulateyour readers

  • To help you reflecton your work






Getting down to writing
Getting down to writing:

  • Story

  • Structure

  • (Style)


Quick foray into matters of style
Quick foray into matters of style!

  • “Good prose is like a window pane…”

  • Short sentences

  • Nouns and verbs!

  • Avoid purple prose


Journalists first lesson borrowed from kipling s serving men
Journalists’ first lesson (borrowed from Kipling’s serving men)

  • What, why and when

  • and How and Where and Who


George orwell 1
George Orwell (1) serving men)

“[Language] becomes ugly and inaccurate because our thoughts are foolish, but the slovenliness of our language makes it easier for us to have foolish thoughts.


George orwell 2
George Orwell (2) serving men)

  • Never use a metaphor, simile, or other figure of speech which you are used to seeing in print.

  • Never use a long word where a short one will do.

  • If it is possible to cut a word out, always cut it out.

  • Never use the passive where you can use the active.

  • Never use a foreign phrase, a scientific word, or a jargon word if you can think of an everyday English equivalent.

  • Break any of these rules sooner than say anything outright barbarous.


Strunk and white
Strunk and White serving men)

  • Make the paragraph the unit of composition: one paragraph to each topic

  • As a rule start each paragraph with a topic sentence; end it in conformity with the beginning

  • Omit needless words

  • Use the active voice


Paragraphs
Paragraphs serving men)

Topic sentence: what’s the idea you want to talk about?

Elaborate on that idea

Final sentence: round off the point you are making….

…and, ideally, form a link to the next idea


Read this can you re write this
Read this: serving men)can you re-write this?

Data obtained from the audits were analysed. Significant problems in preoperative and postoperative care were identified. Review of preadmission processes identified significant delays in transfer of patients from the emergency department to the two wards with alternating admissions. Delay in physician input was identified and the high level of mortality was unacceptable. There was a need within the hospital for a more proactive culture in the management of this situation.


Is this better
Is this better? serving men)

Our audit showed problems in preoperative and postoperative care with an unacceptably high mortality rate. Patients were slow to be admitted from the emergency department and physicians did not assess them promptly. We urgently need to find better ways of looking after this vulnerable group of patients.


Getting down to writing1
Getting down to writing: serving men)

  • Story

  • Structure

  • (Style)


Your story
Your story: serving men)

  • Recall quality improvement work that you would like to share

  • Write about it in just paragraph or two.

  • Get it down to its “basics” – bullet points OK here


Instructions for readers listeners
Instructions for ”readers/listeners” serving men)

  • Listen very carefully….(!)

  • Do you understand what the “story” is?

  • What is missing that would help you understand?

  • Write down any questions


Best of british our tabloids 1
Best of British –our tabloids - 1 serving men)

  • Amy stole coke from Kate’s bag

  • Boozy Brits give NHS a sore head

  • Experts admit their forecast is washout

  • How a broken tumbler cost one pub £18,000


Best of british our tabloids 2
Best of British – our tabloids– 2 serving men)

  • Asda withdraws corned beef after 50% nag traces

  • 10 teens in hospital on mind-bending party drug rocket fuel

  • Jobs gloom leads to a baby boom

  • PM: no job… then no benefits for you


Readers listeners
“Readers/listeners” serving men)

  • Now write your “Sun headline”


Authors
Authors serving men)

  • Is that “Sun headline” a correct summary?


Authors now revise your bullet points into paragraph s
Authors now revise your bullet points into paragraph(s) serving men)

  • Listen to the play- back/questions from your readers.

  • Be clear about “What is the ‘story’?”

  • Revise your brief description of your quality improvement work

  • Make sure that you make the main messages clear.


Getting down to writing2
Getting down to writing: serving men)

  • Story

  • Structure

  • (Style)


Quality improvement papers using a structure
Quality improvement papers: using a structure serving men)

  • Structure can help the process of writing

  • Essential for some journals

  • Ensure that use the structure appropriate for the journal and article type

  • Otherwise, useful for structuring thoughts


Quality improvement papers using a structure1
Quality improvement papers: using a structure serving men)

  • Structure provides a logical sequence

  • Contains “the story” within it

  • Setting objectives for the paper is important

  • Continuity between sections is important

  • Link back to objectives throughout

  • End should connect with beginning i.e. “discussion” must relate to “introduction”


Structure for qi work should reflect
Structure for QI work should reflect serving men):

  • Cyclical nature of QI

  • Process of assessment

  • Process of gaining understanding of organisational issues

  • Complexity of organisational change

  • Steps required for organisational change

  • Processes of review and re-assessment


Structure for quality improvement reports
Structure for quality improvement reports serving men)

  • The context

  • Outline of problem (patient centred)

  • Key measures of improvement

  • Process of gathering information about problem

  • Analysis and interpretation – how the information helped your understanding of the problem/solution

  • Strategy for change; implementation of change

  • Effects of change - reassessment

  • Next steps - lessons learnt – messages for others


Convincing others
Convincing others serving men)

  • Narrative important but not all

  • Measurement and data are essential

  • Need data that is robust

  • But clearly QI is not RCT

  • Beware spurious use of statistics

  • How do you know your change is improvement


Now…. serving men)

  • Take the 2 paragraphs you wrote about your quality improvement report , remembering the input from your “reader”

  • Revise it using the structure provided…..


Your structured abstract
Your structured abstract serving men)

  • Does this help?

  • Could you convey your messages using this structure?

  • What are the problems?

  • Could you write your story for your reader?


Publishing qi work

Publishing QI work serving men)


What type of paper reflects your work
What type of paper reflects your work? serving men)

  • A quality improvement report?

  • A research paper?

  • A review?

  • A “How To Do It?”

  • An opinion/view point?

  • A letter?

  • Etc etc etc.....


Quality improvement reports for publication
Quality improvement reports for publication serving men)

  • Not necessarily completely original

  • Must have a message for others

  • Be explicit about context

  • If change has occurred - how did you manage it and sustain it ?

  • Organisational changes - important

  • Interpersonal interactions - important

  • Real message may lie in difficulties

  • Progress may not be linear

  • Be clear about messages


Quality improvement reports check essentials
Quality improvement reports: serving men) check essentials?

  • Is it about improving the quality of care?

  • Does it have a message relevant to improving the quality or safety of patient care?

  • Does it describe changes that improve patient care? Is the evidence robust?

  • Is the message generalisable? What is in it for others to learn?


Squire guidelines
SQUIRE guidelines serving men)

http://www.squire-statement.org/guidelines


Squire guidelines1

Introduction serving men)

Background knowledge

Local problem

Intended improvement

Study question

Methods

Ethical issues

Setting

Planning intervention

Planning study of intervention

Methods of evaluation

Analysis

Squire Guidelines:


Squire guidelines2

Results serving men)

Outcomes

Nature of setting and improvement intervention

Changes in processes of care and patient outcomes

Discussion

Summary

Interpretation

Relation to other evidence

Limitations

Conclusions

Other factors

Squire Guidelines:


Quality improvement papers finding a structure
Quality improvement papers: finding a structure serving men)

  • Standard structure for research papers. “IMRaD”

  • Introduction/Methods/Results and/Discussion

  • Perhaps not a helpful structure for QI work


Introduction
Introduction serving men)

  • Back ground to the paper

  • Makes the “case for” the need for the paper

  • Should end with objectives of the paper

  • Whole of rest of paper should be written to the stated objectives

  • Objectives are the “thread of the paper


Methods
Methods serving men)

  • Headed sub-sections

  • Helps with writing (can be taken out later)

  • Logical order

  • Do not include results

  • End with section “Data analysis” that outlines how you intend to use data to meet stated objectives as well as any statistical analyses


Results
Results serving men)

  • Headed sub-sections

  • Helps with writing (can be taken out later)

  • Logical order - start with demographics

  • Must link to objectives

  • Whole number with percentages in brackets x/y(n%)


Discussion
Discussion serving men)

  • Short “pithy” summary of main findings – must link to objectives

  • Outline of clinical or other implications

  • If appropriate compare results with other relevant work

  • Outline limitations of work

  • Reflect on possible future research


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