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Ethics oversight of quality campaign institutions
When are quality improvement initiatives ‘research’ and how can institutions assure that those that are not, are conducted in an ethically sound manner? A systematic assessment of current ethics review committee (Institutional Review Board) practices was conducted by a survey of a random sample of the 3000 US institutions that participated in the IHI 100 000 Lives initiative. While 83% indicated that their institutions conducted oversight review, these were predominantly administrative in nature. As 69% indicated that the oversight mechanisms considered ethical issues, only 16% indicated their ethics review committee was involved in formal review. Finally, while two-thirds indicated some sort of ethical review was part of the formal oversight, it was unsystematic in nature. These data offer an overview of the current ethics oversight of QI initiatives in the US and indicate that, in this example, QI initiatives are not conducted by colleagues who are independent of the initiative or have formal research ethics training. (See page 271).
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