Shedding Light on the Oversight of Quality Improvement Initiatives
<p>While quality improvement (QI) is a priority for many health care providers—and often is required by accrediting organizations and others—the process of improvement can at times raise ethical issues. And without a coherent approach to the ethical oversight of QI initiatives, both quality improvement and patient safety can be stymied.</p>
<p>In a new Commonwealth Fund <a href="/publications/issue-briefs/2010/aug/ethical-review-health-care-quality-improvement-initiatives">issue brief</a> drawing from surveys of hospital CEOs and quality improvement professionals, experts at Johns Hopkins University report wide variation in the review of QI initiatives by hospitals. Such programs are routinely reviewed by a variety of internal mechanisms prior to implementation, although rarely through an institutional review board (IRB) or other independent body charged with ethical oversight. Moreover, little consensus exists on the characteristics that distinguish QI efforts from human subjects research requiring IRB approval.</p>
<p>Further research is needed, the authors say, to understand barriers to reviewing QI studies, determine whether alternative approaches are viable, and develop best practices for this field. <br /></p>