Research involving human participants must undergo REB review and approval; quality improvement projects do not.

Research is defined as: “an undertaking intended to extend knowledge through a disciplined inquiry and or systematic investigation. Research aims to produce generalizable knowledge by answering a specific research question or testing a hypothesis via scientific methods.

Quality improvement projects aim to introduce changes that will lead to improved patient outcomes (health), system performance (care) and/or professional development. Often, quality improvement projects seek to implement already established best practices. Quality improvement projects generally do not place any additional burdens on participants other than what is expected during standard care or practice.

Research and quality improvement exist on a continuum. Some projects may contain features of both research and quality improvement that can make it difficult to clearly distinguish research from quality improvement initiatives.

Refer to Table 1 for more details on the differences between research and QI.

No, intent to publish does not determine whether a project requires REB review. However, if you plan to publish your QI project in research journals, you may be required to provide proof of REB review exemption to the journal editor. If planning to publish in research journals, best practice would be to submit the QI project for REB review to obtain the REB exemption letter as the REB can only provide an exemption letter prior to starting the QI project.

Intrinsic components of QI are shared learning; therefore, it is entirely appropriate to disseminate and replicate QI successes, including through channels that are external to an organization. This may include presentations at meetings and publications in professional journals (e.g., QI journals). Therefore, the mere intent to publish the findings of a QI project in QI journals does not obligate REB review. Please note, the publication should not refer to the activity as research and must be made clear that the publication is the result of a quality improvement initiative.

This tool should be completed if:

• You are uncertain as to whether your project needs to be submitted for REB review or
• You are certain it is QI and may plan to publish. Consider submitting for review to obtain an exemption from REB review letter to provide at time of publication as this may be requested by the journal.

Note: The REB does not retroactively review projects that have already been completed, so an exemption needs to be sought at the outset of a project.

The final authority as to whether a project requires REB approval lies with the REB Chair/Vice-Chairs. A copy of the REB letter with the final determination of whether the project is QI or research will be provided to you and a copy will be sent to the Quality Office for their records.

This Applies To:
Physicians, staff (including staff acting as investigators outside the institution), fellows, residents, volunteers, and students.

No, intent to publish does not determine whether a project requires REB review.