The Alberta Research Ethics Community Consensus Initiative (ARECCI) is a collaborative undertaking of organizations and entities who have chosen to work together to enhance the ethical oversight of certain types of knowledge generating projects in health care in Alberta (research, quality improvement, quality assurance, program evaluation). ARECCI is a joint initiative of the Alberta Heritage Foundation for Medical Research (AHFMR), Research Ethics Boards (REBs) in the province, Health Authorities, and Alberta Health and Wellness. It has also benefited from input from many others, including the Canadian Institutes of Health Research and interested organizations and individuals in other provinces and countries.
ARECCI was created in 2003 with the objectives of creating greater clarity and consistency across the province in health-related ethics review processes, and to address issues related to delay or duplication of review. In particular, ARECCI focused on the question of what constitutes research for the purposes of ethics review. ARECCI also recognized that there were situations in the province that were problematic. It was sometimes unclear what projects needed review; the same project was sometimes treated differently by REBs in different jurisdictions; there was an increasing sense that there was a wide range of projects that would benefit from ethics review but that some were going to an REB unnecessarily.
Questions arose early in the work as to whether knowledge generating projects understood to be something other than research, such as quality improvement, quality assurance, and program evaluation, should be ethically reviewed, and if so, by whom. With the current emphasis on evidence-based practices, projects seeking to gather such evidence are being encouraged across the health system. Whether such projects are labeled as quality and evaluation1 , they may pose some of the same risks to human subjects as projects that are labeled as research. It needs to be made clear what needs ethics review and why. Review processes need to be transparent and consistent, whether undertaken by an REB or by another process.
ARECCI also recognized that not all projects need a full ethics review, and those projects that do, need not obtain that review from an REB. What matters is that ethical considerations are addressed in knowledge generating projects and that all ethics screening and review processes across the province occur effectively, efficiently, and in a timely and non duplicative manner. Most importantly, these screening and review processes encourage research as well as other projects which enhance the quality of services provided, while ensuring risk and harm to people involved are minimized.
The purpose of ARECCI is thus to develop consensus amongst key organizations and groups in the province with respect to processes to ensure that Albertans who are involved in research or quality and evaluation projects are protected from harm, and that ethics screening and review is efficient and effective.
1ARECCI uses the collective term 'quality and evaluation' to encompass knowledge generating projects understood to be something other than research such as quality assurance, quality improvement or program evaluation.