ATI Hematologic System Related

Review ATI Hematologic System related questions and content

A pediatric fellow is planning a project intended to decrease the incidence of acute chest syndrome among patients with sickle cell disease who are already admitted to the hospital for other reasons. The fellow discussed with her mentor whether the project proposal should be submitted for review by the Institutional Review Board (IRB). The mentor explains that, at their intuition, quality improvement activities do not require IRB review but research projects must be submitted to the IRB. Which of the following is NOT a relevant consideration in determining whether the project is research or quality improvement?

  • A. The aim to create new knowledge for the individual institution versus discovering new and generalizable knowledge
  • B. The chosen methodology which will include repeated Plan-Do-Study-Act cycles
  • C. The intent to publish the results in a peer reviewed hematology journal
  • D. The efforts to hold biases/confounders stable over time, rather than control for them with, for example, randomization
Correct Answer: C

Rationale: The correct answer is C because the intent to publish results in a peer-reviewed journal is not a determining factor in distinguishing between quality improvement and research activities. Here's a step-by-step rationale:
1. Quality improvement focuses on improving processes within an institution to enhance patient care, while research aims to generate new knowledge that is generalizable beyond the institution.
2. The chosen methodology (B) such as using Plan-Do-Study-Act cycles is often associated with quality improvement projects to test and implement changes iteratively.
3. Efforts to hold biases stable over time (D) are more aligned with research, as quality improvement projects may not necessarily require controlling for biases like randomization.
4. The intent to publish in a peer-reviewed journal (C) can apply to both quality improvement and research projects, but the key factor in determining the need for IRB review is whether the project aims to generate generalizable knowledge (research) or improve local processes (quality improvement).