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Suggested Citation:"BACKGROUND." Institute of Medicine. 2001. Preserving Public Trust: Accreditation and Human Research Participant Protection Programs. Washington, DC: The National Academies Press. doi: 10.17226/10085.
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Page 135

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APPENDIX C 135 APPENDIX C VA Human Research Protection Accreditation Program Draft Accreditation Standards BACKGROUND The Department of Veterans Affairs has contracted with NCQA to develop and implement an accreditation program for Veterans Affairs Medical Center (VAMC) Human Research Protection Programs (HRPPs). The purpose of the program is to strengthen the protections afforded human subjects of research at VAMCs through an ongoing program of independent, external review. The public must be assured that research is performed ethically and in the best interests of study volunteers to ensure its continued support for, and participation in, research studies. The VA has long held a set of policies governing the conduct of research, and in particular, the protection of human study participants. This program is the first to provide a routine, independent evaluation of VAMCs' compliance with these policies. These draft standards for the accreditation of Veterans Affairs Medical Center (VAMC) Human Research Protection Programs (HRPPs) are being published for public comment. In June 2001, program standards will be finalized after analysis of public comments and results of pilot tests to be conducted in April and May, 2001. The resultant standards will be revised annually to reflect changes in VA policy and other applicable federal regulation. These standards apply to VAMCs that operate their own IRBs, those that operate an IRB jointly with an affiliated university, and those that delegate IRB functions to the affiliated university's IRB. Standards include requirements for the oversight of affiliated IRBs. The VAMC retains responsibility for protecting human subjects of research even when it delegates the performance of some functions (e.g., IRB) to the affiliated university. All the standards for the performance

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Amid increasing concern for patient safety and the shutdown of prominent research operations, the need to improve protections for individuals who volunteer to participate in research has become critical. Preserving Public Trust: Accreditation and Human Research Participant Protection Programs considers the possible impact of creating an accreditation system to raise the performance of local protection mechanisms. In the United States, the system for human research participant protections has centered on the Institutional Review Board (IRB); however, this report envisions a broader system with multiple functional elements.

In this context, two draft sets of accreditation standards are reviewed (authored by Public Responsibility in Medicine & Research and the National Committee for Quality Assurance) for their specific content in core areas, as well as their objectivity and validity as measurement tools. The recommendations in the report support the concept of accreditation as a quality improvement strategy, suggesting that the model should be initially pursued through pilot testing of the proposed accreditation programs.

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