Current efforts to establish accreditation systems are just under way, and the proposed standards remain relatively new and untested. The process for the accreditation of programs is still being configured, and the organizations thus far identified to carry it out are taking on an unprecedented task. The committee therefore offers further suggestions for areas that can still benefit from action by NCQA and AAHRPP:

  • Continue to move toward valid performance measures in lieu of static “documentation” reviews.

  • Identify strategies and dissemination opportunities to share best practices and measured outcomes with the research community.

  • Contribute, by making it explicit in the standards, to clarifying and systematizing accountability for all functions of programs within the various settings and systems in which they can and do operate.

  • Consider accreditation not only of the research organization, but also of organizations established to carry out only one of the functions of a program, such as protocol review (e.g., independent Research ERBs).

As stated in this committee’s first report, independent, nongovernmental accreditation programs, operating under a voluntary mechanism, are likely to be more responsive to the changing demands and needs of protection programs than other existing models (IOM, 2001a). Emerging accreditation programs are, however, still best viewed as pilot projects that should be evaluated in light of field experience. Any accreditation system should be constructed as an evolving tool, and it cannot be expected to immediately correct deficiencies in the collective protection system. As a component of a long-term strategy to improve the quality of research oversight, however, these nongovernmental accreditation processes show promise. It remains unclear, however, how the research universe will be sorted between the two organizations and what ramifications any distinctions between programs might bring. It is encouraging to note that efforts are underway to develop a mechanism that will allow Research ERBs that serve VA facilities and are elements of an academic protection program that has been accredited by AAHRPP to be exempted from NCQA inspection (Otto, 2002a; Speers, 2002b).

Furthermore, the advent of these programs should not prevent the development of other strategies and options for the accreditation of participant protection programs. It may be efficient, for example, to incorporate protection program standards into other existing accreditation systems. For instance, most research organizations involved in health research are already involved in other accreditation reviews, such as medical school or university accreditation. Relevant accreditation bodies can usefully look at their overall accreditation program to ascertain if HRPPP functions might

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