Performance Improvement/Research Advisory Panel: a model for determining whether a project is a performance or quality improvement activity or research.

The determination of whether an activity is performance improvement governed by The Joint Commission standards and local hospital policy or research governed by federal regulation and requiring institutional review board (IRB) review and approval can be complex, especially in academic clinical organizations. Both processes can address scientific validity, fair participant selection, favorable risk-benefit ratio, respect for participants, and independent review. In an attempt to guide staff as to whether their project needs IRB review or not, a performance improvement/research advisory panel (PIRAP) was formed to serve two military organizations. In this article, performance improvement and quality improvement is differentiated from research as much as possible, the composition and function of PIRAP is described, and guidelines for publishing findings that support the nature of the project are provided.