Quality improvement activities

Quality improvement activities:

According to the National Health and Medical Research Council (NHMRC) guidelines, a quality improvement activity (which is also referred to as 'quality assurance’ and ‘audit’) is any activity where the primary purpose is to monitor, evaluate or improve the quality of health care delivered by a health care provider (an individual, a service or an organisation).


The National Statement on Ethical Conduct in Research Involving Humans (2007) defines research as systematic prospective collection of information to test an hypothesis; planned study of existing practices with a view to changing/improving practice in light of the findings in the study and/or to increase understanding; or the administration and analysis of data in response to surveys or questionnaires, interviews or opinion polling.

Is HREC review required?

The following documents can be used to determine whether a project is research or quality improvement activity, and thus if ethical review is required:


Academic journals require evidence of ethical review and approval of a QI project from a HREC, prior to publication. This process acknowledges that the project has under gone ethical review either by a full HREC or non-HREC level alternative.

At WACHS we are currently developing a process for negligible risk and/or QI projects with the intention to publish results which would mean either a QI or Safety and Quality Committee review and/or HREC exemption process, where applicable projects would undergo a non-HREC review. However, at present, no such process has been formally established, and therefore if a researcher intends on publishing findings from an audit or QI/QA project, the project must be submitted to either:

  • WACHS HREC for full ethical review
  • A different WA Lead HREC (or their QI Committee) for a low risk review (If involving other WA Health sites).

As per the WA Health Research Governance Policy and Procedures (2012) ethical review is required by a HREC prior to the commencement of the project as research projects must not be ethically approved by a HREC retrospectively.