60 - Reimagining IRB Rosters: Reducing Reviewer Burden amid a Growing Research Program

Background:  Our IRB faced an oncoming dilemma of integrating a recently-acquired health system’s existing IRB leading to an anticipated increase in submissions. The IRB staff aimed to reduce burden on individual IRB members by adding an additional meeting to accommodate varied clinical schedules, streamlining on- and off-boarding, and lowering quorum.

Program

Description:  This program modified the IRB rosters (Panels A/B) to a minimal primary roster that satisfied FDA and OHRP regulations. Our modified Panel A consists of: one chair, 2 non-scientists (including a community/unaffiliated member), and 4 scientists for a total of 7 members and a quorum of 5. All other IRB members were moved to Panel B, which does not meet, thus quorum is not a concern. Scheduled IRB meetings met as Panel A and all members are able to RSVP to any scheduled meetings that work with their schedules. Voting members are determined based on reviewers, whether alternates are needed, and expertise on a given submission. This program was evaluated by comparing IRB meeting data from 12 months pre-implementation (2022-2023) and the 12 months since implementation (2023-2024) to assess if the IRB was better equipped to review the increased IRB submissions, thus reducing burden on individual IRB members and staff.

Program

Assessment:  Comparing pre- and post-implementation data, the number of full board (FB) IRB submissions increased by 68.4%, however, the average number of submissions reviewed per meeting stayed the same. Additionally, we saw only a minimal increase in the average length of IRB meetings (4.7%). To assess the impact on individual board members, we found that there was no change on the ratio of submissions per reviewer pre- or post-implementation despite the increase in FB submissions during the same time. However, the raw data confirmed some limitations we’d anecdotally observed during the year. For example, we are a smaller institution, and our agendas vary in size and composition, but after implementation, there was a clear inequity in distribution of submissions between the 3 monthly meetings. As two of the meetings were scheduled closer together, the second meeting regularly had less submissions to review. Ultimately, the new structure has accommodated our increased IRB submissions and benefitted our institution’s growing research program.

Limitations: The integration of these two institutions led to an influx of new IRB members present at each meeting. On-boarding for new IRB members consists of a training period including observing IRB meetings and shadowing experienced reviewers. Consequently, this artificially inflated some of the data and made it difficult to accurately assess whether we decreased the number of attendees required at each meeting. These results may not fully reflect the program’s true effectiveness in the future.

Discussion:  As IRB submissions continue to increase, the ability to control for quorum while adding recurring meetings has made this roster model one that our IRB will maintain indefinitely despite any limitations. A key element in implementing this model at other institutions is a willingness to forgo more “traditional” approaches to the IRB composition, rosters, and meetings while continuing to abide by federal regulations. This model’s value lies in the flexibility it allows for institutions to adapt it to the needs of their IRB members, administrative staff, and the priorities of their research programs.