29 - Changing Norms and Mindsets for Improvement – a Singapore IRB’s Journey on Upskilling IRB Staff to Improve Staff Retention and IRB Review Efficiency

Background:  IRBs constantly face the challenge of employing and retaining good IRB Staff. There is also constant pressure and expectation for IRBs to increase their efficiency without increasing manpower. Upskilling IRB Staff to perform beyond administrative work can potentially be an effective strategy to facilitate career development and improve IRB efficiency.

Program

Description:  At this institution, IRB staff primarily comprise IRB Analysts and IRB Assistant Analysts (AAs). Analysts are Executive-level staff who are trained to advise Study Teams and conduct preliminary reviews before the IRB submissions are reviewed by the IRB Chairpersons/Boards. AAs are Executive Assistant-level staff who primarily oversee administrative and logistic matters. This QI initiative aims to train and assign selected AAs to perform preliminary reviews of Study Status Report (SSR) Forms which can be reviewed via the Expedited review route. Once trained, the AAs are empowered to independently correspond with Study Teams to give guidance, make clarifications and/or corrections, prepare summaries for IRB Chairpersons/Reviewers and pre-fill Reviewer Worksheets. We evaluate if this initiative has improved the IRB efficiency by measuring the IRB review turnaround times of the SSR Forms and evaluate staff feedback if this could be scaled up and facilitate their career development.

Program

Assessment:  The organization and IRB Chairpersons were supportive of this initiative, which is also aligned with the Singapore Government’s push for its workers to upskill to remain relevant and competitive in the challenging job market. However, there were initially concerns raised by the AAs. E.g. they were not confident that they were capable to take over these responsibilities, or they were worried that if they pull out mid-way, it might affect their performance review etc. After several consultations and obtaining the buy-in and support from the leaders, we were able to convince and train a few selected AAs who agreed to be the pioneers for this new initiative. Eventually, these trained AAs were also able to train other new IRB Analysts/AAs and even Polytechnic Interns. We will elaborate on the challenges e.g. how it required a change of traditional and fearful mindsets, and the positive impact and outcomes on the IRB review turnaround times and chartered a new pathway for staff’s career development.

Limitations: There were only a few AAs who were willing to be trained, and these were usually those who had worked for a longer period at DSRB. We were quite flexible with the training period as this was a new initiative, therefore the protracted training time might have been a discouraging factor for other AAs to join.

Discussion:  The fact that even Polytechnic Interns can be trained successfully provides confidence to NHG DSRB that this could be scaled to all AAs. Furthermore, as NHG DSRB has transited to a new online system in 2024, some of the IRB workflows have been streamlined to reduce the administrative workload managed by the AAs. The next step is to see how this can be incorporated into the official AA Job Description, adjust remuneration, and facilitate their career development and improve IRB staff retention.