Navigating research ethics for multi-institutional, hospital-based research: Experiences from the Translating Emergency Knowledge for Kids (TREKK) initiative

Health research ethics processes in Canada are guided by the Tri-council Policy Statement (TCPS 2); however, complications still arise when conducting multi-site studies involving research ethics applications to more than one institutional body. The TRanslating Emergency Knowledge for Kids (TREKK) needs assessment study, a low-risk cross-sectional survey in 32 hospitals across Canada, is described as one example of the complex process for obtaining Canada-wide research ethics approvals and illustrates the variation in interpreting and applying the TCPS 2 in different jurisdictions. The TREKK experience with health research ethics raises many questions about whether the TCPS 2 is founded on an aging model of research and advocates for a new, more flexible approach to multi-site research in the Canadian context.