Independent oversight of research conduct is essential to protect human subjects’ rights and welfare, educate investigators on ethical practices, enhance the ethical review process, safeguard institutions from federal regulatory actions, and maintain public trust in medical research ethics committees. Routine monitoring activities ensure studies are being carried out as intended, while prioritizing the health and safety of the participants. However, federal and foundation-funded projects may not have built-in processes for routine monitoring. To address this gap, Duke University created the Clinical Quality Management Program, which provides a robust framework for clinical research studies, including policies, procedures, and tools that allow clinical research units to effectively monitor without external oversight.