Health care ethics programs in U.S. Hospitals: results from a National Survey (original) (raw)
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Cambridge Quarterly of Healthcare Ethics, 2002
In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concerns—ethics consultant, ethics forum, ethics committee—may vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many have some and a few have sweeping clinical powers in hospitals.
Evaluating Ethics Quality in Health Care Organizations: Looking Back and Looking Forward
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ABSTRACT To spark a conversation about how best to evaluate ethics quality, this article draws on the collective experience of the IntegratedEthicsTM evaluation team to reflect on what we have learned and to envision an agenda for future work. The article emphasizes the importance of beginning with a well-defined conceptual model, building an expert team, committing the resources necessary to do evaluation well, and tailoring the evaluation methods to the target audience. The article then describes a five-point agenda for future work on ethics quality in health care: further evaluate and improve ethics programs; further evaluate and improve specific ethical practices; examine the relationships among various aspects of ethics quality; examine the relationships between ethics quality and other important organizational outcomes; and foster cross-institutional collaborations to evaluate and improve ethics quality. The hope is that some day ethics will be fully integrated into the mainstream of health care quality management.
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This study examines factors impacting ethical behavior of 203 hospital employees in Midwestern and Northwestern United States. Ethical behavior of peers had the most significant impact on ethical behavior. Ethical behavior of successful managers, professional education in ethics and sex of the respondents also significantly impacted ethical behavior. Nurses were significantly more ethical than other employees. Race of the respondent did not impact ethical behavior. Overclaiming scales indicated that social desirability bias did not significantly impact the results of our study. Implications of this study for researchers and practitioners are discussed.
AJOB Primary Research, 2013
Background: IntegratedEthics TM (IE) establishes a new model for ethics programs, with the goal of continuously improving "ethics quality" in health care. This article describes the IntegratedEthics Facility Workbook (IEFW), an evaluation tool developed by the National Center for Ethics in Health Care (NCEHC) to help health care facilities improve ethics quality in their organization. The workbook helps facilities to evaluate their local ethics programs relative to specific quality standards established for the IE model. This article describes the origins of the quality standards established for the IE model, explains IEFW conceptual underpinnings and tool development, illustrates how ethics programs use the tool to drive local program quality improvement, and provides longitudinal IEFW national results (2008-2011) for Department of Veterans Affairs (VA) IE programs. Methods: The project uses descriptive analysis of IEFW data submitted by VA facilities from 2008 through 2011. Results: In VA,
Strategies to Improve Health Care Ethics Consultation: Bridging the Knowledge Gap
AMA journal of ethics, 2016
Serious concerns have been raised about the quality of health care ethics consultation (HCEC) services in US hospitals, the fact that these services operate with little oversight, and the possibility that low-quality HCEC might harm patients [1-4]. The largest and most comprehensive study of HCEC to date was published in the American Journal of Bioethics in 2007 [1]. It found, among other things, that: significant resources are devoted to HCEC; HCEC practices vary widely; many HCEC practitioners have little training; and HCEC services are rarely evaluated for quality. This study was received as a "wake-up call" [3] by the bioethics field and catalyzed several national quality improvement efforts.