A Practical Guide To Developing Sustaining A Clinical Ethics Consultation Service

To our knowledge, no existing book or article describes how to establish and operate a vibrant and sustainable clinical ethics consultation service (ECS) from the ground up. As a result, ECS directors and ethics consultants may be charged with building or reinvigorating and sustaining a high-quality, successful service without sufficient practical guidance on how to plan, implement, and monitor their efforts. This lack of guidance can give rise to problems, including wasted time and effort, as well as misalignments in expectations and goals between hospital administrators and ethics consultants on what constitutes "success" and "failure" in service activities. Toward the goal of providing this much-needed guidance, we describe key considerations and strategies for developing, implementing, and monitoring a high-quality, successful service. It is important to note that in responding to hospital administrators' expectations and establishing a successful service, it is necessary but not sufficient to demonstrate the competence of individual consultants. Thus, some portions of this guide are addressed to the individual or individuals leading an ECS, but many chapters will be useful to anyone engaging in clinical ethics consultation or playing a role in overseeing or otherwise advocating for an ECS. Our focus is on building and sustaining high-quality, successful services in ways that go well beyond the traditional focus on how to conduct an ethics consultation. Specifically, we have chapters and sections devoted to working through a case, mediation skills, and conducting and facilitating family meetings that should be useful for any ethics consultant, particularly individuals who are new to ethics consultation or seasoned consultants who wish to reflect on their practices, but we also have chapters and sections devoted to "selling points to hospital administrators on the value of ECSs," building an ECS infrastructure, launching a service, etc., that are aimed more towards ECS directors, with the goal of providing essential guidance on ECS development and maintenance. Finally, our goal is to be as practical and clinically-oriented as possible by addressing everyday nuts-and-bolts concerns that apply across demographically- and geographically-diverse hospital settings, subject to some individual variation that we will underscore for our readership. In particular, we arrange this guide according to phases of an ECS. Part 1 will focus on planning for an ECS. Part 2 will discuss how to implement an ECS. Part 3 will then conclude with information about how to monitor an ECS once it is established, and how to address common challenges. We believe that much of the advice we provide can be extended to other consultative or hospital services that are based in hospitals, such as palliative medicine, chaplaincy, or social work services. We hope you find this useful!

This is a book about clinical ethics consultation by two practitioners who together have done more than 700 consultations. There is not another authoritative book like it. Practical rather than theoretical in scope, the book addresses strategies for conducting consultations, relating to patients at the bedside, investigating the ethical issues, making recommendations, following up on cases, and keeping records. Chapters include issues such as the need for training, the skills needed, the problem of certification, how to set up a practice, financial compensation and billing, and the relation of the consultant to committees, particularly ethics committees. The authors include reflections about learning clinical ethics and education of committees, hospital staff, and the general public about issues that arise. The purpose is to help ethics consultants improve their conscious assessment of their work, both how they go about it and its legitimacy for patients, health care providers, and hospitals. The orientation is primarily on clinical care of patients, because the goal of such consultations is always aimed to improve patient care. Other ethics consultants might work to develop institutional policies. Although that is touched on in the book, it is not the primary goal of the authors. The book is aimed at the practitioner in bioethics in a clinical setting.

This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues.

Drawing on the findings of a series of empirical studies undertaken with boards of directors and CEOs in the United States, this groundbreaking book develops a new paradigm to provide a structured analysis of ethical healthcare governance. Governance Ethics in Healthcare Organizations begins by presenting a clear framework for ethical analysis, designed around basic features of ethics – who we are, how we function, and what we do – before discussing the paradigm in relation to clinical, organizational and professional ethics. It goes on to apply this framework in areas that are pivotal for effective governance in healthcare: oversight structures for trustees and executives, community benefit, community health, patient care, patient safety and conflicted collaborative arrangements. This book is an important read for all those interested in healthcare management, corporate governance and healthcare ethics, including academics, students and practitioners.

This comprehensive medical textbook is a compendium of the latest information on healthcare quality. The text provides knowledge about the theory and practical applications for each of the core areas that comprise the field of medical quality management as well as insight and essential briefings on the impact of new healthcare technologies and innovations on medical quality and improvement. The third edition provides significant new content related to medical quality management and quality improvement, a user-friendly format, case studies, and updated learning objectives. This textbook also serves as source material for the American Board of Medical Quality in the development of its core curriculum and certification examinations. Each chapter is designed for a review of the essential background, precepts, and exemplary practices within the topical area: Basics of Quality Improvement Data Analytics for the Improvement of Healthcare Quality Utilization Management, Case Management, and Care Coordination Economics and Finance in Medical Quality Management External Quality Improvement — Accreditation, Certification, and Education The Interface Between Quality Improvement and Law Ethics and Quality Improvement With the new edition of Medical Quality Management: Theory and Practice, the American College of Medical Quality presents the experience and expertise of its contributors to provide the background necessary for healthcare professionals to assume the responsibilities of medical quality management in healthcare institutions, provide physicians in all medical specialties with a core body of knowledge related to medical quality management, and serve as a necessary guide for healthcare administrators and executives, academics, directors, medical and nursing students and residents, and physicians and other health practitioners.

This book provides a robust analysis of the history of clinical ethics, the philosophical theories that support its practice, and the practical institutional criteria needed to become a practicing clinical ethicist. Featuring cases and a step-by-step approach, this book combines knowledge points associated with moral philosophy and medicine with general skill objectives for ethics consultants. The book aids in developing analytic moral reasoning skills for clinical ethicists, fostering the comprehensive education and professional development of clinical ethics consultants. In addition, it offers key components of how an ethics consultation curriculum manifest in an educational venue for clinical ethicists are illustrated. Adaptable and relevant for educating multiple disciplines in health care, this resource enables ethicists to understand the philosophical foundations and practical application of clinical ethics.

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns—whether ethics consultation is best done by individuals, teams, or committees; how an ethics consult service should be structured; the need for institutional support; and techniques and programs for educating and training staff—without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics.

This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical ethics consultants can draw methods and strategies for effectively delivering ethics consultation.