A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Fins, Joseph J.; Kodish, Eric; Cohn, Felicia; Danis, Marion; Derse, Arthur R.; Dubler, Nancy Neveloff; Goulden, Barbara; Kuczewski, Mark G.; Mercer, Mary Beth; Pearlman, Robert A.; Smith, Martin L.; Tarzian, Anita J.; Youngner, Stuart J.

doi:10.1080/15265161.2015.1134705

Cited by 48 publications

(35 citation statements)

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“…It is a well-known fact that CES is a diverse field. In particular, there has been a ‘historic value’ placed on the diversity of approaches to ethics consultation 30. Our item bank, developed in round 1, reflects that diversity, and suggests that when discussing CESs in the USA, there is similar diversity.…”

Section: Discussionmentioning

confidence: 89%

Objectives and outcomes of clinical ethics services: a Delphi study

2019

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ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field.

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Section: Discussionmentioning

confidence: 89%

Objectives and outcomes of clinical ethics services: a Delphi study

2019

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“…Accrediting ECS at the service level will take the assessment of overall HCEC quality to the next level. The American Society for Bioethics and Humanities (ASBH) has outlined and completed the pilot phase of its quality attestation (QA) process through an assessment of portfolios submitted by clinical ethics consultants (CECs) (Kodish et al 2013;Fins et al 2016). These portfolios provided evidence of the individual's background and training, a philosophy of ethics consultation, and 12 case writeups and analyses.…”

Section: Resultsmentioning

confidence: 99%

A Call for Multiple Means of Assessing Quality in Clinical Ethics Consultation

Wasson

2016

The American Journal of Bioethics

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“…With pilot evaluations recently completed (Fins et al 2016), this proposed two-step process of portfolio review and oral examination highlights key features for ensuring excellence in ethics consultation, such as experience with ethics consults, familiarity with fundamental ethics cases and concepts, and real-time reasoning through the ethics consultation process. This process is very useful in establishing whether individuals can reliably perform quality ethics consultation, but is distinct from establishing whether a particular consultation is of high quality.…”

Section: Discussionmentioning

confidence: 99%

The use of an online comment system in clinical ethics consultation

Hauschildt

Paul

Vries

et al. 2017

AJOB Empirical Bioethics

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Background Although a mechanism for resolving ethical issues in patient care is required for accreditation of American hospitals, there are no formal qualifications for providing clinical ethics consultation (CEC), and there remains great variability in the composition of ethics committees and consult services. Consequently, the quality of CEC also varies depending on the qualifications of those performing CEC services and the format of CEC utilized at an institution. Our institution implemented an online CEC comment system to build upon existing practices to promote consistency and broad consensus in CEC services and enable quality assurance. Methods This qualitative study explored the use of an online comment system in ethics consultation and its impact on consensus building and quality assurance. All adult ethics consultations recorded between January 2011 and May 2015 (n=159) were analyzed for themes using both open and directed coding methods. Results We found that comments broadly reflected three categories: expressions of approval/agreement (87% of consults), comments about the case (89%), and comments about the written record (72%). More than one-third of consults included responses to other comments (37%). The most common types of “comments about the case” included requests for additional information (36%), recommendations for additional services (21%), and references to formal policies/standards (28%). Comments often spanned multiple categories and themes. Comments about the written record emphasized accessibility, clarity, and specificity in ethics consultation communication. Conclusions We find the online system allows for broad committee participation in consultations and helps improve the quality of CEC provided by allowing for substantive discussion and consensus building. Further, we find the use of an online comment system and subsequent records can serve as an educational tool for students, trainees, and ethics committee members.

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A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Cited by 48 publications

References 5 publications

Objectives and outcomes of clinical ethics services: a Delphi study

Objectives and outcomes of clinical ethics services: a Delphi study

A Call for Multiple Means of Assessing Quality in Clinical Ethics Consultation

The use of an online comment system in clinical ethics consultation

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