Ethics Committee Benchmark Project

1
Ethics Committee Benchmark Project

• William J. Kirkpatrick, LICSW
• Director, Clinical Social Work

2
Participating Hospitals

• Bradley
• Butler
• Charlton (Southcoast)
• Kent
• Landmark
• Memorial
• Miriam

• NEMC
• Newport
• Rhode Island
• Roger Williams
• St. Annes
• South County
• Woman Infants

3
Does your hospital have a functioning ethics
committee?

• Results 13/13 100

4
What is the reporting relationship of your
ethics committee within the hospital hierarchy?

• Quality Council
• Board of Trustees
• Medical Director
• Sub-Comm. Of Medical Staff
• CEO
• Board of Trustees

• Board of Trustees
• Medical Staff
• President CEO
• Board of Trustees, Chair
• Medical Staff Exec. Committee

5
Does the Ethics Committee document the results of
a consult in the medical record?

• 13/13 responses
• 7/13 54 yes
• 3 use forms
• 4 use progress notes
• 2 debating action

6
Do you have an individual on your committee with
bio-ethics training?

• 11/13 responses 85
• PhD in Philosophy
• MDiv MAT
• MD/Fellowship in ethics
• PhD in bio-ethics
• RN, Prof. Of Philosophy
• Ethicist

7
Does your ethics committee conduct educational
activities in the hospital?

• 11/13 responses yes
• Grand Rounds
• Palliative Care Conference
• CME Program
• Nursing Residents
• End-of-life issues Advance Directives
• Rounds

8
How many formal ethics consults are presented to
your committee annually?

• 11/13 responses
• 1 to 2 2
• 2 to 3 1
• 3 to 7 2
• 7 to 10 2
• 10 to 15 3
• 15 to 20 1

9
Is your ethics committee accessible 24/7?

• 12/13 responses
• 7 yes
• 5 no

10
Would your ethics committee be interested in
participating in a regional network?

• 12/13 responses
• 10 yes
• 1 already participating
• 1 not able due to geographical distance

11
Analysis

• Ethics Committees institutionalized.
• All conducting some form of self-examination.
  (ASBH knowledge and skills assessment)
• Variability in position within hierarchy.
• Variability in activity.
• Most engage in some education.
• Could have asked about nature of consults.

12
Future Project

• Contact additional hospitals
• Conduct literature search
• Size of hospital/annual discharges/patient days
• Issues peculiar to Rhode Island
• Decision making vs. consultative
• 3 Most common reasons for consult
• What are the consults

13
Future Project

• Does your hospital have a futility policy?
• Have you discussed the issue of Ethics Committees
  as a Peer Review entity
• Decision making vs. advisory function
• Composition of Committee disciplines/community
  representatives
• Pros and cons of documentation how did the
  decision to document evolve