Implementing Electronic Medical Record (EMR) Orders for Ethics Consultation Requests in a Not-For-Profit, Community Hospital

Abstract: This project embarked on a comprehensive needs-based assessment within the confines of an independent, not-for-profit community hospital. Process improvement efforts were needed to optimize the functionality of the current ethics consultation model, an ethics committee. The focus was on enhancing the efficiency of consultation request and response time. Respondents in the needs-based assessment expressed uncertainty about the procedures for submitting a consultation request. Organizational inconsistencies lead to variation in a process that should be systemized. Multiple modalities existed: email, phone extension, informal conversations. The policy pertaining to the ethics committee duties and function referenced an extension that remained unattended and unmonitored by ethics committee personnel. In addition, the organization website indicated that a member of the ethics committee is on-call at all times. This on-call individual is never communicated to the organization. This lack of standardization raised concerns about non-compliance with the established policy and procedures. In response to this, working with our Informatics department and in light of Joint Commission requirements, the existing inconsistencies needed to be resolved. The recommendations and implementations that were completed included the creation of dedicated phone extension coverage and electronic medical record referrals, as well as policy revision and staff education. This transformation was communicated through hospital-wide channels, and the organization’s website was promptly updated to ensure patients, families, and other stakeholders had access to the most current information. The impact of these changes was tangible, evidenced by Intensivist utilization within the first 24 hours of Go Live.