Optimizing Clinical Ethics Committee Utilization in a Large Teaching Hospital: Identifying Barriers and Proposing Solutions for Improved Patient Care
Saturday, September 21, 2024
11:30 AM – 12:30 PM CT
Location: Midway 11 (First Floor)
Abstract: Clinical Ethics Committees (CECs) have a crucial role in resolving ethical in-patient care by alleviating distress among patients, providers, and families while improving patient outcomes. They offer guidance on medical decision-making, surrogate designation, and patient treatment refusal through principles such as beneficence, non-maleficence, autonomy, and justice. Despite their potential benefits, CECs still encounter underutilization or delayed requests due to various barriers, including logistical challenges and clinician perception.
This study investigated CEC utilization at our large teaching hospital with Level 1 adult and Level 2 pediatric trauma centers. Our objectives were to identify utilization barriers and propose solutions. Consultation volume metrics from 2016 to 2022, including the consult-to-bed ratio (CBR) and consult-to-admissions ratio (CAR), were analyzed and classified as either low, moderate, or high. While 2018 showed the highest ratios (CBR: 0.26, CAR: 4.49), volumes generally remained low to moderate.
Understanding the relationship between fluctuating consultation rates and external factors can guide interventions to improve accessibility and address clinician concerns. Specific interventions were formulated for the suspected influences on low utilization. To target the accessibility of services and increased utilization of intersecting services (ex: Complex Case Review Committee), recommendations included increasing CEC visibility, early education for new staff, and collaboration with intersecting services. To improve clinician perception, quality improvement surveys may be beneficial. Improving clinician perception and accessibility of CECs can facilitate timely interventions, leading to better patient outcomes and efficient healthcare resource allocation. This study underscores the significance of effective CEC utilization in advancing ethical decision-making and patient care.
Learning Objectives:
After participating in this conference, attendees should be able to:
Understand the role and importance of Clinical Ethics Committees (CECs) in resolving ethical dilemmas in patient care, including their guiding principles and objectives.
Identify common barriers to the utilization of CECs in healthcare settings, such as logistical challenges, clinician perceptions, and external factors.
Evaluate strategies and recommendations proposed to enhance CEC utilization, including increasing visibility, early education for staff, and quality improvement surveys, with the aim of improving ethical decision-making and patient outcomes.
Pierce Randall, PhD – Assistant Professor, Alden March Bioethics Institute, Albany Medical College
