Preventing ethics conflicts and improving healthcare quality through system redesign

Quality and Safety in Health Care

Volumn 19, Issue 6, 2010, Pages 526-530

  Nelson, William A ^a,d   Gardent, Paul B ^a,b   Shulman, Eliza ^c   Splaine, Mark E ^a  

^a DARTMOUTH INSTITUTE FOR HEALTH POLICY AND CLINICAL PRACTICE   (United States)

^b DARTMOUTH COLLEGE   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d DARTMOUTH MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONFLICT; ETHICS; HEALTH CARE QUALITY; HUMAN; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PRIMARY HEALTH CARE; SAFETY; UNITED STATES;

CONFLICT (PSYCHOLOGY); HUMANS; ORGANIZATIONAL INNOVATION; PRIMARY HEALTH CARE; QUALITY ASSURANCE, HEALTH CARE; SAFETY MANAGEMENT; UNITED STATES;

EID: 78650366947     PISSN: 14753898     EISSN: 14753901     Source Type: Journal    
DOI: 10.1136/qshc.2009.038943     Document Type: Article

References (36)

1. Bischoff SJ, DeTienne KB, Quick B. Effects of ethics stress on employee burnout and fatigue: An empirical investigation. J Health Hum Serv Adm 1999;21:512-32.
2. Daly G. Ethics and economics. Nurs Econ 2000;18:194-201.
3. Fandray D. The ethical company. Workforce 2000;79:74-7.
4. Holloran SD, Starkey GW, Burke PA, et al. An educational intervention in the surgical intensive care unit to improve ethical decisions. Surgery 1995;118:294-8; discussion 8-9.
5. Heilicser BJ, Meltzer D, Siegler M. The effect of clinical medical ethics consultation on healthcare costs. J Clin Ethics 2000;11:31-8.
6. Schneiderman LJ, Gilmer T, Teetzel HD, et al. Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: A randomized controlled trial. JAMA 2003;290:1166-72.
7. Veit L. Ethical matters. Credit Union Management 2001;18:18-20.
8. Nelson WA. Ethical uncertainty and staff stress. Healthc Exec 2009;24:38-9.
9. Nelson WA, Weeks WB, Campfield JM. The organizational costs of ethical conflicts. J Healthc Manag 2008;53:41-52; discussion 52-3.
10. Bacchetta MD, Fins JJ. The economics of clinical ethics programs: A quantitative justification. Camb Q Healthc Ethics 1997;6:451-60.
11. Weeks WB, Waldron J, Foster T, et al. The organizational costs of preventable medical errors. Jt Comm J Qual Improv 2001;27:533-9.
12. Institute of Medicine. Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001.
13. Forrow L, Arnold RM, Parker LS. Preventive ethics: Expanding the horizons of clinical ethics. J Clin Ethics 1993;4:287-94.
14. Dowdy MD, Robertson C, Bander JA. A study of proactive ethics consultation for critically and terminally ill patients with extended lengths of stay. Crit Care Med 1998;26:252-9.
15. McCullough LB. Preventive ethics, managed practice, and the hospital ethics committee as a resource for physician executives. HEC Forum 1998;10:136-51.
16. McCullough LB. Practicing preventive ethics-the keys to avoiding ethical conflicts in health care. Physician Exec 2005;31:18-21.
17. Vernillo A. Preventive ethics and rural healthcare: Addressing issues on a systems level. Am J Bioeth 2008;8:61-2; author reply W3-4.
18. Nelson WA. Dealing with ethical challenges. How occurrences can be addressed before they happen. Healthc Exec 2007;22:36, 38.
19. Aulisio MP, Arnold RM, Youngner SJ, eds. Ethics Consultation: From Theory to Practice. Baltimore: Johns Hopkins University Press, 2003.
20. Dubler NN, Webber MP, Swiderski DM, et al. Charting the future. Credentialing, privileging, quality, and evaluation in clinical ethics consultation. Hastings Cent Rep 2009;39:23-33.
21. The Report of the American Society for Bioethics and Humanities: Core Competencies for Health Care Ethics Consultation (Draft). Glenview, IL: American Society for Bioethics and Humanities, 2009. http://www.asbh.org/publications/ pdfs/ CCUpdateNov09.pdf (accessed 1 Sep 2010).
22. Nelson WA, Neily J, Mills P, et al. Collaboration of ethics and patient safety programs: Opportunities to promote quality care. HEC Forum 2008;20:15-27.
23. Nelson WA, Gardent PB. Ethics and quality improvement. Quality care and ethical principles cannot be separated when considering quality improvement activities. Healthc Exec 2008;23:40-1.
24. Opel DJ, Brownstein D, Diekema DS, et al. Integrating ethics and patient safety: The role of clinical ethics consultants in quality improvement. J Clin Ethics 2009;20:220-6.
25. Anderson CA. Ethics committees and quality improvement: A necessary link. J Nurs Care Qual 1996;11:22-8.
26. Ahmed PK, Machold S. The quality and ethics connection: Toward virtuous organizations. Total Qual Manage Bus Excel 2004;15:527-45.
27. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 5th edn. New York, NY: Oxford University Press, 2001:293-312.
28. Preventive Ethics. U.S. Department of Veterans Affairs. National Center for Ethics in Health Care. http://www.ethics.va.gov/IntegratedEthics/pec.asp (accessed 1 Sep 2010).
29. Wasson JH, Anders SG, Moore LG, et al. Clinical microsystems, part 2. Learning from micro practices about providing patients the care they want and need. Jt Comm J Qual Patient Saf 2008;34:445-52.
30. Godfrey MM, edr. Clinical Microsystem Action Guide: Improving Health Care by Improving Your Microsystem. revised ed. Hanover NH: Trustees of Dartmouth College, 2004.
31. Wasson JH, Godfrey MM, Nelson EC, et al. Microsystems in health care: Part 4. Planning patient-centered care. Jt Comm J Qual Saf 2003;29:227-37.
32. Williams I, Dickinson H, Robinson S. Clinical Microsystems: An Evaluation. Birmingham: Health Services Management Centre, University of Birmingham, 2007. http://chain.ulcc.ac.uk/chain/documents/hsmc-evaluation- report-CMS2007final.pdf (accessed 1 Sep 2010).
33. Mohr J, Batalden P, Barach P. Integrating patient safety into the clinical microsystem. Qual Saf Health Care 2004;13(Suppl 2):ii34-8.
34. Nelson EC, Bataldne PB, Godfrey MM. Quality by Design: A Clinical Microsystems Approach. Lebanon, NH: Center for the Evaluative Clinical Sciences at Dartmouth, 2007.
35. Godfrey MM, Melin CN, Muething SE, et al. Clinical microsystems, Part 3. Transformation of two hospitals using microsystem, mesosystem, and macrosystem strategies. Jt Comm J Qual Patient Saf 2008;34:591-603.
36. Orgrinc GS, Headrick LA. Fundamentals of Health Care Improvement: A Guide to Improving Your Patients' Care. Oakbrook Terrace, IL: Joing Commission Resources, 2008.