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CS78
Clinical Ethics Consultation: There is a Better Way!
By: Donna Fuerst, Maureen Seckel, Arlene Bincsik, Marie Essex, Joan McLaughlin, Timothy Rodden, John Goodill, Neil Farber, Brad Slease; Christiana Care Health System, Wilmington, DE
For further information, please contact: dfuerst@christianacare.org
Purpose: The goal of the Consult Screening Team is to provide a timely response to requests for information or consultation, determine optimal course of action based on information gathered and coordinate the consultation process as appropriate.
Description: Our previous structure for ethics consultation did not provide for consistent 24 hour/7 day on-call coverage. Consultation was provided by physician members of the Ethics Committee, who also may have been consulted on the same patient in their primary role as palliative care physicians. This created a potential conflict of interest. An interdisciplinary team was convened to explore resolution to potential conflicts of interest while providing expanded coverage and decreasing response time. A model was developed which includes the education & training of a core interdisciplinary team of non-physicians who are available and responsible for responding to requests for ethics consultation on a 24 hour/7 day per week basis. Guidelines and algorithms were developed to aid decision-making and data is collected to evaluate effectiveness.
Evaluation: When ethics advice or consultation is sought, the request is answered by a trained consultant. Our current average response time is 6 minutes. 50% of calls have been converted to palliative care, 15% resulted in full ethics consultation, 35% have been resolved through facilitated communication. An interdisciplinary response team in medical ethics can avoid potential conflicts of interest, improve response times, and allow for better patient outcomes.
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