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To our knowledge, no existing book or article describes how to establish and operate a vibrant and sustainable clinical ethics consultation service (ECS) from the ground up. As a result, ECS directors and ethics consultants may be charged with building or reinvigorating and sustaining a high-quality, successful service without sufficient practical guidance on how to plan, implement, and monitor their efforts. This lack of guidance can give rise to problems, including wasted time and effort, as well as misalignments in expectations and goals between hospital administrators and ethics consultants on what constitutes "success" and "failure" in service activities. Toward the goal of providing this much-needed guidance, we describe key considerations and strategies for developing, implementing, and monitoring a high-quality, successful service. It is important to note that in responding to hospital administrators' expectations and establishing a successful service, it is necessary but not sufficient to demonstrate the competence of individual consultants. Thus, some portions of this guide are addressed to the individual or individuals leading an ECS, but many chapters will be useful to anyone engaging in clinical ethics consultation or playing a role in overseeing or otherwise advocating for an ECS. Our focus is on building and sustaining high-quality, successful services in ways that go well beyond the traditional focus on how to conduct an ethics consultation. Specifically, we have chapters and sections devoted to working through a case, mediation skills, and conducting and facilitating family meetings that should be useful for any ethics consultant, particularly individuals who are new to ethics consultation or seasoned consultants who wish to reflect on their practices, but we also have chapters and sections devoted to "selling points to hospital administrators on the value of ECSs," building an ECS infrastructure, launching a service, etc., that are aimed more towards ECS directors, with the goal of providing essential guidance on ECS development and maintenance. Finally, our goal is to be as practical and clinically-oriented as possible by addressing everyday nuts-and-bolts concerns that apply across demographically- and geographically-diverse hospital settings, subject to some individual variation that we will underscore for our readership. In particular, we arrange this guide according to phases of an ECS. Part 1 will focus on planning for an ECS. Part 2 will discuss how to implement an ECS. Part 3 will then conclude with information about how to monitor an ECS once it is established, and how to address common challenges. We believe that much of the advice we provide can be extended to other consultative or hospital services that are based in hospitals, such as palliative medicine, chaplaincy, or social work services. We hope you find this useful!
Drawing on the findings of a series of empirical studies undertaken with boards of directors and CEOs in the United States, this groundbreaking book develops a new paradigm to provide a structured analysis of ethical healthcare governance. Governance Ethics in Healthcare Organizations begins by presenting a clear framework for ethical analysis, designed around basic features of ethics – who we are, how we function, and what we do – before discussing the paradigm in relation to clinical, organizational and professional ethics. It goes on to apply this framework in areas that are pivotal for effective governance in healthcare: oversight structures for trustees and executives, community benefit, community health, patient care, patient safety and conflicted collaborative arrangements. This book is an important read for all those interested in healthcare management, corporate governance and healthcare ethics, including academics, students and practitioners.
This comprehensive medical textbook is a compendium of the latest information on healthcare quality. The text provides knowledge about the theory and practical applications for each of the core areas that comprise the field of medical quality management as well as insight and essential briefings on the impact of new healthcare technologies and innovations on medical quality and improvement. The third edition provides significant new content related to medical quality management and quality improvement, a user-friendly format, case studies, and updated learning objectives. This textbook also serves as source material for the American Board of Medical Quality in the development of its core curriculum and certification examinations. Each chapter is designed for a review of the essential background, precepts, and exemplary practices within the topical area: Basics of Quality Improvement Data Analytics for the Improvement of Healthcare Quality Utilization Management, Case Management, and Care Coordination Economics and Finance in Medical Quality Management External Quality Improvement — Accreditation, Certification, and Education The Interface Between Quality Improvement and Law Ethics and Quality Improvement With the new edition of Medical Quality Management: Theory and Practice, the American College of Medical Quality presents the experience and expertise of its contributors to provide the background necessary for healthcare professionals to assume the responsibilities of medical quality management in healthcare institutions, provide physicians in all medical specialties with a core body of knowledge related to medical quality management, and serve as a necessary guide for healthcare administrators and executives, academics, directors, medical and nursing students and residents, and physicians and other health practitioners.
Now in its 5th edition Midwifery Preparation for Practice continues to present a global model of midwifery best practice that is supported by a range of examples from the Australian, New Zealand and international midwifery contexts. Endorsed by the Australian College of Midwives and the New Zealand College of Midwives the text continues to reinforce the established principles of midwifery philosophy and practice – that of midwives working in partnership with women, in woman-centred models or midwife-led care. This focus is what sets this text apart from other physiology-based midwifery texts, making it a highly valued resource for students and practicing midwives alike. The highly esteemed team of editors once again lead a group of internationally recognised leaders in midwifery to share their knowledge and expertise in midwifery practice, education, research and regulation across Australia, New Zealand and internationally. Aligned to local and international midwifery standards for practice and guidelines Endorsed by the Australian College of Midwives and the New Zealand College of Midwives Presented in 2 volumes for ease of use Videos to support learning New chapters Sustainability and Environmental Health Care Ethical Frameworks for Practice Updated midwifery guidelines and practice examples throughout
In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns—whether ethics consultation is best done by individuals, teams, or committees; how an ethics consult service should be structured; the need for institutional support; and techniques and programs for educating and training staff—without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics.
Clinical Ethics introduces the four-topics method of approaching ethical problems (i.e., medical indications, patient preferences, quality of life, and contextual features). Each of the four chapters represents one of the topics. In each chapter, the authors discuss cases and provide comments and recommendations. The four-topics method is an organizational process by which clinicians can begin to understand the complexities involved in ethical cases and can proceed to find a solution for each case.
28 detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of difficult consultations.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.