Checklists have been used to improve quality in many BX-795 industries

Checklists have been used to improve quality in many BX-795 industries including healthcare. to ethics consultants about process steps that are important for most patient-centered ethics consultations (2) to create consistency in the ethics consultation process across the medical system and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist it was distributed to 46 ethics professionals. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents 11 self-reported as experts in ethics consultation nine perceived themselves to have mid-level expertise and five self-reported as novices. The majority (68 percent) of all respondents regardless of expertise believed that the checklist could be a “helpful” BX-795 or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system utilized a small sample size and BX-795 used self-reported quality outcome measures. Despite these limitations to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly our findings shed light on ways this checklist can be used to improve ethics consultation including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. Introduction The use of checklists in healthcare has recently gained momentum in the United States 1 and their use is positively correlated with a wide range of health and quality outcomes in the literature.2 Research most strongly supports the use of checklists in procedurally based clinical interventions 3 but studies have not assessed their use in clinical ethics. Checklists have gained the most prominence in surgical settings where they were found to reduce or eliminate “never events ” such as operating on the incorrect patient.4 Studies report reductions in mortality 5 improved quality of care 6 and increased safety and communication with the implementation of checklists.7 Outside the surgical setting checklists have been found to improve quality and consistency in sonograph8 and central venous catheterization skills.9 Most studies report that the use of checklists that were designed to standardize processes in healthcare improved the quality of care.10 The goal of ethics consultation is “to improve the quality of healthcare through Sdpr the identification analysis and resolution of ethical questions or concerns.”11 Effectiveness in health services research is often defined as either procedure-based or outcome-based. In this article we have focused on procedure-based outcomes. On initial review ethics consultation may appear to defy a procedural approach because each ethics case is unique with variation in ethical issues interpersonal dynamics among stakeholders and nuanced moral perspectives and analysis. These characteristics may limit the helpfulness of a “one size fits all” approach to ethics consultation because consultants must think objectively and independently and apply knowledge skills and experience to analyze and manage a case to ensure a “good ethics consultation outcome.” Nevertheless there are multiple procedural steps BX-795 that should be considered for most patient-focused ethics consultations. These standard actions can be categorized as information gathering documentation and follow up and can appropriately be included in an ethics consultation checklist. Quality outcomes in ethics.