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National Center for Ethics in Health Care

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IE in the News

Overview

Program Management

Ethics Consultation

Preventive Ethics

Ethical Leadership

Education

Ethics Evaluation

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IE in the News

Go to IE in the News


Overview

Read

Fox E, Bottrell MM, Berkowitz KA, Chanko BL, Foglia MB, Pearlman RA. IntegratedEthics: An Innovative Program to Improve Ethics Quality in Health Care. The Innovation Journal. 2010 Summer;15(2).

Improving Ethics Quality: Looking Beneath the Surface - one-page article uses an iceberg model to describe the three levels of ethics quality in health care

IntegratedEthics: Closing the Ethics Quality Gap - two-page article describes how the IntegratedEthics model can be used to identify and fix ethics gaps

What Is Ethics Quality? - one-page article describes how the IntegratedEthics model defines ethics quality in health care

Fox E. IntegratedEthics: Making It Easier to Do the Right Thing. VAnguard. 2005; March - April.

Domains of Ethics in Health Care 

A Brief Business Case for Ethics - two-page article describes how a strong ethics program can reap concrete benefits for a health care organization.  

IntegratedEthics Policy (VHA Handbook 1004.06)

Watch

IntegratedEthics: Improving Ethics Quality in Health Care Video - ten-minute video provides an introduction and overview of the benefits of IntegratedEthics


Program Management

Read

Fox E, Bottrell MM, Berkowitz KA, Chanko BL, Foglia MB, Pearlman RA. IntegratedEthics: An Innovative Program to Improve Ethics Quality in Health Care. The Innovation Journal. 2010 Summer;15(2).

Improving Ethics Quality: Looking Beneath the Surface - one-page article uses an iceberg model to describe the three levels of ethics quality in health care

IntegratedEthics: Closing the Ethics Quality Gap - two-page article describes how the IntegratedEthics model can be used to identify and fix ethics gaps

What Is Ethics Quality? - one-page article describes how the IntegratedEthics model defines ethics quality in health care

Understanding Ethics and Business Integrity

IntegratedEthics Policy (VHA Handbook 1004.06)

Watch

IntegratedEthics: Improving Ethics Quality in Health Care Video - ten-minute video provides an introduction and overview of the benefits of IntegratedEthics

Use

Tools to explain the role of the IE Program Officer and the IE Council:

Tools to explain the role of the IE Regional (VISN) Coordinator and the Regional (VISN) IE Advisory Board:

Tools to assess the structures and processes of an IE program:

Tools to support IE Councils:


Ethics Consultation

Read

Ethics Consultation: Responding to Ethics Questions in Health Care - The primer provides an introduction to health care ethics consultation, and outlines a step-by-step approach to conducting ethics consultations using the CASES approach. Intended for staff who participate in ethics consultations, including leaders responsible for overseeing the ethics consultation function.

IntegratedEthics Policy (VHA Handbook 1004.06

Watch

Ethics Consultation: Responding to Ethics Questions in Health Care Video - This two-part course (each part is 45 minutes in length) discusses important elements of a successful ethics consultation service and, using specific examples and interactive exercises, reviews CASES, a five-step approach to performing effective ethics consultations.

Use

Ethics consultation core tools:

Tools to increase awareness of ethics consultation:

Tools to assess ethics consultant knowledge and skills:

Six advanced training modules on the CASES approach to ethics quality improvement for Ethics Consultation Coordinators and other team members:

Tools to explain the role of the ethics consultation coordinator:


Preventive Ethics

Read

Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level - The primer provides an introduction to preventive ethics and outlines a step-by-step approach to improving systems and processes that influence ethics practices in a health care organization

Foglia MB, Fox E, Chanko B, Bottrell MM. Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level. Joint Commission Journal on Quality and Patient Safety. 2012;38(3):103-11. Epub 2012/03/23.

IntegratedEthics Policy (VHA Handbook 1004.06)

Watch

Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level Video - 45-minute, interactive video to teach viewers how to apply principles of quality improvement to proactively address ethics issues on a systems level

Use

Preventive Ethics core tools:

Document a completed improvement cycle:

Six advanced training modules on key PE concepts for Preventive Ethics Coordinators and team members:

Tools to explain the role and responsibilities of the Preventive Ethics Coordinator:


Ethical Leadership

Read

Ethical Leadership: Fostering an Ethical Environment and Culture 

Foglia MB, Cohen JH, Pearlman RA, Bottrell MM, Fox E. Perceptions of Ethical Leadership and the Ethical Environment and Culture: IntegratedEthics Staff Survey Data from the VA Health Care System. AJOB Primary Research, 2013. 4(1) 44-58.

IntegratedEthics Policy (VHA Handbook 1004.06)

Watch

Ethical Leadership: Fostering an Ethical Environment and Culture Video

Use

Tools to explain the role of the Ethical Leadership Coordinator:

Tools to support the development of ethical leadership skills:

Talk About Ethics - an activity and activity guide for all staff members to help them consider how they "talk about ethics" and to encourage discussion with their colleagues

Ethics Discussion Activities - using journal articles and media examples, activities prompt group discussion of ethical leadership concepts.

Managing for Organizational Integrity - a March 1994 Harvard Business Review article by Lynn Sharp

Psychology of Fraud: Why Good People Do Bad Things - a May 2012 presentation on NPR by Chana Joffe-Walt and Alix Spiegel (NPR article and presentation)

Reward and Discipline - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Peer and Leader Influence - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Moral Disengagement - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Decision Frames - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Tools to improve plans to strengthen an organization's environment and culture:


Education

Tools for all IE Staff:

Planning a VISN-wide IE Training Program: A Guide for the VISN IE POC - tool to assess learning needs for IE Program staff across a region, plus stand-alone assessment questionnaire

Ethics Consultation education tools:

ECWeb - VA's National Center for Ethics in Health Care developed this web-based program to document, track, evaluate, manage, and continuously improve ethics consultation quality.

Six advanced training modules on the CASES approach to ethics consultation for Ethics Consultation Coordinators and other team members:

See also Ethics Consultation: Responding to Ethics Questions in Health Care primer and videos

Preventive Ethics education tools:

Six advanced training modules on key PE concepts for Preventive Ethics Coordinators and team members:

See also Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level primer and video

Ethical Leadership education tools:

Ethical Leadership Self-Assessment Tool (ELSA)

Peer Feedback Activity on Leadership Behaviors and the Organization's Ethical Environment - based on the ELSA, this 15-minute group activity allows leaders to obtain specific information from their peers on behaviors that have had positive and negative effects on their organization's ethical environment

Value of the Month Ethical Leadership Activities - a set of brief discussion activities that include value and discussion prompts, examples, and case studies. Intended for leaders at all levels, including committee chairs, to help employees articulate their individual values and improve mutual understanding of how values impact the work of the group or committee (editable version)

Value of the Day Discussion - a week-long series based on the Value of the Month activity

Value of the Day E-mail Activity - email activity based on the Value of the Day Discussion

Ethical Leadership Curriculum (Faculty Guide) - based on the ethical leadership compass, this training curriculum is intended to help leaders develop new skills and behaviors consistent with ethical leadership. Includes slides, activities, and handouts for facilitators and participants.

Ethics Discussion Activities - using journal articles and media examples, activities prompt group discussion of ethical leadership concepts.

Managing for Organizational Integrity - a March 1994 Harvard Business Review article by Lynn Sharp

Psychology of Fraud: Why Good People Do Bad Things - a May 2012 presentation on NPR by Chana Joffe-Walt and Alix Spiegel (NPR article and presentation)

  • Leader Guide
  • Participant Guide

Reward and Discipline - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Peer and Leader Influence - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Moral Disengagement - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

Decision Frames - (Un)Ethical Behavior in Organizations by Linda Klebe Treviño

See also Ethical Leadership: Fostering an Ethical Culture and Environment primer and video

Tools to educate Veterans and their families about ethics consultation:

Educational modules about general ethics topics


Ethics Evaluation

Read

A special issue of AJOB Primary Research, a journal of the American Journal of Bioethics, features seven papers describing VA’s experience evaluating ethics quality in the VA health care system as part of IntegratedEthics (IE), VA’s comprehensive model for managing ethics in health care organizations.

Use

ECWeb - VA's National Center for Ethics in Health Care developed this web-based program to document, track, evaluate, manage, and continuously improve ethics consultation quality

Assess learning needs for IE Program staff:

Assess ethics consultant knowledge and skills:

Assess employee perceptions of ethics in health care (IESS):

  • The IntegratedEthics Staff Survey (IESS) was developed to assess ethics practices in health care settings and to serve as a catalyst for the improvement of practices. IESS assesses staff perceptions of what they have observed and experienced related to ethics in health care. Background, use, and validity testing is described here.

Assess IE program implementation:

  • IntegratedEthics Facility Workbook - designed to help facilities assess current ethics quality, identify strengths as well as opportunities for improvement, set goals, and develop quality improvement plans. (See also article on IEFW background and field testing.)
  • IntegratedEthics program achievement goals - IntegratedEthics Program data are collected with the purposes of monitoring implementation of IntegratedEthics as required in VHA Handbook 1004.06 and to obtain examples of strong practices in ethics consultation, preventive ethics, ethical leadership, and the Facility IntegratedEthics Council and VISN IE Advisory Board.
  • IE Program Status Check and Planning Tool - two-page tool to assist IE Councils in performing a high level assessment of the organization's IE program
  • IE Council Self Assessment Tool - (Revised 2014) Simple two-step tool to assist IE Councils with assessing their performance and identifying strengths and areas that need improvement

Review leadership behaviors in support of an ethical environment and culture:


Archives

The following materials were used in the initial 2008 launch of the VA IntegratedEthics program:


 

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Highlights

What's New

Ethical Leadership Tips - Double-sided tip sheet with quick and practical information about the Four Compass Points of Ethical Leadership

IE Council Self-Assessment Tool - Simple two-step tool to assist IE Councils with assessing their performance and identifying strengths and areas that need improvement

EL Interview Questions Tool - Behavior-based interview questions for HPDM level 2-4 leadership candidates, corresponding to the Four Compass Points of Ethical Leadership


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