2O14 2O15 · organization has now begun to take shape in full. In 2014 the Covenant Health Ethics...

Assisting patients, residents, and families in making challenging health care decisions when there is conflict or uncertainty about the “best” thing to do.

SUMMARY OF ACTIVITIES

COVENANT HEALTH ETHICS CENTRE

2O152O14

2O15GROWTH

2O14

The 2014-2015 Ethics Centre Summary of Activities report is all

about growth; the Centre saw exponential growth in almost all

areas of our work. Growth is exciting, hopeful, and inspiring, but

must also be done in a way that honours our commitment to

financial stewardship and the allocation of public funds.

Growing services in our organization must be done with due

diligence and foresight; the impact that we will have on our

patients and residents is always in our forethought and drives

all that we do. With the help of the Covenant Health Project

Management Office and Covenant Communications, the Ethics

Centre established a comprehensive work plan to help guide

our work while being mindful of our end goal: exemplary

patient and resident care. The development of our work plan

has helped us to set priorities by engaging with stakeholders

that intersect with various points of care in our organization.

Because of this detailed approach, we are happy to share many

successful initiatives from the past year.

COVENANT HEALTH | A BEGINNING ...

A BEGINNING...

What began as a simple commit-

ment to grow ethics capacity in the

organization has now begun to take

shape in full. In 2014 the Covenant

Health Ethics Centre expanded to

meet the organization’s growing

clinical and organizational ethics

needs. Two new full time staff

members were added to support the

development of virtual resources,

contribute to moral development

and formation across the organi-

zation, and to pursue innovative

approaches to address increasingly

complex health care ethics

challenges. Mrs. Caitlin Congdon,

Ethics Centre Administrator, and

Dr. Eleanor Stewart, Clinical Ethicist,

have joined the team and have since

made important contributions.

The Ethics Centre has become a

hub for the organization’s ethics

related activities and is active in

developing virtual resources to

meet staff “where they are”.

COVENANT HEALTH | SUMMARY REPORT 02

Highlights of the Centre’s development through 2014 and 2015 include:

• Establishing a virtual web-based

presence and rapidly expanding

our cache of easily accessible ethics

frameworks, ethics related policies,

and electronic links

• Streamlining access to the

Covenant Health ethics consultation

services and developing an online

ethics consultation request process

to enhance province-wide

accessibility

• Collecting and incorporating

“satisfaction” survey data to inform

our quality improvement activities

and innovation

• Creating an organization-wide

ethics newsletter for a swiftly

growing distribution list

• Centralizing the collection of ethics

consultation records through a secure

online ethics consultation database

COVENANT HEALTH | A BEGINNING ...

• In a Nutshell, offering regular

succinct reviews of ethics literature

written for the busy professional, as

well as quarterly articles written by

Ethics Centre staff arising from

every-day ethics issues.

• The formation of the Covenant

Health Ethics Centre Book Club

• The 2014 biennial Ethics Retreat

and 2015 co-sponsored Ethics

Immersion focused on committee

member capacity development,

ethics consultation skills, the

identification of ethics issues, and

self-care amidst compassion fatigue.

• The development of an online

Essential Education learning module

“Ethics at Covenant Health” on the

CLiC learning platform

Other activities of interest as identified by ethics committee members, staff, and physicians include:


Before the days of ethicists and “ethics experts”, health care organizations relied heavily on staff members who graciously donated their time and exper-tise to provide ethics reflection to colleagues, patients, and families. Today, our ethics committee members remain a critical part of the effectiveness of our ethics services. They are the heart of the culture within the ethics program and help to foster our organization’s culture through their contribution to ethics education, policy development, and consultation.

COVENANT HEALTH | THE HEART BEAT ...


THE HEART BEAT...

• The Edmonton Area Clinical

Ethics Committee developed the

now Covenant-wide ethics

framework policy on the Long-Term

Use of Medically Administered

Nutrition, and assisted in the

development of other policies/

guidelines such as Family Presence

During CPR, and the drafting of

Responding to Requests for

Physician Hastened Death.

• The Banff Mineral Springs Hospital

Ethics Committee coordinated and

co-sponsored two successful

Community Ethics Education

Forums, bringing awareness to

challenges that intersect multiple

agencies in the Bow Valley. In 2014

the discussion focused on the “hard

to serve” population and in 2015

the committee raised the issue of

human exploitation and trafficking.

• Recognizing the ongoing

challenges surrounding patient

privacy and confidentiality in rural

health care, the St. Mary’s Camrose

Ethics Committee lead the way for

the organization in clarifying

processes and enhancing education

regarding patient privacy and

confidentiality for individual volun-

teers and organizations volunteering

within Covenant Health sites.

• Covenant Health’s Rural Ethics

Network has concentrated its

efforts on raising awareness of and

responding to rural homelessness.

This growing challenge has led the

network to survey our communities

and identify opportunities to

collaborate with other local agencies

to meet and respond to the needs

of this vulnerable population.

Through the support and direction of the Ethics Centre, Covenant Health’s committees have been active participants in the development of policy, education, and community engagement in 2014 and 2015.

Our efforts, be they in policy,

education or administration, are all

conscious of enhancing the care

and care-relationships we share

with our patients, residents, and

families. In 2014 and 2015 the

Ethics Centre was privileged to

contribute directly to the care and

support of our patients, residents,

and staff through our ethics

consultation service. Our 24 hour

service experienced an increase in

consultation requests over this time

period with issues becoming more

complex and frequently extending

beyond the bedside with

administrative and organizational

ethics components.

COVENANT HEALTH | FINDING YOUR WAY ...

FINDING YOUR WAY...

53An increase of over 100%

1

7

6

2

2

9

5

7

2

8

2

2

REQUESTED CONSULTATIONS BY MONTH

JUN.

JUL.

AUG.

SEPT.

OCT.

NOV.

DEC.

JAN.

FEB.

MAR.

APR.

MAY

Supporting positive and constructive patient-provider relationships is the core of our day to day focus.


REQUESTORS BY ROLE

17

108

7

4

2

1

1

1

1

1

M P A C S n ph d m h almeta-chart.com

32%

19%15%

13%PhysicianUnit Manager/sUPervisor

social WorkerchaPlain

nUrse Practitioner 2%

2%

2%

2%

4%

2%

7%

PharMacist

Dietician

MeDical intern

health care aiDe

alberta health services

aDiMinistrator

32%

19%15%

13%

CONSULTATION REQUESTS BY THEME

10

7

76

5

4

3

3

1

1

M P A C S n ph d m hmeta-chart.com

21%

15%13%

15%10.6%

coMPlex PlaceMent/transfer/Discharge

caPacity/consent/inforMeD Decision-Making

organizational ethicsWithholDing/refUsing/WithDraWing interventions

DifficUlt/non-coMPliant/abUsive Patient

health care ProviDer coMMUnication

Privacy anD confiDentiality

resoUrce allocation

Professional ethics

DifficUlt faMily 8.5%

2%

2%

6.4%

6.5%

COVENANT HEALTH | FINDING YOUR WAY ...

FINDING YOUR WAY...

NUMBER OF CONSULTATION REQUESTS BY FACILITY

16

13

11

2

2

2

2

1

1

1

1

1

M P A C S n ph d m h al

Slicemeta-chart.com

1

1

1

1

1

2

2

2

216

1113

yoUville hoMe | st. albert

killaM health centre

villa caritas

bonnyville health care centre

st.JosePh’s general hoPsital vegreville

st.Mary’s health care centre trochU

banff Mineral sPrings hoPsital

other-non-cov

eDMonton general continUing care centre

MisericorDia coMMUnity hosPital

grey nUns coMMUnity hosPital

st.Mary’s hosPital | caMrose


2021

10

1 1

0-1 1-3 3-5 5-10 10+hoUrs

case

CONSULTATION REQUESTS

BY TOTAL TIME SPENT


BY URGENCY

statiMMeDiate

Urgent24 - 48 hrs

non-Urgent48+ hrs

30

19

4

13.2

86.8

P

meta-chart.c

om

87%

13%RURAL

URBAN


BY LOCATION

CONSULTATION REQUEST BY

CARE SETTING

43%LONG-TERM/CONTINUING

57%ACUTE

COVENANT HEALTH | CRUNCHING THE NUMBERS ...

CRUNCHING THE NUMBERS…

JUn.2014

2015

JUl.

aUg.

seP.

oct.

nov.

Dec.

Jan.

feb.

Mar.

aPr.

May.

$10,196.68

$708.31

$1,412.16

$4,869.61

$2,564.09

$1,462.94

$337.75

$1,241.55

$576.23

$1,496.70

$1,042.26

$3,511.51

SPENDING BY MONTH


SPENDING BY CATEGORY

CATEGORY EXPENSE

ec PlanneD eDUcation events

ec staff travel (Provincial)

ec staff travel (local)

ec staff eDUcation

eDUcation - general

office sUPPlies/fUrnitUre

telePhone - es anD cc

aDvertising/ProMotion

hosPitality

coMMittee eDUcation - sPonsorshiP

gifts

$14,444.92

$ 3,787.43

$ 1,879.81

$ 2,142.62

$ 1,391.25

$ 1,684.22

$ 1,680.00

$ 961.80

$ 854.50

$ 567.00

$ 26.24

Slice:14444.92

Slice:3787.43

Slice:1879.81

Slice:2142.62

Slice:1391.25

Slice:1684.22

Slice:1680

Slice:961.8

Slice:854.5

Slice:567

Slice:26.24

Slice Slice Slice Slice Slice Slice Slice Slice

Slice Slice Slicemeta-chart.com

49%

13%6.4%

7.4%

0.5%

2%

4.3%

3%

5.7%

5.7%

3%

ec PlanneD eDUcation events

ec staff travel (Provincial)

ec staff travel (local)

ec staff eDUcation

eDUcation - general

office sUPPlies/fUrnitUre

telePhone - es anD cc

aDvertising/ProMotion

hosPitality

coMMittee eDUcation - sPonsorshiP

gifts

COVENANT HEALTH | MAKING A DIFFERENCE ...

MAKING A DIFFERENCE...

ACCREDITATION

October 2014 marked the beginning of the

organization’s second 4-year cycle of

Accreditation Canada’s Qumentum accreditation

program. Leadership and Governance standards

including Principle-based Care and

Decision-making were surveyed—highlighting

the work and services of Covenant Health Ethics

programs. We celebrate with the organization in

its achievement of attaining the highest level of

performance: Accredited with Exemplary

Standing. We were proud to have the Ethics

Centre recognized in the final report.

ETHISPHERE

Reflective of our commitment to foster an ethical

climate by “going beyond”, the Ethics Centre led

Covenant Health’s inaugural submission to

Ethisphere’s Most Ethical Companies © adjudi-

cation process. Focused on organizational and

business ethics practices, the 2014 adjudication

process was a rich learning experience with many

of the recommendations already addressed


within our organization. We look forward to the

2015 adjudication process and are pleased to have a

central role in the 2015 submission.

PHYSICIAN HASTENED DEATH

At a political level, 2014-2015 is significantly marked

by the Supreme Court of Canada’s decision to strike

down the section of Canada’s Criminal Code that

made physician assisted suicide a criminal offense.

With the support of the Catholic Health Alliance

of Canada (CHAC), and under the leadership of

Dr. Gordon Self, a template policy (“Responding

to Requests for Physician Assisted Suicide”) was

developed and shared among Network members

to be adapted by CHAC member organizations for

use in their local contexts, as appropriate. Through

Dr. Self, the Ethics Centre, in keeping with Covenant

Health’s preventative ethics strategy and commit-

ment to serve through leadership at a national level,

has played a significant role in proactively

addressing complex moral and ethical issues.

the eDMonton general continUing care centre is the hoMe to the ethics centre Main office

COVENANT HEALTH | IN THE COMMUNITY ...

IN THE COMMUNITY…

In keeping with Covenant Health’s preventative ethics strategy and aligned with the organization’s strategic plan, the Ethics Centre has committed to greater investment in our external relationships. Several of our contributions to and investments in our collaborative communities are as follows:

In 2014-2015 the Ethics Centre formally began

providing ethics consultation support and

resource development to Covenant Health’s

sister organization, Covenant Care

Ethics Centre staff facilitated ethics education

and dialogue at the First Nations and Inuit

Health Annual Education Days

The Ethics Centre provides ongoing

representation for the organization on

the University of Alberta Health Research

Ethics Board

Centre staff made presentations on Physician

Hastened Death at Covenant Health’s Annual

Palliative Care Conference, Ambrose

University’s Faith, Life and Learning Community

Education Forum, and to the University of

Alberta’s Medical Students

ETHICS CENTRE

STAFF MEMBERS:

Dr. Gordon Self

Dr. Eleanor Stewart

Jon Gilchrist

Caitlin Congdon

ETHICS CENTRE

ADVISORY GROUP :

Lori Bryan

Shelley Buchan

Ralph Hale

Cory Komant

Sharna Polard

Scott Stewart

PROJECT

MANAGEMENT OFFICE :

Joy Shapka

Natasha Pedersson

COVENANT HEALTH

COMMUNICATIONS

COVENANT HEALTH | ACKNOWLEDGEMENTS AND THANKS ...

ACKNOWLEDGEMENTS

AND THANKS…

COVENANT HEALTH

ETHICS NETWORK:

Brenda Brigley

Janet Chaney

Marjorie Charest

Geraldine Clark

Charlotte Ewanowich

Reno Guimond

Ralph Hale

Pamela Newton

William (Bill) Patterson

Diane Semotiuk

Nicholas Wasylowich

Jim Wilson


The Mission, Ethics and Spirituality portfolio, with special thanks to

Michelle Hawgood and Shaye Perrett for administrative support.

CAMROSE ETHICS

COMMITTEE :

Cherylyn Antymniuk L.

Kim Lorenz

Warren Lindberg

Kim Roberts A.

Karen Burton

Irine Sware

Kathy Henderson

Peggy Grundberg

Glenda Shiell

Joann Reinhart

Shelly Dalueg

Mandy Megan Conyers-Smith

BANFF MINERAL

SPRINGS HOSPITAL

ETHICS COMMITTEE:

Peter Baylis

Shelley Buchan

Diane Gibson

Natalie Palmer

Sandy Penrose

Kristin Robson

Margie Smith

Case Vink

Amanda Wagner

Dr. Priscilla Wilson

Tamara Wewetzer

EDMONTON AREA

CLINICAL ETHICS

COMMITTEE MEMBERS:

Akosua Benson

Bryce Clarke

Donna Brown

Jane Christensen

Meg Hagerty

Heather Gallant

Mary Jo Harland-Gregoire

Dr. Lori Harper

Karen Harrison

Kris Gray

Deb Kirkpatrick

Sarah Kosowan

Bonnie Launhardt

Brenda Madsen

Ralph Magnus

Sheila McNary

Dr. Thamarai Moorthy

Beryl Parsons

Barbara Roemer

Josh Stachniak

Scott Stewart

Michelle Stone

Bonnie Tejada

Mark Vigrass

[email protected] OR 1-855-497-5353

Visit covenanthealth.ca/ethics-centre

2O14 2O15 · organization has now begun to take shape in full. In 2014 the Covenant Health Ethics...

Documents

Transcript of 2O14 2O15 · organization has now begun to take shape in full. In 2014 the Covenant Health Ethics...