Ethics and Quality Improvement

Astrid Grgurich

Ethics

Metaethics Normative Ethics

How are ethics related to quality improvement

When an outcome of a process or system does not meet the necessary or desired

quality.

To identify areas/processes that are causing deficit to a final outcome.

To test and implement positive change.

To monitor progress of outcomes.

How are ethics and quality improvement connected?

Reduce harm and wasteGoal of QI QI projets delayed/cancelledEthical implications

Is it justified and neceiessary??

Ethical Recommendations for QI

Health care organizations should recognize that QI cannot always be meaningfully differentiated from other activities that occur in the clinical arena, notably treatment and research

Recommendation 1

Health care organizations should ensure that the rights and interests of patients involved in all health care activities – including QI – are adequately protected.

Recommendation 2

Health care organizations should take care that efforts designed to protect patients do not unnecessarily encumber the QI process.

Recommendation 3

Health care organizations should clearly define the locus of responsibility for the ethical conduct of QI.

Recommendation 4

Health care organizations should proactively promote the ethical conduct of QI.

Recommendation 5

QI activities should produce benefits that outweigh their potential burdens or risks.

Recommendation 6

QI activities should respect each patient’s right to self-determination.

Recommendation 7

QI activities should preserve patients’ privacy and confidentiality.

Recommendation 8

QI activities should be fairly distributed across patient groups.

Recommendation 9

Health care organizations should develop specific policies and procedures that fit their unique circumstances and needs

Recommendation 10

Conclusion...

Baily, M., Bottrell, M., Lynn, J., & Jennings, B. (2006). The ethics of using QI methods to improve health care quality and safety. Garrison, NY: The Hasting’s Center.

Barclay, L. (2007). Guidelines issued for ethics of quality improvement. Annals of internal medicine, 146, 666-673.

Gensler, H. (2011). Ethics. New York, NY: Routledge. Jennings, B., Baily, M., Bottrell, M., & Lynn, J. (Eds.). (2007). Health care

quality improvement: Ethical and regulatory issues. Garrison, NY: The Hastings Center.

National Centre for Ethics in Health Care. (2006). Recommendations for the ethical conduct of quality improvement. Retrieved from http://www.ethics.va.gov/docs/necrpts/NEC_Report_20020501_Ethical_Conduct_of_Quality_Improvement.pdf

U.S. Department of Health & Human. (2011). Report to congress: National strategy for quality improvement in health care. Ontario: Queen's Printer.

World Health Organization. (2000). Operational guidelines for ethics committees that review biomedical research. Geneva, Switzerland: Author.

World Health Organization. (2012). Ethics. Retrieved from http://www.who.int/topics/ethics/en/

References