Ethics committees and quality improvement: a necessary link

Can UK clinical ethics committees improve quality of care?

Failings in patient care and quality in NHS Trusts have become a recurring theme over the past few years. In this paper, we examine the Care Quality Commission's Guidance about Compliance: Essential Standards of Quality and Safety and ask how NHS Trusts might be better supported in fulfilling the regulations specified therein. We argue that clinical ethics committees (CECs) have a role to play in this regard. We make this argument by attending to the many ethical elements that are highlighted in the Commission's Regulations and by providing practical examples of how CECs can (and in some case already do) provide ethics support to health professionals and trusts. Although CECs have been traditionally associated with case consultation, i.e., discrete problems caused by individual circumstances, in the previous 10 years the literature suggests that clinical ethics services have become more integrated into the life of the health care organization and are increasing construed as proactive agents of systematic change. We provide evidence from a recent survey of UK clinical ethics services that this trend is present in the UK.

Integrating ethics and quality improvement: practical implementation in the transitional/ extended care setting

A major challenge in health care today is to provide high-quality care that results in the best outcomes possible for patients and residents within the limits of available resources. Throughout the past decade, there has been a call from ethicists for health care institutions to integrate the ethics and quality improvement processes. This article describes how a transitional/extended care facility integrated the quality improvement process within an ethical framework to achieve high-quality care while controlling cost.