Lessons learned from implementing a responsive quality assessment of clinical ethics support

Servant Leadership and Followers Prosocial Rule-Breaking: The Mediating Role of Public Service Motivation

This research explores the effect of servant leadership on prosocial rule-breaking (PSRB) and the mediating mechanism of public service motivation (PSM) between the association of servant leadership and PSRB. The said phenomenon is examined in the civil service context of Pakistan during the continuing crises of the COVID-19 pandemic, a situation where the traditional civil service policy and rule system has become highly complicated for passionate employees' service performance and efficiency, and where servant leadership has received greater attention for inspiring the attitudinal and behavioral outcomes of frontline workers during the pandemic. Data were collected from 546 frontline workers of the corona relief tiger force. The findings of the study revealed that servant leadership has a significant effect on PSRB and PSM, and that PSM significantly promotes PSRB. The results also revealed that servant leadership has a significant impact on PSRB via engendering PSM.

Quality Characteristics for Clinical Ethics Support in the Netherlands

Background: This article presents a set of quality characteristics of clinical ethics support (CES) in the Netherlands.Methods: The quality characteristics were developed with a large group of stakeholders working with CES, participating in the Dutch Network for Clinical Ethics Support (NEON).Results: The quality characteristics concern the following domains: (1) goals of CES, (2) methods of CES, (3) competences of CES practitioners, and (4) implementation of CES.Conclusions: We discuss suggestions for how to use the quality characteristics, discuss some aspects that stand out about these quality characteristics, and reflect on the method and the status of the quality characteristics. The quality characteristics are meant as a heuristic instrument, helping CES practitioners to explore and improve the quality of CES in a health care organization, but at the same time they can be improved based on experiences during their application to CES practices.

Conceptualizing and Fostering the Quality of CES Through a Dutch National Network on CES (NEON)

The prevalence of Clinical ethics support (CES) services is increasing. Yet, questions about what quality of CES entails and how to foster the quality of CES remain. This paper describes the development of a national network (NEON), which aimed to conceptualize and foster the quality of CES in the Netherlands simultaneously. Our methodology was inspired by a responsive evaluation approach which shares some of our key theoretical presuppositions of CES. A responsive evaluation methodology engages stakeholders in developing quality standards of a certain practice, instead of evaluating a practice by predefined standards. In this paper, we describe the relationship between our theoretical viewpoint on CES and a responsive evaluation methodology. Then we describe the development of the network (NEON) and focus on three activities that exemplify our approach. In the discussion, we reflect on the similarities and differences between our approach and other international initiatives focusing on the quality of CES.

Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019

BACKGROUND

Amidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons.

METHODS

Guided by Levac et al's (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.

RESULTS

Nine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified - the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.

CONCLUSION

This review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy. To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards.