Title: Use of Preventive Ethics Rounds to Identify, Anticipate, and Proactively Address Ethical Dilemmas
Presenters: Janice Firn, PhD, LMSW, Katie Feder, M2, Sally Salari, M4
The intersection of complex, critical illness and evolving medical technology in hospital intensive care units (ICUs) drives ethical dilemmas which in turn affect patient care and contribute to moral distress and burnout in providers. Rounding regularly in ICUs allows clinical ethicists to proactively intervene in ethically challenging cases at a time when they are most amenable to intervention. Through case discussion, clinical ethicists can help educate and support critical care providers in thinking through ethical issues pertinent to patient care throughout the hospital course. This approach can be helpful in offering a common language and framework for addressing ethical issues in every day clinical practice. To provide real-time education in the clinical context and early identification of ethical issues, Michigan Medicine initiated novel, system-wide “preventive ethics rounds” in all the ICUs (medical and surgical, adult and pediatric) in the form of a pre-consult rounding service. Providers use ethics related tools to constructively work through difficult cases as they arise; which can improve patient care and ameliorate moral distress. The presenters will address the ways in which preventative ethics rounds have impacted the formal consultation process, the types of ethical issues and patient characteristics discussed during rounds, and if/how these differ from those discussed during formal ethics consultation.