Case Complexity and Quality Attestation for Clinical Ethics Consultants

Area of Science:

• Bioethics
• Medical Humanities
• Health Informatics

Background:

• The American Society for Bioethics and Humanities (ASBH) proposed criteria for ethics consultants.
• Current ASBH proposals may overlook the critical factor of case complexity in evaluating candidate qualifications.
• Ensuring competence in ethics consultation requires addressing the nuances of case difficulty.

Purpose of the Study:

• To assess the feasibility of evaluating case complexity for ethics consultation.
• To develop and validate a system for scoring the complexity of ethics consultation cases.
• To advocate for the inclusion of case complexity assessment in professional standards.

Main Methods:

• Retrospective analysis of over 500 ethics consultation summaries from an academic medical center (2013).
• Development of a case complexity scoring system utilizing text analytics.
• Demonstration of the scoring system using a range of case complexity examples.

Main Results:

• A proof-of-concept complexity scoring system was successfully developed.
• The system demonstrated feasibility in differentiating between uncomplicated and very complicated cases.
• Analysis of historical consultation data provides a foundation for objective complexity assessment.

Conclusions:

• A minimum level of case complexity should be mandated by the ASBH for ethics consultant qualification.
• Attestation portfolios should require multiple moderately complex cases and at least one highly complex case.
• Implementing a case complexity assessment will enhance patient safety and organizational integrity.