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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Ethics support in community care makes a difference for practice.

Morten Magelssen1, Elisabeth Gjerberg1, Lillian Lillemoen1

  • 1Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Norway.

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Summary

Ethics activities in Norwegian municipalities significantly improved daily practice and patient care. Key factors for success include stakeholder support, adequate time, and trained ethics facilitators.

Keywords:
Care of the older personclinical ethicscommunity caremoral/ethical climate of organizationsprimary health practice

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Area of Science:

  • Healthcare ethics
  • Public health initiatives
  • Organizational psychology

Background:

  • The Norwegian ethics project has established ethics activities across over 200 municipalities in the health and care sector.
  • Evaluating the impact and sustainability of these widespread ethics initiatives is crucial for evidence-based practice.

Purpose of the Study:

  • To assess the outcomes of municipal ethics activities.
  • To identify factors that promote or inhibit the significance and long-term sustainability of these ethics initiatives.

Main Methods:

  • Two online surveys were administered to municipal contact persons and ethics facilitators.
  • Response rates were 55% for the first survey (137 participants) and 33% for the second survey (217 participants).

Main Results:

  • Approximately 50% of respondents reported high significance of the ethics project for daily professional practice.
  • Positive outcomes included improved ethical challenge management, enhanced employee cooperation, better service quality, and stronger patient/next-of-kin relations.
  • Factors promoting sustainability and significance were stakeholder support, dedicated time, and facilitators with adequate ethics knowledge, skills, and supervision.

Conclusions:

  • Ethics initiatives in community health and care services can be both sustainable and significant.
  • Developing regional/national follow-up structures and comprehensive ethics training for facilitators is recommended.
  • Future initiatives should incorporate documented promoting and inhibiting factors for successful large-scale implementation.