Tracking Ethics Consults and Moral Distress Rounds in 2021
KAREN JONES , MS , RN , HEC-C
ETHICS CONSULTS
On Aug . 1 , 2021 , Children ’ s Hospital Colorado began developing an ethics database using REDCap , a data collection platform and application . Using this tool , Children ’ s Colorado has compiled information related to ethics consults , designed to help patients , families , surrogates or healthcare providers address uncertainty or conflict regarding value-laden issues that emerge .
In 2021 , the Children ’ s Hospital Colorado team consulted on 32 patients over five months , averaging six to seven consults per month . This amounts to 72-84 consults per year .
Key terms :
Level 6 : Inpatient Surgical / Rehabilitation Unit
Level 8 : Inpatient Medical Unit
Level 9 : Inpatient Medical Pulmonary
Inpatient consults :
19
Patients ( extrapolates to 45 per year )
Outpatient consults :
13
Patients ( extrapolates to 31 per year )
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• Level 6
• Level 8
• Level 9
• PICU
• NICU
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• Emergency Department
• Center for Cancer and Blood Disorders
• PICU , Colorado Springs Hospital
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• Gastroenterology
• Endocrinology
• Bone Marrow Transplant Program
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• Eating Disorders Program
• Outpatient Psychiatric Clinic
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MORAL DISTRESS ROUNDS |
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In 2021 , Children ’ s Hospital Colorado averaged eight moral distress rounds ( MDRs ) per month for a total of 95 during the year , up from 64 in 2020 . Additionally , 10 new teams / departments requested MDRs . Moral distress rounds provide a forum to discuss morally distressing aspects of patient / family care , ethical obligations which may be in tension and to clarify or streamline communication in complex circumstances . The aim is to support team members in expressing their concern and generating ideas about how issues might be effectively addressed .
21 teams / departments requested MDRs including :
• Level 6
• Center for Cancer and Blood Disorders
• Level 8
• Level 9
• CICU and Inpatient Cardiac Progressive Care Unit
• Anschutz inpatient pediatric critical care unit ( PICU )
• Anschutz inpatient neonatal intensive care unit ( NICU )
• Emergency Department ( ED )
• Psychiatric ED
• Pediatric Mental Health Institute / IPU
• Patient advocates
• Child Life specialists and Child Life clinical assistants
• KidStreet Aurora
• Child Health Clinic
• North Campus ED
• South Campus ED
• Developmental Pediatrics
• Kidney Center
• Pediatric residents
• Surgery schedulers
18 People