Evaluating Ethics Quality

Abstract

This special issue of AJOB Primary Research includes a set of articles describing key aspects of the IntegratedEthicsTM (IE) program of the U.S. Department of Veterans Affairs (VA) health care system. The IE program (described more fully elsewhere; see, e.g., Fox et al. 2010) is intended to provide a comprehensive approach to promoting ethics quality in health care. Its goal is to transcend the traditional ethics committee approach by promoting ethical practices in health care using an assortment of tools to help systematize ethics consultation, support a perspective of continuous quality improvement in ethics, and foster an organizational environment and culture that makes it easy for health care personnel to “do the right thing.” IE program tools include educational resources, standardized approaches to various aspects of ethics work, outreach materials, administrative tools to help organize and document work, and assessment tools.1 This set of articles discusses two key components of the IE portfolio, the IE Staff Survey and the IE Facility Workbook, describing the development and field testing of these assessment tools and providing examples of how they have been used by VA to support and improve ethical practices in its health care facilities across the country. While the VA health care system is unique in a number of ways that have made it possible for the agency’s National Center for Ethics in Health Care (NCEHC) to develop and roll out the IE program, the remarkable and helpful body of work described in this special issue will be, we believe, influential well beyond the VA system. IntegratedEthics is groundbreaking in its breadth; its organized, systematic approach to ethical practices; its focus on the pragmatic; and its broad goals for improving ethics in health care, all of which are reflected in the tools discussed in these articles. The program’s aims are audacious, but clear. They include ensuring that ethics consultations use a