Healthcare ethics consultants in the Veterans Health Administration (VHA) document consults in an enterprise-wide web-based database entitled IEWeb, serving as a system of record for healthcare ethics documentation at 1300 VA facilities. The need arose to evolve the database from an ethics process training resource into a more streamlined documentation repository that captures essential consult elements. A VHA National Center for Ethics in Health Care (NCEHC) Improvement Team convened for three tasks: (1) Specify and prioritize IEWeb changes (occurred via six focus groups composed of "new user" and "super user" cohorts with analysis of existing documentation patterns); (2) Pilot the changes regionally (via regional communication, training, and reviews of pre-post use patterns); and (3) Measure the impact of national change implementation on user perspectives (via pre-and post-change implementation polls). Focus groups identified six implementable priority areas for ethics consult documentation improvement, including the development of a usable consult summary note for ready conversion from IEWeb fields into the electronic health record. Post-IEWeb updates showed an increased number of consults documented, a reduction in "time to consult documentation closure" by a mean of 4.5 days, and a clinically-meaningful improvement in the quality of documentation (78% of ethics questions scored "above-bar" on the validation tool pre- vs. 89% scored "above-bar" post-IEWeb changes, n = 140). According to national survey findings, the number of consultants documenting "all" consults in IEWeb increased, satisfaction increased, and perception of documentation difficulty decreased. IEWeb simplification enabled ethics consultants to re-focus their documentation completion efforts by decreasing perception of documentation burden while improving documentation frequency and quality in a clinically-meaningful way.

Meaghann S. Weaver

Anita J. Tarzian

Hannah N. Hester

Karinne R. Davidson

Rodney P. Dismukes

Mary Beth Foglia

HEC Forum

HEC 论坛是一份经过同行评审的国际刊物，收录了执业医师、护士、社会工作者、风险管理人员、律师、伦理学家和其他 HEC 委员会成员感兴趣的原创贡献。欢迎来自任何相关来源的投稿，但应编写文本以供 HEC 成员和非专业读者欣赏。 HEC 论坛发表论文、研究论文，并包含以下部分： 关于实质性生物伦理/健康法问题的论文 程序或运营委员会问题的分析 文件交流 专题文章 国际视角 MT./ST.匿名：案例和机构政策 点/对位论证 案例审查、分析和决议 主席的“难点”部分 关键注释 卫生法警报 网络新闻 致编辑的信

HEC Forum is a peer-reviewed international journal that publishes original contributions of interest to practitioners such as physicians, nurses, social workers, risk managers, lawyers, ethicists, and other members of HEC committees. We welcome submissions from any relevant source, provided that the text is written in a manner accessible to HEC members and non-specialist readers. HEC Forum publishes papers, research articles, and includes the following sections: papers on substantive bioethics/health law issues, analyses of procedural or operational committee matters, document exchanges, thematic articles, international perspectives, anonymous discussions of cases and institutional policies, point/counterpoint arguments, case reviews, analyses and resolutions, the Chair's 

HEC Forum 是一本经过同行评审的国际期刊，专注于执业医师、护士、社会工作者、风险管理人员、律师、伦理学家及其他 HEC 委员会成员感兴趣的原创研究。我们欢迎来自任何相关领域的投稿，文章应以 HEC 成员和非专业读者能够理解的方式撰写。HEC Forum 发表各种类型的论文和研究，包括：关于重要生物伦理和健康法律问题的论文、程序或运营委员会问题的分析、文件交流、专题文章、国际视角、案例和机构政策的匿名讨论、对立论证、案例审查、分析和决议、主席的“难点”部分、关键注释、卫生法律警报、网络新闻及致编辑的信件。

Category	Quartile
哲学	4
哲学, 伦理学	4

An Ethics Consult Documentation Simplification Project: Summation of Participatory Processes, User Perceptions, and Subsequent Use Patterns

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