Main challenges in utilization of the consultations services of hospital ethics committees: a systematic review of the literature

2020 ◽  
Author(s):  
Rahim Khodayari-Zarnaq ◽  
Mir Sajad Seyyed Moosavi ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Professionals ◽  
Ethical Issues ◽  
Design Method ◽  
Data Extraction ◽  
Ethics Committees ◽  
Structural Factors ◽  
Hospital Ethics Committees ◽  
Hospital Ethics

Abstract Background : To responding ethical issues in clinical practice, hospital ethics committees (HEC) provide the ethics consultation for healthcare professionals. There are numerous challenges in the consultations services of HEC that can impact healthcare professionals and patients, families in the health care setting. This review aimed to identifies main challenges in utilization the consultations services of HEC and proposed possible solutions.Methods : This systematic review was conducted through searching electronic databases including PubMed, Scopus, Science Direct, ProQuest and Embase. Inclusion criteria included studies related to the purpose of the review, publish in English language, were published in a peer-reviewed journal, from 2000 to 2019 and clearly defined the design, method and results of study. Studies selection, quality assessments, data extraction and analysis were completed on all included studies by two researchers independently. Quality assessment was based on the Mixed Methods Appraisal Tool (MMAT) checklist. Finally, thematic analysis method was used to analyses the data.Results : The search originally yielded 1204 articles and 6 of these included to evidence analyses. After analyses the included studies, challenges were categorized in 9 themes: (a) personal views and believes in healthcare professionals, (b) sense of fear in the healthcare professionals, (c) medical culture, (d) environmental factors, (e) managerial and structural factors, (f) characteristics of HEC members, (g) factors related to HEC, (h) problematic process for HEC consultations, and (i) weakness in knowledge about HEC. Accordingly, proposed solutions were organized according to five themes of reforms in the HEC executive processes, creating the appropriate communications, developing awareness about HEC, improving the competences of HEC members, and (e) supporting from HEC consultations.Conclusions : This review highlights that proposed solutions serve as instances of strategies that attempted to solve challenges related in utilization the consultations services of HEC by healthcare professionals.

Main challenges in adoption of consultation services of hospital ethics committees: A systematic review of the literature

2021 ◽  
pp. 147775092199427
Author(s):  
Mir Sajjad Seyyed Mousavi ◽  
Rahim Khodayari-Zarnaq ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Professionals ◽  
Design Method ◽  
Data Extraction ◽  
Ethics Committees ◽  
Structural Factors ◽  
Hospital Ethics Committees ◽  
Hospital Ethics ◽  
Consultation Services

Background There are numerous challenges in the consultation services of the Hospital Ethics Committees (HEC) that can impact the means of providing healthcare. This review aimed to identify the main challenges in the application of consultation services of the HEC and propose possible solutions. Methods This systematic review was conducted through searching electronic databases including PubMed, Scopus, Science Direct, ProQuest, and Embase. Inclusion criteria included studies published in English language in a peer-reviewed journal, from 2000 to 2019 were identified, which clearly defined the design, method, and results of the study. Study selections, quality assessments, data extraction, and analysis were completed by two researchers, independently. The thematic analysis was used to analyze the data. Results The search yielded 1204 articles and 6 of these, included the analyses. Challenges were categorized into 9 themes: (a) personal views and believes in healthcare professionals, (b) sense of fear in the healthcare professionals, (c) medical culture, (d) environmental factors, (e) managerial and structural factors, (f) characteristics of the HEC members, (g) factors related to the HEC, (h) problematic process for HEC consultations, and (i) weakness of knowledge about HEC. Accordingly, proposed solutions were organized according to five themes: reforming the HEC executive processes, creating the appropriate communications, developing awareness about HEC, improving the competencies of HEC members, and (e) receiving support from HEC consultations. Conclusions This review highlights that proposed solutions serve as examples of strategies, which attempt to solve challenges related to the application of the consultation services of HEC by healthcare professionals.

scholarly journals Hospital Ethics Committees in accredited hospitals in Poland—availability of information

2021 ◽  
Author(s):  
Patrycja Zurzycka ◽  
Grażyna Puto ◽  
Katarzyna Czyżowicz ◽  
Iwona Repka
Keyword(s):  
Medical Care ◽  
Medical Staff ◽  
Ethical Issues ◽  
Public Information ◽  
Ethics Committees ◽  
Legal Regulations ◽  
Hospital Ethics Committees ◽  
Hospital Ethics ◽  
The Way

AbstractThe role of Hospital Ethics Committees (HECs) is to support patients and their relatives as well as medical staff in solving ethical issues that arise in relation to the implementation of medical care. In Poland there are no clearly formulated legal regulations concerning the establishment and functioning of hospital ethics committees. Hospitals applying for accreditation are obliged to present solutions defining the way of solving ethical issues in a given institution, some of them appoint HECs for this purpose. The aim of this study was to analyze information concerning the functioning of hospital ethics committees in Poland on the basis of publicly available data published on the websites of accredited hospitals. Very few accredited hospitals (56) make public information about functioning in their ethics consulting facilities through hospital ethics committees. In most cases, the information provided on the functioning of HECs is general, both in terms of the committees’ functioning, type of cases under consideration and the composition of personnel.

Quality Control for Hospitals' Clinical Ethics Services: Proposed Standards

1997 ◽  
Vol 6 (3) ◽  
pp. 257-268 ◽  
Author(s):  
Cavin P. Leeman ◽  
John C. Fletcher ◽  
Edward M. Spencer ◽  
Sigrid Fry-Revere
Keyword(s):  
Health Care ◽  
Quality Control ◽  
Patient Care ◽  
Clinical Ethics ◽  
Health Care Organizations ◽  
Ethical Issues ◽  
Ethics Committees ◽  
Ethics Committee ◽  
Hospital Ethics Committees ◽  
Hospital Ethics

Hospital ethics committees have become widespread over the last 25 years, stimulated by the Quinlan decision of the New Jersey Supreme Court, the report of a President's Commission, and most recently by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), which now man dates that each hospital seeking accreditation have a functioning process for the consideration of ethical issues in patient care. Laws and regulations in several states require that hospitals establish ethics committees, and some states stipulate that certain types of cases and disputes be taken to such committees. At least one state grants legal immunity to those who implement recommendations of an ethics committee.

Hospital ethics committees in the United Kingdom

HEC Forum ◽  
1996 ◽  
Vol 8 (5) ◽  
Author(s):  
EricM. Meslin ◽  
Claire Rayner ◽  
Vic Larcher ◽  
Tony Hope ◽  
Julian Savulescu
Keyword(s):  
United Kingdom ◽  
Ethics Committees ◽  
The United Kingdom ◽  
Hospital Ethics Committees ◽  
Hospital Ethics

Systematic review of interventions to improve gender equity in graduate medicine

2021 ◽  
pp. postgradmedj-2020-138864
Author(s):  
Sinéad Lydon ◽  
Emily O'Dowd ◽  
Chloe Walsh ◽  
Angela O'Dea ◽  
Dara Byrne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gender Equity ◽  
English Language ◽  
Clinical Medicine ◽  
Data Extraction ◽  
Self Report ◽  
Clinical Settings ◽  
Reference List ◽  
High Quality Research ◽  
Work Settings

Women are substantially underrepresented in senior and leadership positions in medicine and experience gendered challenges in their work settings. This systematic review aimed to synthesise research that has evaluated interventions for improving gender equity in medicine. English language electronic searches were conducted across MEDLINE, CINAHL, Academic Search Complete, PsycINFO and Web of Science. Reference list screening was also undertaken. Peer-reviewed studies published between 2000 and March 2020 that evaluated interventions to improve gender equity, or the experiences of women, in academic or clinical medicine were reviewed. Dual reviewer data extraction on setting, participants, type of intervention, measurement and outcomes was completed. Methodological rigour and strength of findings were evaluated. In total, 34 studies were included. Interventions were typically focused on equipping the woman (82.4%), that is, delivering professional development activities for women. Fewer focused on changing cultures (20.6%), ensuring equal opportunities (23.5%) or increasing the visibility or valuing of women (23.5%). Outcomes were largely positive (87.3%) but measurement typically relied on subjective, self-report data (69.1%). Few interventions were implemented in clinical settings (17.6%). Weak methodological rigour and a low strength of findings was observed. There has been a focus to-date on interventions which Equip the Woman. Interventions addressing systems and culture change require further research consideration. However, institutions cannot wait on high quality research evidence to emerge to take action on gender equity. Data collated suggest a number of recommendations pertaining to research on, and the implementation of, interventions to improve gender equity in academic and clinical settings.

scholarly journals Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Nyan Lynn Tun ◽  
Waqas Haque ◽  
Marie Gilbert Majella ◽  
Ranjith Kumar Sivakumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
English Language ◽  
Clinical Decision Making ◽  
Clinical Laboratory ◽  
Data Extraction ◽  
Meta Analysis ◽  
Severe Disease ◽  
Factors Associated ◽  
Risk Of Mortality

Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45; 95%CI 1.23,1.71), dyspnea (RR 2.55; 95%CI 1.88,2.46), diabetes (RR 1.59; 95%CI 1.41,1.78), hypertension (RR 1.90; 95%CI 1.69,2.15). Congestive heart failure (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

scholarly journals Cancer services during the COVID-19 pandemic: systematic review of patients' and caregivers' experiences

2021 ◽  
Author(s):  
Symran Dhada ◽  
Derek Stewart ◽  
Ejaz Cheema ◽  
Muhammed Abdul Hadi ◽  
Vibhu Paudyal
Keyword(s):  
Systematic Review ◽  
Cancer Screening ◽  
Cancer Patients ◽  
English Language ◽  
Resource Constraints ◽  
Data Extraction ◽  
Psychological Wellbeing ◽  
Cancer Services ◽  
Data Extraction Form ◽  
The Impact

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing. Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.

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