Assessment Tools

Evaluating Your Ethics Committee

The following pages attempt to provide a framework and suggested questions for use in evaluating your ethics committee. Not all of the questions will be appropriate for your committee, nor will all questions that could help you be included in the following pages. The best tool for evaluating your committee will be the one that you sculpt for your own unique situation.

Areas of evaluation that deserve attention are:

1. Individual Self-Evaluation
   1. Assessment of past performance
   2. Plan for future
2. Evaluation of Committee by Individual Committee Members
   1. Assessment of past performance
   2. Plan for future
3. Evaluation of Committee by Institutional Groups
   1. Those who have actually experienced the committee as a forum for case review: patients, families, professionals
   2. Institutional groups with a special interest in the service of the committee: administration/ medical staff/ nursing staff/ pastoral care/ social service/ etc.

I.   Individual Self-Evaluations:

Each member of the committee would review the following areas in assessing her/his membership on the committee. This process is for the personal benefit of each member and not expected to be shared with the committee.

Participation:

Attendance at meetings:

• How does my attendance compare to my attendance at other committees of which I am part?
• What counts for me as an excuse for not attending?
• Notification of my expected absence

Participation at meetings:

• About issues being discussed: cases, readings, etc.
• About issues of committee functioning: quality of meetings, structure of committee, etc.

Preparation for meetings:

• Read case/ literature/ policy, etc. distributed.
• Read minutes carefully.
• Read questionnaires, etc.

General self-education:

• Quantity, quality of private reading in area
• Attendance at workshops
• Attention to media handling of ethical issues

Personal Growth:

• Understanding/ Applying the discipline of ethics to specific issues.
• Integrating personal system of ethics.
• Expressing personal perspectives.

Communication:

• Stretching to hear perspectives different from mine
• Expressing my ideas even when they represent a minority opinion
• Communicating my personal world of experience, feelings as clearly and directly as possible
• Speaking up at the meeting, not waiting until afterward

Future Plan:

What two specific changes would most improve my participation as a member of the committee?

II.   Evaluation of Committee by Individual Members

Goals/Purpose/Objectives:

1.   The goals, purpose, objectives of our committee are clearly stated and understood.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

2.   There is consensus in the committee on these goals, purpose, objectives.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

3.   There is good correspondence between our stated goals and the behavior of the committee.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

4.   The goals, purpose, objectives of our committee deserve to be revised in the light of our experience.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

5.   We should periodically evaluate our performance against our goals, purpose, objectives.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Support of Committee:

6.   Our committee has an adequate budget to support its operations.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

7.   Our committee experiences good support from key publics: trustees, administration, physicians, nurses, allied health professionals, etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Time/Place of Meeting:

8.   Our meeting room, with its size arrangement of seating, etc., is conducive to good group contact and communication.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

9.   Our meeting room is well suited to various educational modes--audio/ visual presentations, small group discussion, etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

10.   The time slot we have chosen is the best we can do and needs no further attention for now.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

11.   The length of our meetings seems well suited to committee needs.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Meetings:

12.   Our meetings are held regularly, with appropriate frequency.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

13.   Our meetings start and end as scheduled.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

14.   We receive agendas and meeting materials with sufficient lead time.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

15.   We receive an appropriate quantity of materials for meetings.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

16.   Materials sent out are adequately focused on and discussed by the committee at the subsequent meeting.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

17.   We consistently use our meeting time well--issues get the time and energy proportionate to their importance.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

18.   Attendance at our meetings is consistent with no individuals or groups being notably absent.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

19.   Our committee treats consistent attendance as a criterion for continued membership on the committee.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

20.   Our meetings are a good mix of theoretical study and practical application.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

21.   Group process of our discussions is planned and well suited to the nature of the materials being handled.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

22.   What I like most about our meetings…

 

 

 

23.   What I like least about our meetings…

 

 

 

Records/Charting:

24.   Our record keeping is adequate for committee needs.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

25.   Our record keeping has been reviewed adequately from a legal viewpoint.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

26.   The extent to which the committee should enter material into the patient's chart needs to be reviewed.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Membership:

27.   There is a good multi-disciplinary mix of nurses, physicians, social service, pastoral care, administration, outside members, etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

28.   Our membership represents the special needs that we have regarding issues such as: handicapped, age, gender, race, socio-economic status, etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

29.   We have selected members who respect other members as individuals, not because of their status or power.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

30.   We have members who are committed to further study and education.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

31.   We have members who do their homework and come to meetings prepared for the agenda.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

32.   We make good use of sub-committee structure to divide and coordinate our work.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Case Consultation:

33.   Case consultation as one function of the committee is understood by and accessible to patients, families, and hospital staff.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

34.   Case consultation is well understood and well carried out by the committee.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

35.   Our case consultations are helpful to others who seek the committee's help--professionals, patients, families.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

36.   Issues concerning consultations are clear: e.g., charting, record keeping, voting, who has access to the committee, how one accesses the committee.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

37.   We have good ways of getting evaluation of our case consultation function from those utilizing this service.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

38.   We seem to be meeting the needs of the institution, staff, patients/ families in our provision of a forum for case review.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

39.   We have good protocol for doing case consultation.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Policies/Guidelines:

40.   We have done a good job in developing policies/ guidelines for the institution.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

41.   It would help us if we have a sub-committee on policy development.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

42.   We have developed effective educational programs as part of implementing policies.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

43.   Some areas of policy development where we might be helpful are:

 

 

 

Self-Education:

44.   The committee spends adequate time on its initial self-education.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

45.   The committee continues to spend adequate time on its ongoing self-education.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

46.   The committee provides solid initial education to its new members as they come on board.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

47.   The committee has a good mechanism for planning and executing its on-going self-education.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

48.   The committee makes good use of multiple education approaches: case study, systematic articles, audio-visuals, guest experts, etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

49.   When educational materials are sent to committee members (e.g., articles) it is clear if and which one(s) will be discussed at the meeting.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Leadership:

50.   The leadership of our committee is well defined and functions adequately.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

51.   The addition of a co-chair or steering committee would better spread the responsibilities of leadership.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

52.   Our leadership makes good use of delegation of responsibility and work.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Communication/Interaction at Meetings:

53.   Careful attention is given to the question of group process at our meetings.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

54.   Group process is consistently planned and is appropriate to the material being handled.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

55.   As a general rule, when I speak I feel listened to and have a chance to clarify misunderstandings.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

56.   Discussions tend to be dominated by a relatively small group of persons.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

57.   Special attention is given to eliciting "minority opinions" when an emerging consensus might tend to chill their expression.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

58.   There is a consistent concern that everyone have an adequate chance to express his or her opinion.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

59.   More often than I like I leave the meeting with things I wished I had said.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

60.   Time is provided not only for exchange of ideas but for quiet reflection of one's own thoughts.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

61.   We give consistent attention to educating other groups in our institution.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

62.   We utilize a wide range of approaches in our educational programs.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

63.   We use existing forums as part of our ethics education efforts--section meetings, new hire orientations, new physician orientation.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

64.   We use existing printed media--employee publications, medical staff newsletter, etc.,--to raise awareness of ethical issues.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

65.   The two most important groups in our institution needing ethics educational programs are:

 

 

 

66.   The three most important areas needing educational attention are: (pick three)

• Ethics in general: how does it differ from legal, medical etc.
• Living will, durable power of attorney
• Decision to forego treatment
• Withdrawing nutrition/hydration
• Euthanasia
• Confidentiality
• Care of seriously ill newborns
• Allocation of resources
• Informed consent

Developing as a Community:

67.   We have found effective ways of being together in a social mode as well as a task-oriented mode.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

68.   We have used some group-building exercises as part of our meeting time.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

69.   A periodic half-day retreat would help the committee grow as a community.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

70.   One criterion for selecting committee members concerns their desire and ability to build up a sense of community.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

"Marketing" of Committee Services:

71.   We do a good job of letting others know that we exist.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

72.   We have done a good job of letting others know what we do/ do not do.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

73.   We have used many ways to accomplish this task: brochures/ articles in publications/ videos/ live presentations/ visiting meetings/ etc.

1	2	3	4	5
Strongly Agree			Strongly Disagree

Comments:

 

 

 

Suggestions for Improving Committee

Given my review of the committee I would recommend the following priorities:

• Immediate Attention

  What:

  By whom:

  Time line:

• Twelve-Month Goals/Objectives

  Goals: (longer range change of state/ condition)

  Objectives: (measurable changes/ time lines)

  Who should accomplish:

• 36-Month Goals/Objectives

  Goals: (longer range change of state/ condition)

  Objectives: (measurable changes/ time lines)

  Who should accomplish:

Reproduced with permission from St. Joseph Health System, Orange, CA.

© 2007 Ascension Health