Uh oh! You're using an unsupported browser.

It appears you're using Mirosoft Internet Explorer or an early version of Edge. To fully enjoy this website — and pretty much every modern website in existence — we suggest you upgrade to Chrome or Firefox. You'll be happier.

VEN Ethics Survey Results

Posted: November 5, 2019

Below are the overall de-identified results from our recent Ethics Survey for Vermont and New Hampshire conducted between July 15 and August 31, 2019. Questions that included identifying information about the respondent have been excluded from these publicly available results. For a more detailed analysis by audience type (e.g. Vermont hospitals, New Hampshire nursing homes, etc.), please contact us.

Respondent Demographics

  • Total # of respondents: 172 (138 in Vermont; 21 in New Hampshire)
  • Organizations represented:
    • 24 hospitals (14 in Vermont; 10 in New Hampshire)
    • 16 home health and hospice agencies (11 in Vermont; 5 in New Hampshire)
    • 21 nursing homes (all in Vermont)
    • 15 other organizations (8 in Vermont)

Respondent Characteristics

  • Q: Is your organization designated a “Critical Access Hospital”?
    • A: Yes: 31% / No: 61% / I don’t know: 8%
  • Q: Have you ever served on an ethics committee?
    • A: Yes: 52% / No: 48%
  • Q: Have you ever received formal healthcare ethics training?
    • A: Yes: 53% / No: 47%
  • Q: Does your organization currently have an ethics committee?
    • A: Yes: 64% / No: 27% / I don’t know: 9%

Issues Encountered

Q: In the following section, please think about how often you – or others in your organization – encounter ethical questions and conflicts in the areas listed:

Summaries

Full Data

At least once per weekAt least once per monthAt least once per yearOnce every few yearsNeverI don't know
Shared decision making, e.g. informed consent, determining patient decisional capacity/determining a surrogate, patient-family disagreements, requests for futile (non­ beneficial) treatments, etc.51%23% 18%4%1%4%
End-of-life decision-making, e.g. questions about physician aid in dying, withholding or withdrawing life-sustaining treatment, code status discussions/advance care planning, health care proxy/surrogate decision-maker, etc.47%26%15%6%3%4%
Caring for patients with mental health issues, e.g. concerns over treatment plan, lack of appropriate placement or bed availability, stigma and/or bias affecting patient care, decision-making questions surrounding management of co-occurring psychiatric and somatic illness, etc.46%25%16%6%2%4%
Resource allocation and access to care, e.g. allocation of limited resources, inadequate staffing or services, difficulties creating equal access to healthcare, inability or refusal to pay for services, third party reimbursement issues, etc.44%21%10%7%4%13%
Confidentiality, e.g. privacy of patient information and records, boundary issues (relationships between patients and caregivers in the community), etc.43%22%20%4%3%8%
Opioid epidemic, e.g. staff distress in response to patient choices or behavior, stigma and bias affecting patient care, concern for under or over-treatment of pain, difficulty advocating for (or obtaining resources to provide) evidence-based care for patients using opioids, etc.30%23%19%4%14%10%
Patient-provider relationships, e.g. disagreement over plan of care, disclosure of conflicts of interest (financial incentives for research, treatments, or testing), legal conflicts (e.g. patient's right to refuse versus clinical obligations), etc.17%28%23%15%6%12%
Truth-telling, e.g. family decision-making or request to withhold information from a patient, disclosure of medical errors or adverse events, accurate and timely reporting of diagnosis and prognosis, etc.14%29%28%8%4%17%
Cultural, personal, or religious values, e.g. tension between local/cultural values and professional standards of care/institutional policy, clinician objection to treating a patient, patient refusal of standard of care, etc.10%22%30%19%7%12%
Professional standards, e.g. providing care outside scope of practice or evidence base, reporting peer impairment, reporting professionalism violations, etc.6%13%25%26%9%21%
Other ethics questions or conflicts not listed above21%16%12%3%5%43%

Helpful Resources

Q: How helpful would additional ethics resources be in addressing ethical questions or conflicts in the following areas?

Summary

Full Data

Very helpfulNeither helpful nor unhelpfulUnhelpful
Shared decision making77%22%1%
End-of-life decision making77%21%1%
Confidentiality51%45%4%
Resource allocation and access to care69%31%1%
Truth-telling61%37%2%
Patient-provider relationships62%37%1%
Cultural, personal, or religious values57%42%1%
Professional standards63%36%1%
Opioid epidemic68%30%2%
Caring for patients with mental health issues89%11%0%
Other ethics questions or conflicts not listed above51%46%3%

Q: Which of the following resources would help staff address clinical ethics issues more effectively at your organization?

Summary

Full Data

Currently available; additional resources are not neededCurrently available; additional resources would be helpfulCurrently unavailable; additional resources are not neededCurrently unavailable; additional resources would be helpfulI don't know
Online education series on common ethics issues (audio/video)7%27%11%43%13%
On-site staff training on recognizing and responding to ethics issues12%32%8%42%6%
Regional ethics trainings or workshops9%36%10%38%7%
Conference calls/video meetings with other institutions involving discussions of recent cases10%24%13%35%18%
Online or print healthcare ethics resources that address common ethical themes and guide staff in responding to ethics issues13%38%5%32%13%
Help developing written polices for addressing ethics issues13%24%13%25%25%
Access to clinical ethics consultation (on-site/in-person)26%36%7%21%9%
Local ethics committee31%38%4%15%12%

Collaboration Opportunities

Q: Please rate your interest in collaboration with the following types of established ethics programs or services:

Full Data

1 (Not Interested)2345 (Very Interested)
State-wide ethics organizations3%8%20%29%40%
Local, multi-facility partnerships4%10%19%28%39%
Academic medical centers7%10%23%34%26%
All of the above2%8%22%29%40%

Opportunities for Improvement

Q: Please select the 3 greatest opportunities to improve ethics quality in your organization:

Summary

Full Data

ChoiceResponse
Staff professional development in ethics60%
Training staff to recognize ethics issues56%
Standardized process for addressing ethical concerns from patients and staff54%
Determining the role of ethics in the organization33%
Ethics policy development26%
Leadership support of staff who raise ethical concerns26%
Concern about impacting relationship with the community15%
I do not know enough about existing quality gaps to answer9%