CECBC Electronic Data Capture - 2024 Data

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CECBC Electronic Data Capture

As the name suggests, the Clinical Ethics Consultation Benchmarking Collaborative (CECBC) is a group of collaborators who want to learn more about clinical ethics practices in the United States, with the aim of improving the benchmarks by which we understand and assess our work. The project began as the result of a peer-to-peer problem-solving session during the 2022 UnConference sponsored by WellStar Health. At the ASBH 2023 meeting in Baltimore, the first CECBC data were presented, covering 316 hospitals who provided data during our first year of data collection. We have held additional sessions at the ASBH 2024 meeting in St. Louis and at the 2025 UnConference sponsored by Sutter Health.

We are currently accepting entry of data from January 1, 2024 - December 31, 2024.

If you would prefer to enter data using Excel, please visit cecbc.net to download a template spreadsheet for standardized data entry. If you are entering data for more than 15 hospitals, we recommend using this spreadsheet to streamline entry. Send the completed spreadsheet to Stowe.Teti@inova.org. Please use the file naming convention "CECBC data collection_2024_[health system OR hospital name]".

If multiple individuals will be entering data across your system, we recommend completing either the Excel spreadsheet or REDCap electronic data collection instrument together in real time. This suggestion is based on experiences of members during previous data collection periods.

Please email critesj@ccf.org for help with any technical issues with the REDCap electronic data collection instrument.

The project has been determined to be Research Not Involving Human Subjects. A data use agreement (DUA) is available should your institution require completion before sending data. Please contact Stowe.Teti@inova for a DUA that others have used within the Collaborative.

By contributing data, you automatically become a member of CECBC, which allows you access to our annual report on trends in clinical ethics consultation and access to aggregate data you may use for benchmarking your institution. Scholars who are members of CECBC and interested in utilizing CECBC data are encouraged to propose academic studies to the Publication Group within the Collaborative. Please review the Guiding Principles document found on cecbc.net for further details.

For more information about the Collaborative, visit cecbc.net.

General notes:

If you are entering data for more than one hospital, please complete the entire data entry form for the first hospital and then follow the instructions to add another hospital found at the end.
You may choose to complete data entry for the current or additional hospitals at a later time by clicking on "Save & Return Later" below.
- If you do so, make note of the RETURN CODE on the next page. If you enter your email address on that page, you will receive an email with a link to return to this data collection instrument, but you must enter the return code in order to continue entering information.
  - Please note that the return code is unique to the current entry, so if you have added multiple hospitals the return code will correspond only to the current hospital.
- You may also use the original public link or the link that will be sent to your email to complete data entry for additional hospitals at a later time. Again, you will need to enter the return code for each specific hospital to continue.
  - Once the return code is entered, you will need to navigate to the end of the data collection instrument and follow instructions to add another hospital.
- If you forget your return code, please email critesj@ccf.org or Stowe.Teti@inova.org before proceeding with a new entry.

Hospital Demographics, Consult Volume, Consultation Model(s), and ECS Activities

Hospital demographics: Please enter basic hospital demographics. The CMS Certification Number can be found online through a search engine or on the CMS website (click here).

Consult volume:

Please indicate the total number of ethics consults completed in the last year however you count or define a "consult" at your hospital.
Entering information about the breakdown of consult types (formal, informal, and review consults) and defining your schema for categorizing consults are optional. If you enter values here, they should add up to the number of total consults.
- The question about alternate ways of defining or categorizing consult types is optional.

Consultation model(s): Please provide an estimate of what percentage of ethics consults are conducted by single individuals only, small teams only, full committees only, or a hybrid of these models. The estimates should add up to 100%.

ECS activities: Please indicate the frequency of activities listed at the hospital level.

Name of person completing this form*
Email of person completing this form*
Calendar year of data being entered:

* required

Hospital Demographics

System name*		Hospital name*
Hospital state*		Hospital zip code*

CMS certification number*

* required

Type of facility:

Type of Control:

Total staffed beds:

Total discharges:

Total patient days:

Verified trauma program:

Teaching status:

Number of interns and residents (FTEs):

Total average length of stay (Medicare patients):

Medicare case mix index:

Inpatient origin for top 3 zip codes, #1:

Inpatient origin for top 3 zip codes, #2:

Inpatient origin for top 3 zip codes, #3:

Special care available beds:

Total number and types of consults at ______

Total consults*	Formal consults	Informal consults	Review consults

* required

A "formal" consult is prospective, in response to a specific, active patient case and follows a comprehensive and systematic process.
An "informal" consult is prospective, in response to a specific, active patient case and does not follow a comprehensive and systematic process.
"Review" consults are retrospective and do not primarily pertain to a specific, active patient case.

Optional: If you use different categories to track consult types other than those outlined above (formal, informal, review) at ______, please provide the categories and their definitions here. If you do not use definitions of consult types, please describe the ways that you distinguish different types of consults responded to by the ethics consultation service. (If these practices are consistent across multiple hospitals or health systems, enter them only once and state in subsequent entries the name of the hospital under which to find your original answer.)

Estimated percentage of consults performed at ______ using each consultation model (should total 100%)

Single individual only*	Small team only*	Full committee only*	Hybrid of other models*

	These must equal 100
* required

Ethics Activities*

The purpose of the following questions is to capture the cumulative effort of all persons who contribute to the activities of the ethics consultation service at the hospital level.

How often does the ECS perform the following ethics activities at ______?

* required

Daily or multiple times per week

Once per week

A few times per month

A few times per quarter

A few times per year

Never

Responding to a request for ethics consultation, when on service.

* must provide value

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Performing a provider moral distress intervention that is separate from an ethics consultation.

* must provide value

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Participating in hospital or health system policymaking, including organizational ethics activities even where a policy does not result.

* must provide value

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Providing organizational leadership on bioethical issues, such as through hospital or health system committee service (including ethics committees), or managing employees in ethics or other roles.

* must provide value

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Supporting research ethics activities, such as through IRB service or responding to requests for research ethics consultation.

* must provide value

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Developing or providing educational programs related to bioethics.

* must provide value

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Contributing to scholarship, research, or professional development related to bioethics.

* must provide value

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OPTIONAL: Any comments about additional information related to hospital demographics, consult volume, or consultation model(s)?

Yes

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Please provide any comments about hospital demographics, consult volume, or consultation model(s).*

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Additional Information Related to the Ethics Consultation Service (ECS) and Ethics Consultants

Please enter additional information in this section about the ECS and the consultant(s) engaged in clinical ethics work. Additional guidelines are provided with the questions.

Title of consultation service lead: Please enter the institutional rank or title of the person who manages, directs, or is most directly responsible for the ECS (e.g., Center Director, VP Ethics, Department Chair, Senior Ethicist). Do not enter their name.

Number of ethics consultants: Some ECS utilize employees who are paid to do the work associated with an ECS as their full-time job. Other ECS include people who may "split" a position, for example, being paid for teaching responsibilities and for serving on an ECS. Still others may have people who have other paid full-time or part-time roles, but do ethics consultations on a volunteer basis, such as a Chaplain who contributes to an ECS.

Please include however many individuals performed any consultations associated with the ECS in the last calendar year, regardless of whether they are paid to provide this service, either as an individual or part of a small group--but not those who performed ethics consultations only as part of a full committee. If you have one or more individual(s) who perform(s) ethics consults for another ECS in your system, they should be counted for every hospital's ECS on which they serve. The additional questions about breakdown of paid and volunteer consultants should add up to the total number of ethics consultants. Please answer all questions using whole numbers.

Total ethics consultation service FTEs: An FTE ("full-time equivalent") is a measure of how time is distributed among one or more paid work responsibilities, based on one full-time employee. So if someone's whole job is dedicated to the work of an ECS, their FTE would be 1.0. If someone splits a full-time, paid position equally between teaching and ethics consultation, their FTE for teaching would be 0.5 and their FTE for clinical ethics work would be 0.5. Or if you have three people who each spend half their paid time (0.5) doing clinical ethics consultation, together this would equal 1.5 FTEs for that work.

For the question about FTEs, please only count the work done by people who are paid to do ethics consultations--not volunteers.

Consults by facility types: Please provide the percentage of consults by facility types listed. So if there are 50 total consults, 35 of of which are on inpatient units, 5 of which are for a clinic, and 10 of which are at a non-acute care facility (like a nursing home), you would enter 70% inpatient, 10% outpatient/ambulatory, and 20% non-acute care facility. If you do not know specific distributions, please provide an estimation. Entered values should add up to 100%.

ECS and Ethics Consultant Narrative: For this question, we are asking that you provide a brief description about how the ECS is situated within your hospital or health system and the general structure of how individuals complete various aspects of clinical ethics work. Generally speaking, this might be how you would describe your service or ethics program to someone who is familiar with clinical ethics work but not necessarily familiar with your service or ethics program. You should include information about ECS coverage, how work is distributed (including an explanation of how you calculated FTEs), and general composition of your service and ethics program. Some examples are provided below.

Does the ECS about which you are providing information serve only ______ or multiple hospitals?

* must provide value

Additional ECS and Ethics Consultants Information

Title of person primarily responsible for the ECS at ______*

(Please enter the title, not their name.)

* required

Total ethics consultants*	Paid ethics consultants*	Volunteer ethics consultants*

* required

"Paid ethics consultants" refers to individuals who were compensated specifically for ethics consultation;
"Volunteer ethics consultants" refers to those who performed any ethics consultations in the past calendar year, except those whose only consultation(s) were performed as part of a full committee, but were compensated only for work done in their primary role (e.g., as a chaplain).

Total FTEs for the ECS that serves ______*
* required

Estimated percentage of consults performed by the ECS by facility type (should total 100%)

Inpatient*	Outpatient / Ambulatory*	Non-acute care facility*

	These must equal 100
* required

Additional ECS and Ethics Consultants Information

How many hospitals does the ECS serve?*

What is the name of the market or region in the health system that this ECS serves?*

Title of person primarily responsible for the ECS*

(Please enter the title, not their name.)

* required

Total ethics consultants*	Paid ethics consultants*	Volunteer ethics consultants*

* required

Enter the number of ethics consultants in the ECS itself, not just for a particular hospital.
"Paid ethics consultants" refers to individuals who were compensated specifically for ethics consultation;
"Volunteer ethics consultants" refers to those who performed any ethics consultations in the past calendar year, except those whose only consultation(s) were performed as part of a full committee, but were compensated only for work done in their primary role (e.g., as a chaplain).

Total FTEs for the ECS*
* required

Estimated percentage of consults performed by the ECS by facility type (should total 100%)

Inpatient*	Outpatient / Ambulatory*	Non-acute care facility*

	These must equal 100
* required

ECS and Ethics Consultant Narrative

Here are some examples of different ECS structures for your information only. Below these examples, please describe your own structure. These descriptions will help us describe how different structures allocate ethics work across ethics FTEs and the facilities they serve.

Ethics Consultation Service Structure A

ECS Structure A serves a small health system (less than 15 hospitals) composed of one or two large regional referral centers and several outlying hospitals. The ethics program serves primarily or exclusively the large regional referral centers and any ethics coverage by the ethicists for the outlying hospitals is limited if it exists at all. The program staffs one or more professional ethicists who provide clinical ethics consultation, perform ethics rounds, review policies, staff the ethics committee, and provide ethics education. There may or may not be some volunteer ethics consultants to assist with call for consultation. The ethicists report to the same department and share call coverage for consultation and primarily use the individual consultant model.

Ethics Consultation Service Structure B

ECS Structure B serves a medium sized health system (15 to 49 hospitals) and employs 10 professional clinical ethicists in a single center. They rotate coverage for a single clinical ethics consultation service that covers all hospitals in the system. When not on consultation service, ethicists perform activities like ethics education, case discussions, journal clubs, attend clinical committee meetings, or provide embedded ethics services to various service lines. Several ethicists have some protected FTE time for academic teaching at affiliated medical and nursing schools. Consultation is primarily done by the individual consultant model.

Ethics Consultation Service Structure C

ECS Structure C serves a large health system (50 or more hospitals) with a combination of paid professionally trained ethicists and volunteer ethics consultants. Each region in the system has a few full-time professional ethicists who work on ethics education, policy review, organizational ethics, and some clinical ethics consultation. Most ethics committee work and consults are done by employees and physicians who volunteer their time for ethics and are not compensated specifically for ethics. Many consults are done by the individual consultant model, and some hospitals may use the team or committee model. There are also some professional ethicists at the system level who support the ethicists and volunteer ethics consultants. All professional ethicists report to the same department at the system level.

Ethics Consultation Service Structure D

ECS Structure D serves a single hospital. It is staffed entirely by physicians and employees who volunteer their time for ethics work. Some may have formal training in ethics like a certificate or workshop, but there are no professional ethicists except perhaps a community member on the ethics committee. The volunteer ethics consultants lead consultation and staff the ethics committee. They might review ethics related policies or provide some ethics education as available. Almost all consults use the team or committee model with few if any done by an individual ethics consultant.

Please provide a narrative description of the ECS that covers ______ and the general structure of your ethics program. See the examples above for guidance. Adapt one or more of these examples that may be similar to the ECS at ______. Please use details; the examples are generic but your description should be as specific as you are able to be.

If you have answered this question previously and nothing is different for the current hospital (e.g., your ECS covers multiple hospitals or a health system), simply enter "Already entered for..." and the name of the hospital or health system for which it was previously entered.

* must provide value

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OPTIONAL: Any comments about additional information related to ECS and ethics consultants?

Yes

reset

Please provide any comments about additional information related to ECS and ethics consultants.*

Expand

If you would like to add information for another hospital, please click "Add another hospital" below.

You may choose to complete data entry for the current or additional hospitals at a later time by clicking on "Save & Return Later" below. If you do so, make note of the RETURN CODE on the next page. If you also include your email address on that page, you will receive an email with a link to return to this survey, but you must enter the return code in order to continue entering information. Please note that the return code is unique to the current entry, so if you have added multiple hospitals the return code will correspond only to ______. To enter information about an additional hospital, you will need to navigate to the end of the data collection instrument after entering the return code for ______ and follow instructions to add another hospital. If you forget your return code, please email critesj@ccf.org or Stowe.Teti@inova.org before proceeding with a new entry.

If you are done entering information, please click "Submit" below.

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