FROM THE FIELD Inside Out: The Value of a New Perspective When Evaluating and Assessing Ethics Programs

Is it working? That is the question Trinity Health sought to answer when it began a critical examination of competencies for its acute care ethics committee and consultation service members in the fall of 2008. With significant resources invested in strengthening the role and effectiveness of ethics committees and consultants, the organization listened when committee leaders expressed the desire to create a new standard for excellence — something to ensure that physicians navigating a challenging ethical terrain would continue to call on them for assistance. After considerable study and much thought, I began to develop PEERS, the “Programmatic Ethics Evaluation Reciprocity System, ” as one answer to the question. Still in development, PEERS is a theoretical approach for evaluating ethics programs and their effectiveness in a more objective manner than is typically the case. The first step in developing PEERS involved working with the committee to survey the literature, other health care systems, and existing — as well as developing — standards within Trinity Health. Next, we developed new competency standards for ethics committees and consultation services, and then created a method for evaluation and assessment. The direction we chose for the latter was atypical. Usually, ethics program evaluation and assessment do not receive much attention either in practice or in the literature. When it is discussed, the discussion is sparse with regard to its necessity as well as the methodology to be employed. Generally, ethics program evaluation and assessment are overlooked