The Clinical Ethics Consultation Benchmarking Collaborative: Initial Data from 316 Hospitals

A robust empirical data set with which to benchmark ethics consult service activities against national averages has been long sought but difficult to achieve. Aggregated data on consult volume, distribution across units, time spent engaging in consult work, and other metrics of interest would be a valuable resource to better understand of the work of clinical ethics and improve high-quality ethics consultation practices. It would also serve as a powerful tool to validate funding requests to expand an existing consult service or create one. The Benchmarking Collaborative was borne in service of these goals. Building a broad, lasting coalition was seen as the greatest obstacle, which was addressed strategically by beginning with basic, widely shared metrics and iterating annually to address any methodological issues. Here we present the Collaborative’s development and first-year data: 316 hospitals and 22 health systems contributed 2021 consult data, demonstrating 9,725 consults performed across 66,283 staffed beds and 2.67M annual admissions. The project documented 65.17 FTEs devoted to ethics. Overall average consult-bed ratio (CBR) of 0.097 (median: 0.037, SD=0.158) was observed. 8.9% were academic medical centers (n=28), 1.3% were children’s hospitals (n=4), 44% acute care general hospitals (n=139), 27.5% were community hospitals (n=28), 13.9% were critical access hospitals (n=28), and 4.1% were specialty hospitals (n=28). Formal funding of ethics support ranged from 14.9% at community hospitals to 92.9% at academic medical centers. We suggest how these findings may be used for preliminary benchmarking, the limitations of the data collected, and describe our next iteration.