3. Each committee member should log in to Site maker and review the consult.  Comments & suggestions should be typed into the comment field.  These comments are visible for all members to review.  Comments should be completed within a 24 hour time period so that the final consult can be composed and posted to patient medical record in careweb – where in care web?

4. The consultants should be in communication with the individual who requested the consult throughout the consultation process and notify the individual when the note has been posted in the medical record.

5. In the event that any Committee member has general questions or concerns regarding a particular ethics consultation performed by another member (as regards ethical decision-making, etc.), such concerns may be relayed in email via the "Reply-All" method, albeit in a constructive manner which reflects that level of mutual respect and collegiality expected amongst members of good will or by telephone with the consultant.

6. In the event that the situation arises where one Committee member has substantial and significant differences of opinion with the conclusions drawn by another member's recently completed consultation, it is recommended that such concerns be initially forwarded to the Chair or Vice-Chair of the Committee for review and potential resolution, prior to being emailed to all members. This is recommended in consideration of the fact that email is not secure under all circumstances, as well as to foster a more judicious review of the quality assessment of ethics consultations.

Survey

Family/Patient and Health Care Provider surveys .  http://www.med.umich.edu/adultethics/index.htm

As a process for continually improvement, the Consultant should ask that the individual who requested the consult to complete the survey and explain that this provides the committee feedback on how to improve our service.

Consultant should provide the patient/family and the care team with the appropriate business card.  This card provides both the URL and the address to send a paper response.  The consultant should provide the patient/family with a hard copy of the survey if they do not have access to a computer.

Writing a consult

• In honoring patient privacy and confidentiality, ethics consultations should be written so that all patient identifying information has been appropriately deleted. Additionally, ethics consultations attached to email messages should not be forwarded via email (advertently or inadvertently) to secretaries, administrative support staff, or any other persons outside the membership of the Adult Ethics Committee.

• To the extent that it is possible, in recognizing that all Committee members do not have a formal background in clinical medicine, medical terms should be modified and/or defined so that they may be understandable to all Committee members.