Making it easier to do the right thing: a modern communication QI agenda.

The IntegratedEthics initiative marries two areas in which VHA is a recognized leader: health care quality and health care ethics. Every day in VHA facilities across the country, patients, their families, and the health care professionals who serve them encounter challenging ethical concerns. We know that VHA practitioners are committed to providing the highest quality of care for their patients, and they view ethics as an essential aspect of quality care. We also know that they need and want new tools and resources to help them address the ethical challenges they face each day. “IntegratedEthics,” a new national education initiative from the National Center for Ethics in Health Care, is designed to provide those tools and resources. The IntegratedEthics initiative marries two areas in which VHA is a recognized leader: health care quality and health care ethics. The goal is to help facilities move beyond traditional ethics committees—which in some ways are becoming obsolete—to develop “next generation” ethics programs that infuse awareness of health care ethics throughout the organization at every level. It is now widely understood that the quality of health care delivery depends not only on the performance of individuals, but also on the design and performance of the systems in which those individuals work. To achieve high quality health care, systems must be designed to facilitate and encourage excellent individual performance. The same is true for performance in health care ethics. Excellence is not achieved just by bringing together virtuous individuals, but through an effective ethics program that aims to continuously improve ethical health care practices. To be effective at promoting ethical health care practices, an ethics program must not only respond to ethical concerns on a caseby-case basis, but also must address ethical issues on a systems level, and foster an environment that is conducive to ethical practice. Thus