Integrating clinical ethics into healthcare operations: A roadmap for enhancing patient experience, clinician support and cost efficiency
Abstract
This paper examines how embedding clinical ethics consultation (CEC) into frontline care delivery provides measurable improvements in cost efficiency, clinician moral resilience and patient–family experience. Through illustrative case studies — including those on treatment conflicts and surrogate demands for futile interventions — this paper demonstrates how ethical frameworks facilitate decisions grounded in autonomy, beneficence, non-maleficence and justice. Evidence shows CEC enables significant cost avoidance, with one health system reporting more than US$288,000 in savings over six months, while another study cites annual savings of US$157,000.1,2 Additionally, clinical ethics support contributes to reduced staff turnover, enhanced family communication and improved goal-concordant care. Drawing from implementation experience at Saint Luke’s Health System (now part of BJC Health System), this paper proposes a practical roadmap for clinical ethics integration, ranging from executive sponsorship and resource allocation to committee development and interprofessional embedding. This paper concludes that CEC should be viewed as an operational asset that enhances quality, reduces cost and supports patient-centred decision making. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/.
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Author's Biography
Ryan Pferdehirt, DBe, HEC-C, is the Rosemary Flanigan Endowed Chair of Bioethics and Vice President of Ethics Services at the Center for Practical Bioethics, Kansas City, Missouri. He is also an instructor of bioethics at Kansas City University. His work focuses on supporting healthcare organisations in developing ethics committees and departments, and on strengthening the competencies of member ethics committees, individual consultants and the general public. He collaborates with hospitals, hospices and clinical associations nationwide, providing workshops and ethics consultation services. His research interests include moral philosophy, end-of-life ethics, Catholic health care ethics, philosophy of language and ethics in advance care planning. He has spoken extensively on integrating ethical decision making into standard patient care, applying frameworks for clinical ethics consultations and emphasising word choice in clinical conversations. He has published articles and book chapters on the development of hospital ethics committees, the implications of labelling patients as noncompliant or non-adherent and the importance of professionalism in communicating with patients and their families. He received his undergraduate degree from the University of Pittsburgh, a master’s degree from Creighton University and his doctorate from Loyola University Chicago.
Maggie Neustadt, JD, CPHRM, DFASHRM, is the Vice President of Risk Management for BJC Heath headquartered in St. Louis, Missouri. As an attorney and clinical risk manager, Maggie directs risk reduction and mitigation strategies for the system’s operations across 22 adult, paediatric and specialty hospitals in Illinois, Missouri and Kansas. Her responsibility spans the continuum of care from a academic medical centre to rural critical access hospitals, as well as a wide range of ambulatory and post-acute care settings. Maggie is a frequent speaker and author on trends in healthcare risk reduction and mitigation issues. Maggie earned her certification as a professional healthcare risk manager from the American Hospital Association in 2017 and was awarded Distinguished Fellow status in 2024. Since 2019, Maggie has been a faculty member of the American Society for Healthcare Risk Management’s (ASHRM) Academy, teaching the Applications in Risk Management module. Since 2023, Maggie has been co-author of the quarterly Case Law Update for the Journal of Health Care Risk Management. Maggie serves on the Board for the Center for Practical Bioethics, a non-profit founded in 1984 and nationally recognised for advancing applied bioethics among clinicians and the public.
Alexandra (Alex) Slodov, MS, is a doctoral student in bioethics at Loyola University Chicago. Alex earned her master’s degree in bioethics at Case Western Reserve University and worked as an Institutional Review Board (IRB) specialist at MetroHealth Hospital. Her current research focuses on rural healthcare ethics, particularly on methods to expand access to clinical bioethics across diverse healthcare settings, regardless of their proximity to major medical centres. Alex currently lives near Kansas City, Missouri, with her husband, who serves as a dental officer at Whiteman Air Force Base.
Citation
Pferdehirt, Ryan, Neustadt, Maggie and Slodov, Alexandra (2026, March 1). Integrating clinical ethics into healthcare operations: A roadmap for enhancing patient experience, clinician support and cost efficiency. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 10, Issue 3. https://doi.org/10.69554/KHRB5264.
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