Clinical bioethics integration, sustainability, and accountability: the Hub and Spokes Strategy
- Correspondence to: Ms S MacRae University of Toronto Joint Centre for Bioethics, 88 College Street, Toronto, Ontario, Canada M4C 4H6;
- Received 15 December 2003
- Accepted 15 March 2004
- Revised 12 March 2004
The “lone” clinical bioethicist working in a large, multisite hospital faces considerable challenges. While attempting to build ethics capacity and sustain a demanding range of responsibilities, he or she must also achieve an acceptable level of integration, sustainability, and accountability within a complex organisational structure. In an effort to address such inherent demands and to create a platform towards better evaluation and effectiveness, the Clinical Ethics Group at the Joint Centre for Bioethics at the University of Toronto is implementing the Hub and Spokes Strategy at seven hospitals. The goal of the Hub and Spokes Strategy is to foster an ethical climate and strengthen ethics capacity broadly throughout healthcare settings as well as create models in clinical bioethics that are excellent and effective.
↵i The Project Examining Effectiveness in Clinical Ethics (PEECE) is an ongoing research project being conducted by the Joint Centre for Bioethics involving nine healthcare sites, all of which are member teaching hospitals.