1. Community Ethics Network Strategic Planning Results: 2008 and Kimberley Ibarra Program Evaluation Specialist | Ethics Consultant, Toronto Central CCAC & Joint Centre for Bioethics

2. Overview Strategic Planning Processes Objectives
2008 Key Findings and Priorities
2011 Key Findings and Differences
Priorities and Work Plan

3. Strategic Planning Processes
Outreach Project (2008) surveys and interviews to identify:
Ethical issues at CEN organizations
Membership learning needs
CEN strengths and opportunities for improvement
Future directions
JCB Strategic Planning Survey (2011) to identify:
Membership needs
CEN value to membership
Growth and changes in membership since 2008 survey
27 people participated in interviews identified from membership list from 21 of the 32 member organizations
Interviews lasted around 30 minutes, attempted to elicit common themes, issues and challenges related to ethics in the CEN membership
28 of 71 invited members completed the on-line survey. The majority of interview participants held management positions in their organizations. A limited number of front-line staff were interviewed.

4. Key Findings 2008: Ethical Issues
Majority encounter ethical issues at least weekly (70.3%); 3.7% uncertain
‘The top 5 most pressing issues in my work …’ 1
Autonomy, consent, capacity; client/family/provider conflicts 2
Moral distress & workload 3
Client advocacy issues 4
Human resources issues 5
Access to care; diversity; safety & abuse
-majority of ethics leads have professional training through their graduate degrees, attendance of ethics institutes, grand rounds, and workshops
-encountering an ethical issue isn't inherently bad
-if one organization encounters issues on a daily basis versus never encountering them, this doesn’t mean the organization that never encounters ethical issues is more ethical, it could be that they don’t recognize the ethical issues as they arise. Conversely, the organization that encounters ethical issues on a daily basis is not more ethical than one that never does. It could be that their organizational practices are causing ethical issues to arise.
What this does show is that ethical issues in community organizations are not an uncommon occurrence. Other than the 3.7% that were uncertain of how often, participants encountered ethical issues at least once a month.
So what are these ethical issues?

5. 2008 Resource Utilization
‘Which CEN ethics tools have you/your organization used?’
Code of Ethics (78.3%)
Education and Training Sessions (73.9%)
Ethical Decision-Making Worksheet (69.6%)
Ethics in Action Newsletter (60.9%)
Case Review Collection (26.1%)
Org-Ethics and Capacity-
Building Service (21.7%)
A few participants mentioned they had heard of the case review collection but did not know where or how to access it, while others did not know the collection existed.
60.9% of survey respondents indicated that they have used the Ethics in Action Newsletter, of those 92.9% thought it was helpful. “The newsletter is terrific; it’s the beginning of getting the message out”.
The specialized education and training sessions were well received by participants. Participants found the workshop sessions “helpful”, “relevant”, and “interesting”. Some commented that after participating in these sessions, they went back to their organizations and presented what they learned.
Many interview participants and survey respondents were unaware of the existence of this service or what the service entails.

6. 2008Strategic Issues
Awareness & Visibility: No value added if members don’t know about or can’t access tools and resources
Integration: Lost opportunities for sharing and collaboration
Leadership & Development: Look to CEN to develop tools, particularly in organizational ethics
Education: More training opportunities for members and front-line staff
Sustainability & Accountability: Need a sustainable financial and governance structure, and way to measure success

7. Setting & Addressing Priorities
Concentrate on education
Focus on the front-line
Address sustainability
Inventory and share ethics resources
Explore impact of Apology Act
Specialized education
Build community cases
2009 Fall Conference
Train-the-trainer
Create website
Critical Path
Town Hall

8. Key Findings 2011: Ethical Issues
Majority encounter ethical issues at least weekly (72.7%); 6.1% uncertain; 3.0% never
In 2008
In 2011 1
Consent, capacity; client/ family/provider conflicts
Client/family/provider conflicts 2
Moral distress & workload
Privacy & confidentiality 3
Client advocacy 4
Human resources issues
Client advocacy; autonomy, consent, capacity 5
Access; diversity; safety
-encountering an ethical issue isn't inherently bad
-if one organization encounters issues on a daily basis versus never encountering them, this doesn’t mean the organization that never encounters ethical issues is more ethical, it could be that they don’t recognize the ethical issues as they arise. Conversely, the organization that encounters ethical issues on a daily basis is not more ethical than one that never does. It could be that their organizational practices are causing ethical issues to arise.
What this does show is that ethical issues in community organizations are not an uncommon occurrence. Other than the 3.7% that were uncertain of how often, participants encountered ethical issues at least once a month.
So what are these ethical issues?

9. 2011: Organizational Issues
In my role
In my organization 1
Client/family/provider conflicts
Moral distress & workload 2
Privacy & confidentiality 3
Access to care 4
Client advocacy; autonomy, consent, capacity
Autonomy, consent, capacity 5
Human resources issues
Client advocacy; resource allocation; safety, abuse
-encountering an ethical issue isn't inherently bad
-if one organization encounters issues on a daily basis versus never encountering them, this doesn’t mean the organization that never encounters ethical issues is more ethical, it could be that they don’t recognize the ethical issues as they arise. Conversely, the organization that encounters ethical issues on a daily basis is not more ethical than one that never does. It could be that their organizational practices are causing ethical issues to arise.
What this does show is that ethical issues in community organizations are not an uncommon occurrence. Other than the 3.7% that were uncertain of how often, participants encountered ethical issues at least once a month.
So what are these ethical issues?

10. Building Ethics Capacity
Ethics learning needs
2008
2011
+ / -
I need to learn more about how to identify ethical issues in my daily work
48%
32%
-16%
I need to learn more about using ethical decision-making (EDM) tools/frameworks
67%
45%
-22%
Staff at my organization needs to learn more about how to identify ethical issues
96%
88%
-8%
Staff at my organization needs to learn more about using EDM tools/frameworks
80%
+16%

11. Value of the CEN The CEN… 2008 2011 + / -
Advances ethical practice in community
89%
100%
+11%
Supports ethical decision-making within and across member organizations
82%
97%
+15%
Provides an effective forum for exchanging information among members
77%
87%
+10%
Enables us to more successfully meet Accreditation Canada standards
74%
+8%
Enables us to improve staff awareness and understanding of ethics at work
90%

12. Resource Utilization
‘Which CEN ethics tools have you/your organization used?’
Code of Ethics (93%) +15%
Ethics in Action Newsletter (90%) +29%
Ethical Decision-Making Worksheet (87%) +18%
Case Review Collection (73%) +48%
Org-Ethics and Capacity-
Building Service (43%) +21%
A few participants mentioned they had heard of the case review collection but did not know where or how to access it, while others did not know the collection existed.
60.9% of survey respondents indicated that they have used the Ethics in Action Newsletter, of those 92.9% thought it was helpful. “The newsletter is terrific; it’s the beginning of getting the message out”.
The specialized education and training sessions were well received by participants. Participants found the workshop sessions “helpful”, “relevant”, and “interesting”. Some commented that after participating in these sessions, they went back to their organizations and presented what they learned.
Many interview participants and survey respondents were unaware of the existence of this service or what the service entails.

13. 2011 Strategic Issues
Network engagement & responsiveness: more immediate, timely, and interactive opportunities, including communication and enhanced website
Expand capacity-building resources: more detailed and broader cases, online learning, particularly in org-ethics
Institutional support: mentorship and business case development
Evaluation & quality improvement: performance indicators and sharing leading practices

14. 2011 Priorities Develop more tools and resources
Revisit Network infrastructure
Build organizational ethics capacity
Continue to provide ethics education
Mentor new members | Develop internal engagement strategies and evaluation tools

15. 2012 Work Plan Activities Priority Action Items Tools and Resources
Increase awareness of IDEA Framework
Continue to develop case studies
Infrastructure Review
Review Steering Committee membership and Hub & Spokes model
Revise TOR and Letter of Understanding
Organizational Ethics
Add organizational ethics cases
Explore organizational ethics frameworks
Education and Training
Continue bi-annual workshops
Train the trainer
Leverage use of website
Mentorship | engagement | evaluation
Pilot mentorship program
Update Members list and annual renewal letter
Explore evaluation strategies