RESEARCH PROJECTS FOR 2011-2012
Statement of Current and Planned Research
I. Research in Bioethics
Peter Clark, S.J., PhD
My research agenda can be divided into two distinct categories: First, a number of my research projects are a result of being the Director of the Institute of Catholic Bioethics. Each research fellow in the Institute is responsible for doing research and publishing a paper in a peer-reviewed academic journal. I have worked closely with the research fellows and as a result we have seven published papers. A number of the research projects have been developed as part of the international commitment of the Institute and they are long-term projects.
Second, the majority of my research in the area of bioethics has been the direct result of my work as the Clinical Bioethicist for the Mercy Health System. Doing medical rounds with the interns and residents, sitting on the various Institutional Ethics Committees and Institutional Review Boards (IRB), and participating in ethics consults has allowed me the opportunity to experience first-hand various ethical dilemmas and issues that have a direct result on patient care and the role of health care professionals in Catholic hospitals today. As a result, my research and articles have a direct bearing on clinical policies at the four Mercy Hospitals and have been presented to the larger Catholic health care community as paradigms to be examined and critiqued. The purpose of my research is not only to enrich my teaching but to assist Catholic health care professionals and patients today in dealing with complex medical and ethical issues. This part of my research may appear at first glance to be varied and unrelated but there is a common thread that links it all together. The common thread is that most of the issues are in some way connected to beginning-of-life issues and end-of-life issues. These issues span the spectrum from patient confidentiality, to pain management and medical futility issues, to the ethics of alternative therapies and tube feedings for persistent vegetative state patients, to prejudice in the medical profession. These issues are the dominant ones that confront both patients and health care professionals on a daily basis and often lead to conflict situations that sometimes can only be resolved by the court system. The goal of my writings is to resolve some of these conflicts through policies that can serve as a paradigm for not only the Mercy Health System but other Catholic and non-Catholic health systems both nationally and internationally.
In conclusion, I do have a research agenda that can be divided into two distinct categories and spans two particular areas of medical ethics-beginning-of-life issues and end-of-life issues. I will continue to write in these areas. But I will also be called upon to comment on unrelated issues that I feel compelled to research and comment upon because of the serious nature of the issue. Two of my recent articles fall into this category-"Physician Participation In Executions" and "Medical Ethics at Guantanamo Bay and Abu Ghraib: The Problem of Dual Loyalty." These issues are important and need to be assessed ethically. The following is my current and planned research agenda:
Summer Scholar Research Program - 2012
Peter Clark, S.J., PhD
Research Interests: My research this summer focused on implementing the Mercy Health Promoter Model designed by the fellows and staff of the Institute of Catholic Bioethics for the Nigerian community in Philadelphia. As of March 2010, 11.2 million undocumented immigrants were living in the United States, virtually unchanged from a year earlier according to the new estimates from the Pew Research Center. Estimates show that there are at least 50,000 undocumented African immigrants living in West Philadelphia, constituting eight percent of the total immigrant population. The increase in foreign-born peoples and their need for health care is a complicated issue facing many cities, health systems and hospitals. Over the course of the past few years Mercy Hospital of Philadelphia has treated increasing numbers of foreign-born African patients. The majority have been presenting in the late stages of disease, which has made treatment more complex and costly.
To meet the needs of this growing population, the Mercy Hospital Task Force on African Immigration designed a program that centers on the Third World concept of “Health Promoters” This program is intended to serve as one possible proactive solution for hospitals to cost-effectively manage the care of this growing percentage of foreign-born individuals in the population. This notion of a “Health Promoter” program in Philadelphia is unique as one of those rare occasions when a Third World concept is being utilized in a first world environment. It is also unique in that it could serve as a paradigm for other hospitals in the United States to meet the growing need of health care for the undocumented population.
The implementation of the Mercy Health Promoter Model is a joint venture between the Institute of Catholic Bioethics, the designer of this model, and the Mercy Health System of Philadelphia. This pilot program will be targeted to the Nigerian community of Philadelphia. The Nigerian community was selected because it is well-organized and has a stable basis at St. Cyprian’s parish in West Philadelphia. Initial meetings have been arranged and we are in the process of identifying, with the Nigerian community leaders, potential individuals who will be selected as the health promoters. The hope is that this model could serve as a paradigm for other Catholic hospitals nationally in the care for the most vulnerable members of our society—the undocumented. This pilot program has been endorsed by the Catholic Health Association of the United States and they are very interested in monitoring the implementation, success and evaluation of this model.
GRADUATE FELLOW RESEARCH PROJECT
Disclosure of Medication Errors
Ankit will be researching medication errors that result in patient harm are the leading cause of error-related inpatient deaths. About 34% of all medication errors occur during administration stages. This can cause serious patient harm. The Institute of Medicine (IOM) estimated that about 44,000-98,000 patients die annually due to medication error in US. The research shows that most of these medication errors are preventable. The two most common types of errors are medication administration errors and ordering errors. The introduction of information technology designed to promote safe medication practice, such as the Bar Code Medication Administration (BCMA) system and Computerized Physician Order Entry (CPOE), offers new opportunities for reducing medication errors. These technologies were developed to improve patient safety, improve documentation of medication administration, decrease medication errors and decrease adverse drug events caused by these errors. However, only a small percent of all medication errors are disclosed. In my research, I will look at why the medical institutions have been afraid to confront and openly admit their mistakes, and use what they have learned from the errors to improve their systems so that these errors do not recur. I will focus on organizations that have been successfully disclosing medication errors. I will focus on what these organizations are doing, how they are doing it, and what they are learning to improve their processes and their systems.
UNDERGRADUATE/GRADUATE FELLOW RESEARCH PROJECT