Our vision at Ranken Jordan is to create a world where every child with complex medical needs lives their best life. That means we are always looking for ways to improve care—from helping kids play more to addressing challenges like the private duty nursing shortage.

Most recently, that commitment led us to launch the Ranken Jordan Pediatric Bridge Hospital Ethics Committee, which provides timely guidance for active patient cases while also offering ethics education and training for employees and stakeholders.

It is another innovative step forward in advancing care for children with complex medical conditions.

Health care professionals regularly face difficult decisions but most of the existing research on health care ethics focuses on acute care hospitals.

There is very limited research on ethics in post-acute care settings like Ranken Jordan. Because of our setting and patient population, we thought the nature and frequency of the ethical challenges we encounter might differ from an acute care hospital.

Our team wanted to better understand the ethical challenges pediatric post-acute care providers face and how those differ from traditional hospital settings.

In 2023, we reached out to Erica K. Salter, PhD, HEC-C, chair of the Department of Health Care Ethics at Saint Louis University and co-chair of the Ethics Committee at SSM Health Cardinal Glennon Children’s Hospital, to help us start looking at ethical issues in our post-acute setting and learn how we can best meet the needs of our employees facing ethical challenges, ultimately to  improve the care we provide our patients.

Using our own hospital as a case study, we surveyed 104 Ranken Jordan employees involved in patient decision-making about ethical dilemmas they encounter in pediatric post-acute care.

The results were published last year in the peer-reviewed Journal of Pediatrics: Clinical Practice. Key findings included:

• The most commonly encountered ethical issues in the PPAC setting included discharge disposition (41%), inter-team (33%) and team-parent communication issues (27%), behavior problems (28%), and goals of care (24%).
• We also found many (54%) employees did not feel they had appropriate institutional resources to navigate ethical dilemmas.
• The most identified solution was the creation of an ethics committee.

One direct result of the survey was the creation of the Ranken Jordan Pediatric Bridge Hospital Ethics Committee.

Committees like this are uncommon in hospitals of our size, as smaller and non-academically affiliated hospitals are less likely to have formal ethics services.

Consisting of 20 members, our interdisciplinary ethics committee held its first meeting in August 2025 and now meets every other month. Today, the committee:

• Consults on ethics requests from staff and families regarding challenging scenarios,
• Reviews and helps develop hospital policies through an ethics lens, and
• Supports ongoing staff education and training.

All of these efforts are centered on improving quality of life for children with complex medical conditions and their families.

Our Care Beyond the BedsideⓇ philosophy reminds us to focus on the whole child, which includes parents and loved ones. We want this committee to be a trusted resource for hospital staff and families alike.

Our ethics study was led by the Ranken Jordan Research Department and supported by The Quatrano Family Fund for Research and Publications, created through a generous gift from Dr. Ralph Quatrano, dean emeritus of Washington University and accomplished biology researcher, and his wife Lee Anne, a retired learning disability specialist.

If you are interested in supporting future research initiatives, please consider donating to the fund.

When you support research at Ranken Jordan, you help improve care not only for our patients, but for children and families far beyond our walls.