COVID-19 Ethics Debrief: Pearls and Pitfalls of a Hub and Spoke Model


Cynthia M.A. Geppert, Kenneth A. Berkowitz, Toby Schonfeld, and Anita J. Tarzian


A hub and spoke model offers an effective and efficient approach to providing informed guidance to those who need it. The National Center for Ethics in Health Care (NCEHC) at the Veterans Health Administration, Department of Veterans Affairs, is the largest known hub and spoke healthcare ethics delivery model. In this article, we describe ways NCEHC’s hub and spoke configuration succeeded during the COVID-19 pandemic, as well as limitations of the model and possible improvements to inform adoption at other healthcare systems.



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