Amortal's Favorite Links on chaplaincy from Diigo

Vision: How much does it cost for chaplain services?

Fri, 07 Mar 2008 06:31:34 -0000

How much does it cost for chaplain services?
Fiscal approach actually raises department’s standing

Highlights and Sticky Notes:

“We don’t want to tell you what to do. We want you to tell us what you do.”

We have a comprehensive list of spiritual care services to share with administrators whose understanding of our ministry sometimes seemed limited to praying with patients or saving souls.

For a period of six months we would have to track the number of minutes it took to complete each patient visit and then divide our budget by those numbers.

And then we learned that our budget would be managed by our expense per unit of service (UOS).We would be expected to meet or beat that expense on a monthly basis. Finally, there was this great incentive; we could add staff to the department if we were able to demonstrate that in doing so we would not raise our expense per UOS.

We eventually dropped the term “visit” and replaced it with a more accurate descriptor, “service type.” The result was a catalogue of 28 Direct Service Types

The 14 Indirect Service Types track internal departmental activities.

When a patient or family encounter includes several services, they are recorded separately.

we found that there is a verifiable average time for every service type.

To assign a relative resource unit (RRU) to each service type

the method for calculating an expense per unit of service (UOS) using a one-month hypothetical budget

The result is the cost for each service provided

If we chaplains were in business for ourselves, the cost for every spiritual care service would have to be calculated in a similar fashion. If not, we would not be in business very long.

We have learned that our services are relatively inexpensive compared to those of other departments.We have learned to value our work. We have learned that increased productivity on our part reduces the cost of spiritual care services to patients.

Our list of services has greatly assisted in explaining the exact nature and breadth of our ministry to our administration. And, wonder of wonders, we chaplains -- not known for our love of budgets or the bottom line -- can give an exact accounting of the cost for each of our spiritual care interventions.

And it can tell us what we have accomplished with the staff we have, and what additional staff it would take to address what always remains to be done.

the expense per unit of service and the CARE Program provide each chaplain with a daily report of productivity

Tags: SJHS chaplaincy productivity

Posted by: amortal

Health Progress: Spirituality and Medicine

Fri, 07 Mar 2008 01:13:18 -0000

Hospital patients often count on chaplains for the comfort and inspiration they provide. But at one Midwestern medical center chaplains are working to extend the healing power of spirituality beyond the bedside-into doctors' offices, summer camps for grieving children, even the operating room.

Highlights and Sticky Notes:

extend the healing power of spirituality beyond the bedside-into doctors' offices, summer camps for grieving children, even the operating room

It used to be that the physician and spiritual leader was often "one and the same" person

In 1993, just two years before the Harvard meeting, only three of the 123 colleges of medicine in the United States actually offered courses on the importance spirituality plays in health care. But by 1999, 50 of those institutions were offering spirituality classes.

annual "Faith and Medicine" forums

Among the topics discussed in recent forums were "The Need to Listen versus the Desire to Tell," "Reconciling Personal Beliefs with the Obligation of Medical Professionalism" and "What Do We Say about Each Other as Physicians and Faith Leaders?"

writing letters for terminally ill patients

"In fact, spiritual care and medical care are partners and each has its vital and proven role in the restoration and maintenance of total health."

Tags: SJHS chaplaincy health medicine progress

Posted by: amortal

Health Progress: MEASURING WHAT CHAPLAINS DO

Thu, 06 Mar 2008 20:53:15 -0000

A New Study Sheds Light on Chaplain Competencies and Productivity

Highlights and Sticky Notes:

chaplains are learning to better define their roles, to articulate their duties, and to foster recognition of their contribution to patient care

administrators are often content with the symbolic nature of the chaplain's role

to define:

* A common language to describe what chaplains do

* The typical outcomes of their work

* The most appropriate ways to measure their productivity

families see chaplains as surrogate family members who help them cope with the death of a loved one

"Many of the people surveyed didn't know if they actually met a chaplain or not," he said. "We saw that chaplains had to take part of the responsibility for fuzzy perceptions of their roles. The problem is that fuzzy perceptions are not conducive to clear productivity and performance expectations or assessments for chaplains."

chaplains are available to meet others' needs with no agendas of their own; to provide comfort and support in a variety of circumstances; and to facilitate an individual's journey toward peace and wholeness, among other things

four recommendations to directors of spiritual/pastoral care for the improvement of chaplain performance and productivity measurement:

* Engage staff chaplains in a reflective process of role clarification, to identify and prioritize the most common key activities and competencies expected of them.

* Engage colleagues from other disciplines to help chaplains articulate performance expectations (outcome measurements) in a behavioral, common language.

* As a starting point for an improved and locally customized approach to measuring chaplain productivity (efficiency), create a template to define levels of task complexity for each of five to 10 key chaplain activities.

* Make a firm commitment to continuing education in order to develop the skills and competencies highlighted by the study, which will make a difference in the quality of spiritual/pastoral care.

An example of a task involving a lower degree of complexity is a patient death that is anticipated by both the patient and his or her loved ones. A more complex situation arises in the case of the death of a patient who is unprepared for it or whose family members are in conflict about the wishes of the deceased. "In either case, a chaplain must respond to the patient's death, but many more skills and competencies are needed to deal effectively with the complex situation,"

We have developed algorithms for this and other chaplain tasks to clarify roles, ensure quality spiritual care, and eliminate rework.

a form that helps chaplains perform detailed assessments of patients' spiritual well-being

measure their productivity in terms of outcomes. "We're also studying our chaplains' nonproductive time to determine whether we have the right people doing the right things and using the right tools in spiritual care,"

developing a tool that will serve a dual purpose: to enable patients, families, and caregivers to evaluate chaplain performance and, at the same time, educate those populations about the role of chaplaincy. "The very process of completing the evaluation will educate the user about what they can and should expect from a chaplain,"

Many of our residents conduct life reviews, looking back to assess the things they did or did not do. As chaplains, we can help them achieve closure and let go of guilt or regret. We can help them decide what they want to happen in their lives now as well as during and after their funerals. We also work with families to help them deal with the decline of a loved one.

the importance of gathering qualitative rather than quantitative data

The study helped our chaplains name and claim their profession by identifying some common language, levels of practice, competencies, and standards of care to which they can be held accountable

when CHI's facilities develop their own individual, customized lists of chaplain competencies

a lot of face-to-face dialogue with chaplains throughout our system to gain their acceptance of the study

it is much harder to add value to an organization when no one understands what you do

We dropped the chaplain-specific question from our survey for a number of reasons, but primarily because the chaplains' ministry today is so multidimensional that no single question can adequately capture their impact on patient satisfaction.

more helpful and detailed feedback from routine internal surveys of sample groups of nurses, physicians, family members, and other key stakeholder recipients of their ministry

the Catholic Health Initiatives Task Force on Chaplain Performance and Productivity, Measures of Chaplain Performance and Productivity

Tags: SJHS chaplaincy chaplains health progress

Posted by: amortal

Professional Chaplaincy: Its Role and Importance in Healthcare

Tue, 04 Mar 2008 22:50:29 -0000

This paper describes the role and significance of spiritual care and is the first joint statement on this subject prepared by the five largest healthcare chaplaincy organizations in North America

Tags: SJHS chaplaincy healthcare

Posted by: amortal