Virginia Chaplains Association Annual Conference Quality Spiritual Care—Defined and Measured September 29-30, 2016 Roslyn Retreat Center, Richmond, VA Gordon Putnam, M.Div., MA. BCC Now the process we are going to go through is to look at what we can measure and quantify. Here is the outline. Can we define spirituality How do our spiritual assessments relate to a defined spirituality What is the role of Chaplains

Defining Spirituality I can’t define it but I know it when I see it.* *1964 by United States Supreme Court Justice Potter Stewart to describe his threshold test for obscenity.   Spirituality, define it I can’t define it but I know it when I see it. (1964 by United States Supreme Court Justice Potter Stewart to describe his threshold test for obscenity.)   Have the group suggest words for spirituality and write it on newsprint

Have the group suggest words for spirituality and write it on newsprint

Defining Spirituality  How would you define Spirituality? Now the process we are going to go through is to figure out what we can measure and quantify. Have the group use one word statements to define spirituality

Defining Spirituality 2009 National Consensus Conference 2013 The United States National Consensus Conference on Creating More Compassionate Systems of Care 2014 International Conference on Improving the Spiritual Dimension of Whole Person Care Now that we have some great words that describe spirituality lets look at some definitions that have been developed. Palliative care has been the main force along with chaplains in developing these definitions. National Consensus Conference 2009 The United States National Consensus Conference on Creating More Compassionate Systems of Care 2013 International Conference on Improving the Spiritual Dimension of Whole Person Care 2014

Defining Spirituality APC used the National Consensus Conference “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature.” APC used the National Consensus Conference definition in their Competence Spirituality. “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature and to the significant or sacred. (APC standard of practice)

Defining Spirituality National Consensus Conference Definition, 2009 Seeks and Expresses Meaning Purpose Connectedness to Moment Self Others Nature Significant or sacred Here are the key words from that document.

Defining Spirituality International Conference on Improving the Spiritual Dimension of Whole Person Care, 2014 Spirituality is a dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose and transcendence and experience relations to self, family, others community, society nature and the significant or sacred. Spirituality is expressed through beliefs, values, traditions, and practice. The international conference added more words.

Defining Spirituality International Conference on Improving the Spiritual Dimension of Whole Person Care, 2014 Seek Ultimate Meaning Purpose Experience Relations Self Others Nature Significant or sacred

Defining Spirituality International Conference on Improving the Spiritual Dimension of Whole Person Care, 2014 Seek Ultimate Meaning Purpose Transcendence Experience Relations Self Other Nature Significant or sacred Family Community Society Expressed Through Beliefs Values Traditions Practice

Spiritual Assessments Chaplains find out this information by doing a spiritual assessment (Hand out page of some spiritual assessments)

Spiritual Assessments Pruyser’s Catagories Fitchett’s 7X7 Model Lucas’s Theory Lewis Conversational Theory Spiritual AIM Does anyone use these assessments? Name some other assessments chaplains use

Spiritual Assessment Meets up with Definition Pruyser’s Categories Awareness of the Holy Providence Faith as understood subjectively Grace or gratefulness Repentance Communion Vocation Meaning Purpose Transcendence Relationships Self Family Others Community Society Nature Significant or sacred Expressed By Beliefs Values Traditions Practice How do our assessments compare to our assessments?

Spiritual Assessment Meets up with Definition Meaning Purpose Transcendence Relationships Self Family Others Community Society Nature Significant or sacred Expressed By Beliefs Values Traditions Practice Lucas’s Theory Concept of the Holy - How does the person name or describe the Holy? How does the Holy function in the person’s life? Meaning - What people, purposes, ideas, objects, and/or activities give meaning to this person? Hope - What role does this person play in realizing his/her intermediate and ultimate hopes? Community - Does this person have a community? Who is in the community? Is the community nurturing? Is the community homogenous? Does the community permit risk? How much of this person’s identity is tied to his/her community?

Best Practices of Chaplains What is our role? Who should we visit, why do we visit them and can we make a difference? Can we or how would we evaluate that?

All of health care is becoming an interdisciplinary team sport All of health care is becoming an interdisciplinary team sport. That’s how the complexity is best handled and it also produces the best medical results and is the cheapest. Palliative care is certainly leading the way on this but other specialties are following quickly. If spiritual care and chaplaincy care are going to be fully integrated into the team, we: Have to prove that a position for “spiritual care provider” or “chaplain” needs to be on every team, and then When we get put on the team and called into the game, we have to play our position very well so that the team captain puts us in the next game. Chaplaincy needs evidence developed like it has been in palliative care and increasingly in cancer care. Chaplaincy also needs chaplains who not only work well at the bedside but know what their role is on the team, can articulate that role very well so everyone understands it, knows everyone else’s role is on the team, and knows how to play their position on the team VERY well

Best Practices Russell Dicks in 1940 Responsible to the administrator Cooperate with other Keep records Ecumenical worship Trained chaplain Appointing chaplain Chaplains influence all Have a rational plan for selecting his patients Actually lets go back to Russell Dicks in 1940 and an article he wrote for the Protestant Hospital Convention in Boston. He identified these eight things that a chaplain should be doing.

Best Practices Handzo describes best practices, 2012: Plan with outcomes Targeting Service line Referrals Screening Standards of practice Staff training and support Certification Cost enhancement Competence Ethics process Handzo describes best practices writing in the book Professional Spiritual & Pastoral Care edited by Rabbi Stephen B. Roberts Chaplaincy care services based on a plan with outcomes Targeting of chaplaincy care Assignment by service line Protocol-based referrals Screening for spiritual and religious concerns Standards of practice for assessment, planning, and outcomes Staff training and support Certification of chaplaincy care staff Contributions to cost enhancement Communication and cultural competence Participation in the ethics process

Best Practices HealthCare Chaplaincy Network What is Quality Spiritual Care in Health Care and How Do You Measure It? Process of Testing and validating high-quality spiritual care Defining and promoting quality indicators in spiritual care HealthCare Chaplaincy Network assembled an international, multidisciplinary panel of experts in the field to develop a standard by which to evaluate a hospitals spiritual care. It has three sections.

Best Practices What is Quality Spiritual Care in Health Care and How Do You Measure It? Structural Indicators Process Indicators Outcomes https://www.healthcarechaplaincy.org/docs/research/quality_indicators_document_2_17_16.pdf