1. 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

2. 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

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

4. 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

5. 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

6. 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)

7. 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.

8. 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.

9. 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

10. 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

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

13. 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

14. 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?

15. 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?

16. 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?

18. 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

19. 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.

20. 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

21. 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.

22. Best Practices
What is Quality Spiritual Care in Health Care and How Do You Measure It?
Structural Indicators
Process Indicators
Outcomes