1. Healthcare Delivery in the 21st Century: Providing Interdisciplinary Spiritual Care
Facilitators: Alan E. Bowman, MDiv, MBA
VP, Ministry Formation
Catholic Health Initiatives
Rose Shandrow, MDiv
System Director ,Mission Operations & Spiritual Care
Franciscan Health System

2. Healthcare Delivery in the 21st Century: Providing Interdisciplinary Spiritual Care
Opening Prayer
A Brief Review
Objectives for this Session
Interdisciplinary Care:
Inpatient Example - Palliative Care
Outpatient Example – Parish Nursing
Interdisciplinary Care: - Use of Technology to Offer Spiritual Care Beyond Physical Boundaries 2

3. Opening Prayer Irish Blessing May the morning sun stir you from bed
May the winds of March move you on the road
May the rains of April renew your strength
May the flower of May captivate your sight
May summer heat inflame your zeal
May autumn color stimulate your dreams
May the silver moon make you wiser;
yet may you never be with your self content.
May Jesus and Mary keep you young,
Full of life, laughter; and an Irish song.
Edited and adapted from
A Blessing for Challenge
by Fr. Andrew Greeley

4. Healthcare Delivery in the 21st Century: Providing Interdisciplinary Spiritual Care
Objectives
At the end of the module, participants will be able to:
 Articulate how chaplains can effectively participate in the interdisciplinary team to empower a team approach to the provision of spiritual care
Will be able to articulate specific examples of how chaplains can support interdisciplinary team members in a collaborative approach to spiritual care
Identify some innovative ways to use technology to expand the provision of spiritual care over distances that were previously viewed as barriers

5. Environmental Assessment and Key Drivers of Change
Consumerism
Aging
Chronic Disease
Catholic Identity
Health Care Reform
Physician Dynamics
Rural Challenges
Talent
Treatment & Technology
Payment / Financial Trends 5

6. Interdisciplinary Spiritual Care Palliative Care
Juan Iregui, MD
Franciscan Health System

7. Interdisciplinary Spiritual Care Parish Nursing
Debbi Saint, RN, BSN, FCN
Coordinator, Congregational Health Ministries
Franciscan Health System

8. Objectives
Provide a brief history and definition of faith community nursing and its roles.
Describe our health care organization’s spiritual care program and its relationship with faith community nurses.
Provide examples and ideas of collaborative practice between health care chaplains, faith community nurses and community clergy.

9. Faith Community Nursing History
Judeo-Christian roots with deacons and deaconesses, monks and nuns, parish nursing and the nursing profession itself
Modern day pioneer: Granger Westburg, a Lutheran pastor and hospital chaplain
Relationship between spiritual well-being and physical health
1984, pilot project of partnership of 6 community churches with
Lutheran General Hospital in Chicago, first parish nurse program
A. Djupe, et al., Reaching Out: Parish Nursing Services, International Parish Nurse Resource Center, 1994

10. What is a Faith Community Nurse? (Parish Nurse)
The intentional integration of the practice of faith with the practice of nursing.
Assumes that health is a journey toward well being and is the interrelationship of body, mind, and spirit.
Assumes that health is not merely the absence of disease. It is related to everything a person does, thinks, and feels; therefore parish nurses focus on the whole person as they promote wellness, disease prevention, health education, and healthy spirituality.
International Parish Nurse Resource Center - A Ministry of the Church Health Center

11. Faith Community Nursing Roles
Integrator of faith and health
Health Educator
Health Advocate
Health Counselor
Referral Advisor
Support Group Developer
Health Team Volunteer Coordinator

12. What a Faith Community Nurse is not:
Not a physician
Not a home health nurse
Will not dispense medications or provide prescribed treatments
Not a therapist
Not clergy

13. Supervisor in Training (Congregational Health Ministries)
Mission Operations and Spiritual Care Department
System
Director
Healthcare
Chaplains
Pastoral Care
Volunteers
Clinical
Pastoral Education
Manager
Residents
Interns
Supervisor
Supervisor in Training
Faith Community
Nurse
Coordinator
(Congregational Health Ministries)
Nurses
(Partners)
Administrative
Assistant

14. Congregational Health Ministries
Sponsored by Franciscan Health System
Network of faith community nurses and health ministers
Sharing and supporting each other
Continuing education and training
Opportunities for grant funded projects
Guidance in starting a health ministry programs
Access to health system resources
Monthly support meetings
Partners with Pacific Lutheran University and Northwest Parish Nurse Ministries

15. Spiritual Care Triad: Health Care Chaplain, Faith Community Nurse
and Community Clergy
Health Care Chaplain
Patient/
Congregation Member
Faith Community Nurse
Community Clergy

16. Triad Collaborative Activities
Cross referrals
Pre-hospitalization preparation (ie Advance Directives, chaplaincy services)
Hospice
Discharge/Care transition referrals
Education
Clinical Pastoral Education
Chaplains faculty for Faith Community Nurse Course
Community Forums
Promotion
Introduction of faith community nursing
Promotion of Hospital Services

17. Outcomes
a strengthened link between faith and healing at the congregational and health care level
increased support for church health ministry programs that also transect health care organizations
promotion of health care organization and its outreach into the community
increased coordination of care that focus on achieving holistic health,
an opportunity to learn and utilize the knowledge, skills and talents of the other
resulting opportunities that this will unfold for further collaboration.

18. Executive Director, Mission & Ministry
Interdisciplinary Spiritual Care Use of Technology to Offer Spiritual Care Beyond Physical Boundaries
Julie Jones,
Executive Director, Mission & Ministry
Mercy 
Mission & Ethics

19. Interdisciplinary Care: Use of Technology to Offer Spiritual Care Beyond Physical Boundaries
Trends & Context
E-chaplaincy
Collaboration with Mercy Clinics (physician offices)
Emerging Integration

20. Trends impacting pastoral services
Mercy’s strategic plan
Electronic medical records
Emergence of medical home model and care management
Telemedicine
Growing consumer desire for on-line information

21. Context: “New and exciting method for the delivery of spiritual care”
This is a complete paradigm shift:
from a pastoral visit to an ongoing relationship
from pen/paper to computer/technology
from acute care to patient care site/home
from “come to us” to “we meet you where you are”
From in-person encounter to contact
from silo to integration
-Kenneth Potzman, Director, Pastoral Services, Mercy’s Eastern Communities

22. E-chaplaincy Using e-mail to provide spiritual care
Allows access to a chaplain at times that are convenient
Enables Mercy to extend pastoral services beyond acute care center

23. E-chaplaincy growth Initial thought of way to extend staff ministry
Offer chance for co-workers to connect with chaplain via
Intranet
Built and expanding
Internet
Patient Portal

24. Extending Pastoral Care to Clinic
95% of patient encounters are outside of hospital
Pastoral Services strategic goals are aligned with Mercy’s
VISION: Everywhere and every way Mercy serves, attention to spiritual needs will be evident.

25. Assumptions in Planning
The delivery of pastoral services will look different in clinic setting than it does in hospital.
Cannot just export what exists in hospitals
Need to intentionally plan appropriate attention to spiritual care in Mercy Clinic sites

26. Assumptions in Planning
Redesign priorities and expectations of where chaplains spend time
Pastoral Services resources (people, expertise, printed materials, successful practices) shared across the ministry
Use new technology to connect chaplains with patients in clinics

27. Clinic Demonstration Projects
Approach clinic leaders— physicians and office managers
Invite to be “learning partners”

28. Focus of Demonstration Projects
Process to identify spiritual needs
Screening, Awareness
Referral process
Patient education
Strong suggestion
Consult ordered
Response to the referral
Timing
How: in person, phone, , video
Outcomes and quality

29. Lessons Learned – Referrals
Education is not enough to generate referrals
Referrals cannot be dependent on the personality of or relationship with a chaplain
Need screening tools and “triggers” to ensure appropriate referrals

30. Referrals - What worked
Integration into the care team model
Medical home
Oncology – navigator (care management)

31. Lessons Learned – Staffing
Do not need a chaplain physically present in clinic setting
Technology enables coverage
E-chaplaincy ( )
Phone
Video consult
Video training

32. Emerging Integration
Work with Care Managers to identify protocols for referrals
Triggers for a referral
Appropriate responses
Communicating interventions
Outcomes
Exploration about how to support growing telemedicine consults

33. Dialogue: What are your questions?
Healthcare Delivery in the 21st Century: Providing Interdisciplinary Spiritual Care
Dialogue: What are your questions? 33