1. Metrics in Spiritual Care
What to Measure and Why
Dean V. Marek
Mayo Clinic, Rochester

2. Your Expectations
when you read the schedule and the topic of my presentation, what did you want to see covered, ask about, or comment on?

3. We use metrics all the time

4. so why not use metrics in chaplain services?
we do it subconsciously anyway!
Bring it out into the light!

5. Are Chaplains Professionals?
definition of professionalism:
1. skillfulness by virtue of possessing special knowledge
2. professional status, methods, character, or standards

6. A “Raw” View of Professionalism
"a focused, accountable, confident, competent, motivation toward a particular goal, with respect for hierarchy and humanity, less the emotion" Edward B. Toupin

7. Accountability “motivation toward a particular goal”
what is measurable?
quantity
quality
what is the common factor?
time

8. Variability the human factor individuality of the patient/client
skill and experience of chaplain as Independent practitioners
when services provided are:
self-initiated or by referral

9. Quantity - 1 why count services provided? what can the numbers show?
metric for accountability
report for goals achieved
cost for services (expense per Unit of service)

10. Relative Resource Unit
a relative resource unit (RRU) is the factor of each service event relative to the amount of time it takes to provide that service.
time is the common factor for every provider
the service that takes the least amount of time has an baseline RRU of 1.0
another service that takes 25 minutes has an RRU factor of 2.5

11. Units of Service (UOS) 50 - SE #1 x 2.50 = 125.00
a Service Event (SE) times its Relative Resource Unit (RRU) equals a unit of service (UOS)
SE x RRU = UOS
50 - SE #1 x =
60 - SE #2 x =
46 - SE #3 x =
One Month Total UOS =

12. Expense per Unit of Service (UOS)
an Expense per UOS is determined by dividing the budget by the total number of units of service (all service events times their Relative Resource Unit)
Budget  Total UOS = Expense per UOS

13. come again?

14. Expense per UOS
an Expense per UOS is the way we report direct patient care activity in relation to the budget for our department
It is our method of accountability to our administration
It is expected that we meet or beat our Expense per UOS on a monthly basis

15. Here’s How It All Fits Together

16. Calculating an Expense per UOS
Budget  Total UOS = Expense per UOS
2009 Plan $120,000.00
01/09 Total Direct Expense $10,000.00
01/09 Service Events x RRU =
01/09 Expense per UOS $15.38

17. Cost of Services at $15.38 per UOS
Service Event RRU Cost
SE - # $38.45
SE - # $61.52
SE - # $95.36

19. Quantity - 2 why count services provided? what can the numbers show?
unmet needs - i.e., what remains to be done (how is this done?)

20. Unmet Needs

21. Unmet Needs

22. Unmet Patient Needs
60% (300 patients) receive spiritual/pastoral care at least once during their stay
40% (200 patients) do not
If chaplains were to care for those 200 patients they would find that:
27% would result in a pastoral contact
73% would result in a significant spiritual care intervention

23. Quantity - 3 why count services provided? what can the numbers show?
assignment of resources
department and individual productivity
other?

24. Reprise definition of professionalism:
1. skillfulness by virtue of possessing special knowledge
2. professional status, methods, character, or standards.

25. Quality “skill, methods, character, standards”
elements in each encounter that are measurable/observable:
greeting
rapport/mutuality
spiritual assessment
religiosity
spirituality and practices

26. Quality “skill, methods, character, standards”
elements in each encounter that are measurable/observable:
spiritual/pastoral issues addressed
service or services provided
outcome of the intervention
client response to the intervention
follow up plan

27. Quantity/Quality Improvement
department dashboard metrics
expense per UOS (drill down to cause of increase or decrease)
productivity (drill down to teams, individuals, services)
chaplain response time – codes, referrals
death protocol follow through

30. Quantity/Quality Improvement
referral sources with max and min times of day; e.g. time frame when am-admit patients want a priest for anointing
patient unit use of chaplain resources
ministry to staff
continuity of care –referrals out

31. Quantity/Quality Improvement
what else can the numbers show?

32. The End
Questions: