Metrics in Spiritual Care

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Metrics in Spiritual Care

• What to Measure and Why

Dean V. Marek Mayo Clinic, Rochester
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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?

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We use metrics all the time
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so why not use metrics inchaplain services?

• we do it subconsciously anyway!
• Bring it out into the light!

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Are Chaplains Professionals?

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

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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

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Accountabilitymotivation toward a particular
goal

• what is measurable?
• quantity
• quality
• what is the common factor?
• time

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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

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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)

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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

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Units of Service (UOS)

• a Service Event (SE) times its Relative Resource
  Unit (RRU) equals a unit of service (UOS)
• SE x RRU UOS
• 50 - SE 1 x 2.50 125.00
• 60 - SE 2 x 4.00 240.00
• 46 - SE 3 x 6.20 285.20
• One Month Total UOS 650.20

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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

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come again?
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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

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Heres How It All Fits Together
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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 650.20
• 01/09 Expense per UOS 15.38

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Cost of Services at 15.38 per UOS

• Service Event RRU Cost
• SE - 1 2.50 38.45
• SE - 2 4.00 61.52
• SE - 3 6.20 95.36

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Quantity - 2

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

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Unmet Needs
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Unmet Needs
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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

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Quantity - 3

• why count services provided?
• what can the numbers show?
• assignment of resources
• department and individual productivity
• other?

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Reprise

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

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Quality skill, methods, character, standards

• elements in each encounter that are
  measurable/observable
• greeting
• rapport/mutuality
• spiritual assessment
• religiosity
• spirituality and practices

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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

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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

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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

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Quantity/Quality Improvement

• what else can the numbers show?

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The End

• Questions marek.dean_at_mayo.edu