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Spiritual Care in the 21st Century

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Spiritual Care in the 21st Century Challenges and Opportunities May 16, 2012 Presenters Rose Shandrow, System Director Dept. of Mission Operations & Spiritual Care ... – PowerPoint PPT presentation

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Title: Spiritual Care in the 21st Century


1
Spiritual Care in the 21st Century
  • Challenges and Opportunities
  • May 16, 2012

Presenters Rose Shandrow, System Director Dept.
of Mission Operations Spiritual Care
Services Rev Dr. Garrett Starmer, BCC Clinical
Pastoral Education Manager
2
Opening Prayer Lord, Eternal God, we are about
to begin our webinar and we do so with the
awareness that without Your Divine Presence, here
at the center of our gathering and also within
ourselvesour work will be empty. We thank you
for the privilege of belonging to organizations
that are committed to service. May the
spirituality we share grow and develop ever more
fully by the power of your Holy Spirit among
us. We ask that our work be a vessel for us to
serve one another and You. Guide us as we serve
through our health care ministries Grace us
with Your Wisdom and Vision gift us with Holy
Humor and Humility so that not only this
gathering , but all our lives may be a meeting
place for Your Kingdom. We ask this through our
Lord, Jesus Christ, who lives with You in the
unity of the Holy Spirit, now and forever. Amen
3
CHIs Environmental Assessment and Key Drivers of
Change
4
Matthew 16 13-16
5
  • Who do we say we are as chaplains? What roles
    have and will chaplains play in advocating for
    change that creates a better health care system?
  • Who are our stakeholders? Who do they say we
    are?

6
Spiritual Care in the 21st CenturyChallenges and
Opportunities
  • Objectives
  • Recognize challenges and opportunities from a
    clinical perspective
  • Recognize challenges and opportunities from a
    business perspective
  • Consider options that are available to address
    some of the challenges and opportunities

7
  • Future Clinical Needs
  • 1. INTERNAL VIEW- Our self identity as
    Chaplains
  • a. Who are we?
  • b. What do we do?
  • c. How do we do it and what difference does it
    make?
  • d. When do we do it?
  • e. Where do we do it?
  • 2. EXTERNAL VIEW- WHAT WE NEED TO BE DOING a.
    Acute Care Setting
  • b. Community Settings

8
Crisis in HealthCare
  • DANGER
  • OPPORTUNITY

9
Spirit back into Healthcares Body, Mind Spirit
  • Health care in the US is evolving from an
    exclusive concentration on the physical dimension
    of illness to a more holistic model. (Meader,
    2007 77, Meador, K.G. (2004). Jankowski, Handzo
    Flannelly 2011 abstract

10
The medical profession itself is leading the
charge!
  • Puchalski Ferrells book Making Health Care
    Whole makes the point.
  • Spirit is the missing piece of the puzzle in
    health.

11
Spiritual affects healing
  • Evidence grown since 1990s that
  • Spiritual and religious struggle negatively
    effects mental and physical healing and well
    being.
  • Pargament 2001
  • Fitchett, et al 2004
  • Nelson Becker 2006

12
Research needs
  • Testing the Efficacy of Chaplaincy Care
  • Jankowski, Handzo, Flannelly Journal of
    Health Care Chaplaincy 17, nos. 3-4 2011
    100-125
  • Studied the patient outcomes research in the US.

13
  • They described three major trends in healthcare
  • 1. Increased emphasis on palliative care
  • 2. Greater use of electronic documentation,
    into which spiritual interventions and outcomes
    will be integrated
  • 3. People identifying themselves as spiritual
    but not religious or with no religious
    affiliation.

14
  • They underscored the need for the development and
    validation of the following concepts
  • -measures of spirituality,
  • -spiritual risk
  • -spiritual struggle

15
  • They described the need for additional study in
    the areas of
  • What chaplains do that is unique to chaplaincy
    practice
  • How what they do relates directly to patient
    health outcomes
  • Which practices are best for which kinds of
    patients in what patient settings
  • Jankowski, Handzo, Flannelly

16
DEFINE WHO WE ARE AS PART OF THE MEDICAL /
HEALTHCARE TEAM
  • Spiritual Care Providers -Chaplains Traditional
    Emphasis
  • Spiritual Experts
  • Spiritual Healers
  • Spiritual Educators
  • Spiritual Leaders
  • Spiritual Bridge Builders / Partners

17
Full Circle Spiritual Care
Chart persons assessment and outcome.
Outcomes
Whats Next?
Rapport Maintaining
Identifying the results of your full-circle
spiritual care and what the two of you have
accomplished.
Spiritual Outcomes
Assisting the person in choosing, from their
perspective, an appropriate next step
supporting their needs/desires/resources.
Intervention
Spiritual Intervention
With the persons consent, develop a plan of
care. (Spiritual religious support Ethics,
advocacy referral support Change, adjustment
loss support Emotional support, and Leadership
advocacy)
Spiritual Care Plan
Plan
Spiritual Assessment
Assessing the persons needs, desires resources
within the context of Meaning, Hope,
Relationship/community and Holy.
Assessment
Empathy
Bringing empathy and understanding to the
situation. Withholding judgment. Being
self-aware and reacting appropriately. Bringing a
compassionate objectivity for both the
individual/family and the care givers.
Feelings Emotions
Identifying the persons emotions and feelings.
Using your understanding of the situation, story
and empathy to enable the person to begin
identifying, naming and accepting their feelings
and emotions.
Story Listening
Focus, follow, and ask open questions around the
persons story. Explore the content and emotions
presented. Revealing, sharing and expressing
empathy.
Rapport Building
Engaging
Finding a relational way to connect with the
patient, family member or associate. Two-way
engagement with an awareness of what I bring to
the relationship. Engaged/active listening.
Being Present
Attend to the persons needs, rather than only
our own thoughts, feelings, or our need to
help/minister/fix.
Determine need and timing of visit. What is the
persons need? Self-Awareness of what I bring
to the situation.
Showing Up
Adapted from Steve Gomes stair step concept
within Centura Healths Full-circle chaplaincy
18
Spiritual Experts
  • Name what is Spirituality
  • Name what is Spiritual distress
  • Name what is Spiritual Coping/healing
  • Conversant in Mind, Body Spirit Connections and
    healing

19
  • Lucas VandeCreek The Discipline of Pastoral
    Care Giving Foundations for Outcome Oriented
    Chaplaincy
  • Needs, Hopes Resources
  • Spiritual Assessment
  • Concept of the Holy
  • Meaning
  • Hope
  • Community
  • Educate healthcare team in what we do. Language
    that is understandable, intuitive, connects the
    dots of the body, mind and spirit
  •  From woo woo (and little sharing with staff)
    to clear observable language including Spiritual
    Assessment
  • The assessment, interventions and outcomes
    clearly charted

20
Spiritual Expert Spiritual Care Charting
  • EMR Electronic Medical Record
  • What do we chart?
  • Who reads it?
  • How easy is it to get to the Spiritual Care
    Chart?
  • How does staff refer to chaplain?
  • Charting needs to be intuitively understood.

21
SPIRITUAL INTERVENTIONS
  • INTERVENTIONS
  • Advanced Directive Information provided
    (Single) __Yes __No
  • Advanced Directive Comment
  • (Free text) ______________________________________
    __________________________________________________
    __________
  • EMOTIONAL SUPPORT (Multi)
  • __Anxiety reduction initiated __Emotional Health
    Education provided __Empathic Companioning
  • __ Empowered patient __Established Trust
    __Family/ Significant Other supported
  • __Guided Imagery provided __Hope strengths
    identified __Hope struggles identified
  • __Information provided __Meaning strengths
    identified __Meaning struggles identified
  • __Relationship strengths identified __Relations
    hip struggles identified __Other
  • Emotional Comment (free text)_____________________
    _______________________________________________
  • CHANGE, ADJUSTMENT AND LOSS (Multi)
  • __ Change, adjustment, loss education provided
    __End of life discussion/care

22
SPIRITUAL INTERVENTIONS
  • SPIRITUAL AND RELIGIOUS multi)
  • __Anointing of the Sick __ Baptism provided
  • __Beliefs/Values explored __Blessing/Ritual
    provided
  • __Communion provided __Confession/Reconciliation
    provided
  • __Ed. on Spiritual/Rel. issues provided __Forgive
    ness addressed
  • __God/the spiritual strengths identified __God/th
    e spiritual struggles identified
  • __Holy texts/Scripture read/provided
    __Religious leader/community consulted
  • __ Rosary shared/provided __Prayer shared
  • __Spiritual/Religious life explored __Other
  • Spiritual and Religious Comment (Free text)
  • __________________________________________________
    ________________________________________________
  • ETHICS, ADVOCACY AND REFERRAL(Multi)
  • __Addiction discussed/referral/support made
    __Advocated for patient
  • __Care now and/or in the future
    discussed __Ethical issues discussed
  • __Ethics Committee called __ Ethics, advocacy
    or referral education provided
  • __Family Conference facilitated __Healthcare
    team-Pt./Fam. communication facilitated

23
  • Built in bias in medical
  • Opening Screen Cerner SBAR
  • Interdisciplinary Plan of Care
  • Problems
  • Consults
  • Narrative charting check point charting

24
Spiritual Healers
  • Know what we do
  • Know how what we do effects the patients
    outcomes
  • (Jankowski, Handzo, Fannelly)

25
Spiritual Educators
  • Educate about spirituality
  • Hope, Meaning, Holy, Community/Relationships
  • Spiritual Distress
  • Spiritual Coping
  • How the spiritual is essential to healthcare
    outcomes- body, mind, spirit
  • How they can staff meet spiritual needs
  • When to call a chaplain

26
Spiritual Educators
  • Educate local Faith leaders re health care
  • Educate local Faith group leaders re positive
    connection between positive faith and healing
  • Offer Religious leaders list of social services -
    be a bridge with healthcare functions

27
Spiritual Educators
  • Expand understanding of healthcares financial
    pressures
  • Become conversant in business language
  • Become conversant in balance sheets
  • Become conversant in organizational processes
  • Become conversant in showing cost-savings of
    spiritual care.
  • Polish Presenting skills

28
Spiritual Leaders
  • Care for Medical team
  • Care with the Medical Team
  • Care based on ERDs
  • Care based on Mission and Values-
  • Lead team in workplace spirituality

29
Spiritual Bridge Builders/Partners
  • What types of collaborative processes can we
    engage in with local religious leaders?
  • Collaborate with local faith group leaders for
    health of congregation members
  • Team with Parish Nurses for coordination of
    congregants- patients as move into the community
  • Team with CPE in education of Church Leaders

30
External View
  • Outpatient settings
  • Community offering of care
  • Connect with homecare agencies
  • Work with Social Service Agencies
  • Catholic Community Services
  • Catholic Charities
  • Salvation Army

31
Technology
  • Skype type communication
  • Remote communication
  • Education

32
Cultural/Religious Expertise
  • Spiritual but not Religious
  • Multi-cultural/faith society

33
Research
  • Foundational
  • Essential

34
Business Casein support of Spiritual Care
Services
Challenges Opportunities
35
Catholic Health Association Spiritual Care
Advisory Committee Objective Become a
national voice to educate/advocate for roles and
benefits of professional chaplaincy, and the
value of spiritual care as core to Catholic
health cares identity
36
Clinical Team
  • When seeking assistance from spiritual care and
    professional chaplaincy, what are your asking
    for?
  • As a nurse, when would you refer a patient and
    why?
  • What is your understanding of professional
    chaplaincy and what more do you need to know
    better about the role of chaplains?

37
Executive Team
  • As CEO, what do you understand as the purpose and
    value of spiritual care and professional
    chaplaincy?
  • As CFO, in view of the budget shortfalls in
    healthcare, what additional information do you
    need to have about the value added of spiritual
    care and chaplaincy to feel comfortable in your
    decision-making?

38
Process
  • After the Catholic Health Association Assembly,
    an online survey will be made available through
    mission leaders requesting participation from
    executives and clinical team members.
  • Survey will be available for three weeks-
  • June 11-29, 2012
  • Results will be collated and studied by the CHA
    Spiritual Care Advisory Council
  • Information received will aid in developing and
    communicating messages for respective audiences.

39
Division of Mission Operations/Spiritual
CareDirect Care Encounters by both Chaplains
CPE Residents/Internsn16,638
40
Sources of Referrals-CombinedFiscal Year to Date
41
Categories of Spiritual Care Needs
Addressed-CombinedFiscal Year to Date
42
(No Transcript)
43
(No Transcript)
44
Division of Mission Operations/Spiritual
CareSpiritual Care Interventions-CombinedFiscal
Year to Daten60,778
45
(No Transcript)
46
Franciscan Health System How Spiritual Care
Supports Holistic Care and Healing in our Health
Care System

47
To wish for change will change nothing To make
the decision to take action right now will change
everything. Nick Vujicic
48
Questions??
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