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Spiritual Care in Clinic Offices (Outpatient)


Spiritual Care in Clinic Offices (Outpatient) CHE Spiritual Care Champions October 16, 2013 Introductions Chaplain Ellis Robinson, BCC ... – PowerPoint PPT presentation

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Title: Spiritual Care in Clinic Offices (Outpatient)

Spiritual Care in Clinic Offices (Outpatient)
  • CHE Spiritual Care Champions
  • October 16, 2013

  • Chaplain Ellis Robinson, BCC
  • Chaplain Susan Stucco, BCC
  • Julie Jones, Exec. Director, Mission Ministry

  • Context for our work with Mercy Clinic
  • Assumptions
  • Evolution
  • Working within clinic environment
  • Getting and responding to referrals
  • Changing role of chaplain

Backdrop for Presentation
Why has Mercys Pastoral Services extended to
clinic setting?
  • 96 of patient encounters are outside of hospital
  • Pastoral Services Strategic Goals are aligned
    with Mercys
  • Pastoral Services VISION
  • Everywhere and every way Mercy serves,
  • attention to spiritual needs will be evident.

About Mercy Clinic
  • 1,900 integrated physicians
    practicing in 300 locations
  • Physician led,
    professionally managed
  • Primary care doctor
    and specialists

    are linked by
    electronic health record

Assumptions in Planning
  • Redesign priorities and expectations of
    where and how chaplains
    spend time
  • Cannot just export what exists in hospitals
  • Try new things and learn from them

Assumptions in Planning
  • Pastoral Services resources shared across the
  • Use new
    technology to
    connect chaplains
    with patients in

We are walking on a bridge we are building.
  • FY2011 Began assigning a few chaplains to a
    few clinics
  • FY2012 Conducted pilots to learn more,
    focusing on identifying needs and referrals
  • FY 2013 Compiled Learning and Tools
  • FY2014 (current year) - Expanding and Refining

Learn Culture and Rhythm of Clinic
  • Fast paced, lots of movement
  • Build on what is present
  • Clinical staff already recognize spiritual needs
    and provide some spiritual care
  • What is present in this clinic
  • Physicians and providers in clinic often have
    deep and long-term relationship with patients

Processes and Tools
  • Defined approach
  • Developed training for chaplains about approach
  • Refine education chaplains brought to clinics
  • Developed promotional materials
  • Surveyed clinics
  • Tracked referrals

Getting in the door
  • Introduction important to get welcomed
  • Part of formation efforts in clinic setting
  • Make relevant to their work/patient care
  • Clarify Chaplains purpose for being there
  • Staff support
  • Patient care
  • Education/training
  • Recognizing needs
  • Make referrals

Lessons Learned Start with Education
  • Work within schedule of clinics
  • Education focused on
  • How to recognizing spiritual needs
  • What staff is doing to address basic spiritual
  • How to refer to chaplain

Lessons Learned Getting Referrals
  • Infrastructure/processes for doing so
  • How does staff refer to chaplain who is not in
  • May need to build over time
  • Build trust and skill of staff for referrals
  • Affirming good referrals and following up on them
  • Utilizing communication tools that exists with
    this group
  • Newsletters
  • Gathering

What are we getting referrals for?
  • Coping
  • With illness, new diagnosis
  • Fetal demise
  • Prayer/meditation
  • Fear/anxiety
  • Be available for patient getting bad news
  • Continuity of care from office to direct admit
    to hospital

After referralpatient care
  • Various ways of providing this
  • Face-to-face
  • Phone
  • Follow-up with appointment
  • E-mail after initial phone call
  • Follow-up with staff who made referral to
    reinforce and build their confidence in making

Emerging distinct components
  • Screening
  • Identify need
  • Create referral
  • Referrals for risk of and/or actual spiritual
  • Formal or Informal Assessment
  • Response to a Referral
  • Documentation (EHR)
  • Creates basis for plan of care
  • Interventions
  • Patient outcomes

Different needs from different specialties
  • Survey revealed different needs based on acuity
    risk for and actual spiritual distress
  • Convenient Care
  • Oncology
  • Cardiology
  • Womens health

Spiritual care interventions/needs
  • Chaplains use same skills that they
    used/developed in hospital to meet needs
  • Calming presence
  • Compassionate, active listening to help
  • Patient find their own resources
  • Assist patients in identifying next steps
  • Crisis intervention/support
  • Encourage getting support in places available
  • Make referrals to other disciplines

Distinct spiritual care interventions/ needs
  • Goal of Physician Prevention
  • Clinical staff recognize patients that have
    spiritual crisis that is leading to health care
    crisiswhat can they do to prevent?
  • Part of team for patient care in distinct way
    once illness is present
  • Consistency
  • Over time, not just acute episode for hours or

Unique challenges or barriers for spiritual care
  • Physician understanding of role of spiritual care
    and chaplain
  • Distance between chaplain and clinic locations
  • May not be space for private consultation
  • Patient needs sporadic, episodic
  • Electronic medical record for clinic was distinct
    from inpatientneeded to learn

Group work in clinic setting
  • Debriefing/support with clinics when there is
    some critical event
  • Chaplains have supported some chronic disease
    management groups

Special competencies required of chaplains
  • Passionate about ministry to patients and this
    new place
  • Great communication
  • Professional-confidence in being expert in
    spiritual care
  • Empowering/teaching
  • Flexible with new ways of serving and using
  • Ability to evolve chaplain identity
  • Innovative
  • Part of research
  • Proactive, self-starter and independent yet team
  • Comfortable with layers of accountability-
    multiple teams

Chaplains Perspectives
  • Energizing
  • Changing traditional role

Questions and comments
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