As health care settings become more focused on patient experience and care for the whole person, issues of culture, diversity, personal beliefs, and values have come to the forefront. Staff are expected to deliver not only high-quality clinical care but to do so with compassion and care. Neither of these elements are new, but they are gaining attention as health care is increasingly measured on a number of quality indicators, including patient satisfaction and outcomes.
As health care leaders and administrators face these challenges, unfortunately, many are unaware of a valuable resource that can contribute to their clinical care and organizational goals: professional chaplains. At the same time, they can do their share to help advance optimal spiritual care, to benefit their patients and their families, staff, and organization.
Professional chaplains have been part of hospitals and other health care settings for decades: spiritual care specialists who contribute a unique expertise to interdisciplinary teams. The credentials of a professional chaplain demonstrate a rigorous training similar to other disciplines: graduate degree, clinical residency, demonstration of competency, national certification or credentialing, and annual continuing education.
They bring expertise that is essential to patient and family care, including: assessing, responding, documenting and communicating issues of spiritual distress and interventions to other members of the team; acting as cultural brokers, ensuring beliefs and practices are identified and integrated into care; participating in invaluable conversations when ethical issues arise and consultations are needed; and educating physicians and other clinical staff on spiritual, religious, existential or cultural components that influence beliefs and values, as well as how they can respond as “spiritual care generalists.”
Yet, at a time when perhaps health care chaplains can be more of an asset than ever, there are several issues that have been inhibiting the profession. They are issues that cannot be ignored, not just within the discipline of chaplaincy but by health care leaders.
While professional chaplains, like other disciplines, have graduate education and clinical training, they are also trained in a specialized model, partly because of the expertise they bring, the issues they address and facilitate, and the uniqueness of their role as members of the health care team. For the most part, the current method of training chaplains has remained the same for decades, despite the changes in not only health care but also in the educational advances that other disciplines have incorporated: standardized patients, online learning, and a set of outcome-focused competencies that are validated not only by subjective evaluation but objective testing.
As a result, rural and small town health care settings often find themselves addressing spiritual care needs by hiring untrained chaplains or community religious leaders, which impacts both the quality of care provided and the sensitivity to diversity that is required. In addition, the other members of the clinical team aren’t able to receive the training and support they need — and ask for — in providing generalist spiritual care.
An accompanying issue is the need for a consistent continuing education pathway for chaplains to increase their skills as they grow in the profession and to be able to respond alongside other disciplines to changes in health care delivery.
Health care organizations, administrators, physicians, nurses, and other professionals, as well as the patients and families served, deserve better. It is long past time to determine how to bring training to those who wish to become professional chaplains, those who want to continue to advance their knowledge, and those from other health care disciplines who want to include attention to spiritual needs as a component to their scope of practice.
Also blocking chaplaincy from being on par with other disciplines and, thus, perhaps on the radar of administrators, has been the lack of specific quality indicators and scope of practice in this field. This has now changed.
A distinguished, international panel of experts recently developed and released quality indicators, the field’s most comprehensive evidence-based indicators that demonstrate the quality of spiritual care in health care, along with the metrics that indicate such care is present and suggested evidence-based tools to measure that quality. The set of 18 indicators include spiritual care that reduces spiritual distress, increases client satisfaction, and facilitates meaning-making for clients and family members.
On the heels of this, a separate panel of interdisciplinary experts developed and released the first evidence-based scope of practice, or set of competencies, for professional chaplaincy. They describe how chaplains can help their organizations meet the quality indicators and “effectively and reliably” provide best quality spiritual care.
The statements most directly impact professional chaplains, but they have broad ramifications for spiritual care and health care in general. They give spiritual care specialists, other providers, and administrators a framework in which to provide quality spiritual care in health care settings while also informing the training and ongoing education of chaplains. With them, organizations can better access and guide the provision of spiritual care and demonstrate its value to health care outcomes.
As the profession continues to evolve, there are several actions health care leaders can — and should — do now.
The first step is determining whether your organization has a chaplain(s) on the team. If not, an essential element of whole-person care is missing.
Next, ensure that the chaplain has the education, training and credentialing that is recognized within the profession, and advocate for competency for best patient outcomes.
Encourage other members of the interdisciplinary team to obtain basic knowledge of spiritual care to incorporate into their scope of practice and to facilitate interactions with and referrals to chaplains.
Read the quality indicators and scope of practice documents, and, in collaboration with the organization’s chaplaincy department, commit to the suggested quality indicators and competencies.
Make your voice known that you value chaplains as members of the interdisciplinary team, and support the move within the profession to explore new avenues of training, standardization of practice, and commitment to research and quality.
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