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Healthcare Delivery in the 21st Century: Providing Interdisciplinary Spiritual

Care

Facilitators: Alan E. Bowman, MDiv, MBAVP, Ministry FormationCatholic Health Initiatives

Rose Shandrow, MDivSystem Director ,Mission Operations &

Spiritual CareFranciscan Health System

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• Opening Prayer• A Brief Review • Objectives for this Session• Interdisciplinary Care:

• Inpatient Example - Palliative Care• Outpatient Example – Parish Nursing

• Interdisciplinary Care: - Use of Technology to Offer Spiritual Care Beyond Physical Boundaries

Opening Prayer

Irish Blessing

May the morning sun stir you from bedMay the winds of March move you on the road

May the rains of April renew your strengthMay the flower of May captivate your sight

May summer heat inflame your zealMay autumn color stimulate your dreams

May the silver moon make you wiser; yet may you never be with your self content.

May Jesus and Mary keep you young,Full of life, laughter; and an Irish song.

Edited and adapted from A Blessing for Challenge by Fr. Andrew Greeley

Healthcare Delivery in the 21st Century: Providing Interdisciplinary

Spiritual Care

ObjectivesAt the end of the module, participants will be able to:

• Articulate how chaplains can effectively participate in the interdisciplinary team to empower a team approach to the provision of spiritual care

• Will be able to articulate specific examples of how chaplains can support interdisciplinary team members in a collaborative approach to spiritual care

•Identify some innovative ways to use technology to expand the provision of spiritual care over distances that were previously viewed as barriers

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Aging Chronic Disease

Physician Dynamics

Payment / Financial Trends

Catholic Identity Health Care Reform

Treatment & Technology

TalentRural Challenges

Consumerism

Juan Iregui, MDFranciscan Health System

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Debbi Saint, RN, BSN, FCNCoordinator, Congregational Health Ministries

Franciscan Health System

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•Provide a brief history and definition of faith community nursing and its roles.

•Describe our health care organization’s spiritual care program and its relationship with faith community nurses.

•Provide examples and ideas of collaborative practice between health care chaplains, faith community nurses and community clergy.

Objectives

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•Judeo-Christian roots with deacons and deaconesses, monks and nuns, parish nursing and the nursing profession itself

•Modern day pioneer: Granger Westburg, a Lutheran pastor and hospital chaplain

•Relationship between spiritual well-being and physical health

•1984, pilot project of partnership of 6 community churches with Lutheran General Hospital in Chicago, first parish nurse program

A. Djupe, et al., Reaching Out: Parish Nursing Services, International Parish Nurse Resource Center, 1994

Faith Community Nursing

History

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•The intentional integration of the practice of faith with the practice of nursing.

•Assumes that health is a journey toward well being and is the interrelationship of body, mind, and spirit.

•Assumes that health is not merely the absence of disease. It is related to everything a person does, thinks, and feels; therefore parish nurses focus on the whole person as they promote wellness, disease prevention, health education, and healthy spirituality.

International Parish Nurse Resource Center - A Ministry of the Church Health Center

What is a Faith Community Nurse? (Parish Nurse)

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•Integrator of faith and health•Health Educator•Health Advocate•Health Counselor•Referral Advisor•Support Group Developer•Health Team Volunteer Coordinator

Faith Community Nursing Roles

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•Not a physician

•Not a home health nurse

•Will not dispense medications or provide prescribed treatments •Not a therapist

•Not clergy

What a Faith Community Nurse is not:

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Mission Operations and Spiritual Care Department

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•Sponsored by Franciscan Health System•Network of faith community nurses and health ministers•Sharing and supporting each other•Continuing education and training•Opportunities for grant funded projects•Guidance in starting a health ministry programs•Access to health system resources•Monthly support meetings•Partners with Pacific Lutheran University and Northwest Parish Nurse Ministries

Congregational Health Ministries

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Spiritual Care Triad:Health Care Chaplain, Faith Community Nurse

and Community Clergy

Faith Community Nurse

Community Clergy

Health Care Chaplain

Patient/Congregation Member

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Cross referrals•Pre-hospitalization preparation (ie Advance Directives, chaplaincy services)•Hospice•Discharge/Care transition referrals

Education•Clinical Pastoral Education•Chaplains faculty for Faith Community Nurse Course•Community Forums

Promotion•Introduction of faith community nursing•Promotion of Hospital Services

Triad Collaborative Activities

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•a strengthened link between faith and healing at the congregational and health care level

•increased support for church health ministry programs that also transect health care organizations• •promotion of health care organization and its outreach into the community

•increased coordination of care that focus on achieving holistic health,• •an opportunity to learn and utilize the knowledge, skills and talents of the other

•resulting opportunities that this will unfold for further collaboration.

Outcomes

Julie Jones, Executive Director, Mission & Ministry

Mercy Mission & Ethics

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Trends & Context E-chaplaincy Collaboration with Mercy Clinics

(physician offices) Emerging Integration

Mercy’s strategic plan Electronic medical records Emergence of medical home model and

care management Telemedicine Growing consumer desire for on-line

information

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This is a complete paradigm shift: from a pastoral visit to an ongoing relationship from pen/paper to computer/technology from acute care to patient care site/home from “come to us” to “we meet you where you are” From in-person encounter to contact from silo to integration -Kenneth Potzman, Director, Pastoral Services, Mercy’s Eastern Communities

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Using e-mail to provide spiritual care

Allows access to a chaplain at times that are convenient

Enables Mercy to extend pastoral services beyond acute care center

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Initial thought of way to extend staff ministry

Offer chance for co-workers to connect with chaplain via e-mail

Intranet

Built and expanding Internet Patient Portal

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95% of patient encounters are outside of hospital

Pastoral Services strategic goals are aligned with Mercy’s

VISION: Everywhere and every way Mercy serves, attention to spiritual needs will be evident.

The delivery of pastoral services will look different in clinic setting than it does in hospital. Cannot just export what exists in hospitals

Need to intentionally plan appropriate attention to spiritual care in Mercy Clinic sites

Redesign priorities and expectations of where chaplains spend time

Pastoral Services resources (people, expertise, printed materials, successful practices) shared across the ministry

Use new technology to connect chaplains with patients in clinics

Approach clinic leaders—physicians and office managers

Invite to be “learning partners”

Process to identify spiritual needs Screening, Awareness

Referral process Patient education Strong suggestion Consult ordered

Response to the referral Timing How: in person, phone, e-mail, video

Outcomes and quality

Education is not enough to generate referrals

Referrals cannot be dependent on the personality of or relationship with a chaplain

Need screening tools and “triggers” to ensure appropriate referrals

Integration into the care team model

Medical home

Oncology – navigator (care management)

Do not need a chaplain physically present in clinic setting

Technology enables coverage E-chaplaincy (e-mail) Phone Video consult Video training

Work with Care Managers to identify protocols for referrals

Triggers for a referral Appropriate responses Communicating interventions Outcomes

Exploration about how to support growing telemedicine consults

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• Dialogue: What are your questions?