So appropriate to what professional chaplains do: "We do not believe in ourselves until someone reveals that something deep inside us is valuable, worth listening to, worthy of our trust, sacred to our touch. Once we believe in ourselves we can risk curiosity, wonder, spontaneous delight or any experience that reveals the human spirit." - e e cummings (hat tip to Gratefulness.org)
The Advanced Palliative Care Chaplaincy Specialty Certificate is a joint program of the California State University Institute for Palliative Care and HealthCare Chaplaincy Network.
If you are a Board Certified Chaplain or have completed the Fundamentals / Palliative Care Chaplaincy Specialty Certificate course, the Advanced course is designed to help chaplains play a strong leadership role in their palliative care team. It teaches the skills necessary to effectively work within, lead, and enhance the effectiveness of a palliative care team:
This course begins June 15, 2016, and there are only a few seats left. If you’d like to reserve your spot, please call today or register online. You must be a board certified chaplain or have completed the Fundamentals course to register for this course.
For details and to register: https://csupalliativecare.org/programs/chaplaincy-2/
The goals of this webinar are to:1. Educate all in the field around Medicare Access and CHIP Reauthorization Act (MACRA), Merit Based Incentive Payment Systems (MIPS), and Advanced Payments Models (APMs);2. Identify possible opportunities and pitfalls for palliative care; and3. Solicit comments and questions from our audience.
This no charge webinar will provide an overview of the new payment rules and potential opportunities created under the Medicare Access and CHIP Reauthorization Act (MACRA), along with practical guidance for palliative care providers to implement these changes. Presenters will also solicit participants’ questions, concerns, and suggestions to inform formal responses to Centers for Medicare and Medicaid Services (CMS), which are due June 27.
For readers who may not be familiar with CHIP, per the CMS website: “The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
Please contact Stacie Sinclair (email@example.com) with any questions.
Twelve years ago under the initiative and financial support of HealthCare Chaplaincy Network (HCCN) the Common Standards for Professional Chaplaincy were adopted by six chaplaincy and pastoral counseling membership associations in North America. Throughout the last decade there has been a significant amount of new evidence in the area of spiritual care and the profession of chaplaincy as well as significant changes in the delivery of health care. In view of these changes, HCCN once again took the initiative and gathered an international panel to review the competencies for professional health care chaplaincy taking into consideration developments which would impact these competencies. The result was the HCCN product entitled "Scope of Practice."
The content of this first ever evidence-based Scope of Practice for health care chaplaincy addresses the needs of today's health care environment which demand demonstrated outcomes and value. In addition this document, which is mirrored in other professions, enables professional chaplains to be recognized as qualified in their field as physicians, nurses, social workers, and others are in theirs. The "Scope of Practice" document, which incorporates standards from the 2004 Common Standards and from other models from around the globe, now defines The New Standards for Professional Chaplaincy. It aligns with the evidence-based Quality Indicators document, entitled "What Is Quality Spiritual Care in Health Care and How Do You Measure It," also developed by an international multidisciplinary panel of experts.
Both documents were disseminated earlier this year and have received widespread approval in the professional chaplaincy and spiritual care world. In addition, HCCN has encouraged and requests ongoing comment to incorporate any findings or considerations so as to ensure that these documents continue to reflect the best perspective for our field and for our profession. HCCN and The Spiritual Care Association offer both documents to all chaplains and chaplaincy associations to adopt, test, and continue to contribute to them. I welcome your comments and questions at info@SpiritualCareAssociation.org.
Peace & Blessings!
Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association
April 2016 Issue No. 9
We hope that you find this complimentary monthly e-newsletter informative. Below are short summaries of each selected item with links to the entire pieces. Please feel free to send any questions or comments to firstname.lastname@example.org.
Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network & Spiritual Care Association
Engage patients to improve outcomes and reduce risks (KevinMD.com)
Active patient engagement is a quality measure of the Institute for Healthcare Improvement’s Triple Aim Initiative, a framework targeted at optimizing health systems “to improve care, improve population health, and reduce costs per capita.”
Hearing the Voice of the Patient (The Rev. George Handzo, BCC, CSSBB)
These days, it is almost scandalous to suggest that patients and their family caregivers should not be consulted and included in deciding on their care. Many of us are advocating models in which the patient actually sits in on the team's care planning rather than the team having discussions without the patient and then bringing the patient into the conversation to "discuss" the plan the team has already decided on.
However, as with most conditions in life, this one comes with some consequences that many didn't anticipate and some providers don't necessarily like.
Stigma keeps some cancer patients from getting palliative care (Reuters)
Some cancer patients may turn down care that could ease their pain and improve their quality of life because they think this type of “palliative” treatment amounts to giving up and simply waiting to die, a small Canadian study suggests.
Even though the World Health Organization recommends early palliative care for patients living with any serious illness, negative attitudes among patients and family caregivers often lead them to reject this option, researchers note in the Canadian Medical Association Journal.
Collaborative Care Intervention Improves Side Effects, Quality of Life for Patients and Caregivers (Oncology Nurse Advisor)
Active screening and symptom management in patients with cancer reduces depression, pain, and fatigue, and improves quality of life for patients and their family caregivers, a study published in the journal Cancer has shown.1
Because effective palliative care can improve outcomes for patients and ease the burden of care for their caregivers, researchers sought to determine the efficacy of a collaborative care intervention on depression, pain, and fatigue and quality of life for patients with cancer and their family caregiver.
How chaplains are a valuable part of the health care team (KevinMD.com)
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….
As the chaplaincy profession continues to evolve, there are several actions health care leaders can — and should — do now.
Third Annual Caring for the Human Spirit® Conference Is Best Yet. Health Care Professionals Who Provide Spiritual Care Were Energized by the Knowledge Sharing and Networking (plainviews.healthcarechaplaincy.org)
“I’ve been a chaplain for 16 years, and this was the best conference I’ve attended,” said one participant.
More than 300 in-person attendees and thousands via webcast from 13 countries - chaplains, physicians, nurses, social workers, researchers, educators and others - participated in the third annual Caring for the Human Spirit® conference hosted by HealthCare Chaplaincy Network in San Diego, Calif., April 11-13, 2016.
The conference included six major addresses, 30+ workshops on a wide variety of topics, poster sessions, and considerable opportunities for small group and one-on-one dialogue.
At the conference’s conclusion Denise LaChance, Director of Mission Integration & Spiritual Care for a California medical center said: “ The excellent plenary talks and workshops I attended and several in-depth conversations each addressed something specific we are working on at our hospital, from the big picture perspective of the importance of both research and story in communicating the significance of spiritual care to our health care colleagues to specific new screening tools we may be able to use to screen for spiritual needs. I am very excited about the future of chaplaincy and my place in it after this conference.”
Beth Delaney, a Nurse Practitioner and Assistant Professor of Nursing in Ohio said: “As a nurse practitioner who cares for cancer patients, my nurse research partner and I found attending the Caring for the Human Spirit conference provided a forum for ‘like minded’ health care individuals to form a community of inquiry, where learning and supporting one another encourage all of us to continually strive to improve the care for one of the most unique characteristics of all humans...the spirit.”
New Spiritual Care Association Formed to Advance Chaplaincy Profession and Provision of Spiritual Care by Other Disciplines…Meets Rising Demand for Spiritual Aspect of Whole Person-Care in Today’s Health System
A new interdisciplinary professional organization focusing on spiritual care, the Spiritual Care Association (SCA), was announced on April 11th. It has been established with the goals of providing robust education and career paths in spiritual care in health care, raising chaplaincy to a more standardized and visible profession, and, ultimately, helping more people in need of spiritual support. “It’s time to make spiritual care a priority. This forward-looking model modernizes the profession and maximizes the potential of spiritual care in whole-person care,” said Rev. Eric J. Hall, SCA’s president and CEO.
Watch or read announcement, and download informational brochure here: http://www.healthcarechaplaincy.org/sca.html
Find SCA website here: http://spiritualcareassociation.org/home.html
Send questions or comments to info@SpiritualCareAssociation.org
The Elder Spirituality Project (www.spiritualityandpractice.com)
Elder Spirituality is a focus whose time has come. Traditionally in the world's religions, the last stage of life is seen as a time for intensified spiritual work as well as for passing on wisdom to other generations. In the United States, a Baby Boomer turns 65 every 7 seconds, and people are living longer in other parts of the world as well. Here at Spirituality & Practice, elders are a growing and important group using our resources for spiritual journeys.
Go to site which includes curated content here (http://www.spiritualityandpractice.com/projects/elder-spirituality/overview)
Is High-Quality Spiritual Care in Your Future? (CKN – Cancer Knowledge Network: cancerkn.com)
The value of spiritual care as a contributor to health and healing is increasingly being recognized. Yet, many more inpatients desire conversations about religion/spirituality than actually have them. Some may not know to request a chaplaincy visit or may not be offered one. While chaplains are increasingly engaged as members of palliative care teams, there are health care settings that lack chaplains, don’t fully integrate them into health care teams, or don’t have enough to see all those in need.
Now, many more of these conversations may take place, thanks to some new developments in the field of professional chaplaincy. Two panels of top multidisciplinary experts, convened by HealthCare Chaplaincy Network, have developed evidence-based indicators for determining the quality of spiritual care and evidence-based competencies for chaplains. These tools provide a framework for providing spiritual care and how to measure its outcomes—a buzzword that goes a long way in today’s health care environment.
For individuals and their families, the message is loud and clear: quality spiritual care counts. With these new tools in hand, administrators and chaplaincy departments will be looking at not only if spiritual care is provided, but how it is provided.
The Gift of Presence, the Perils of Advice (www.onbeing.org)
Parker J. Palmer - Quaker elder, educator, activist, and founder of the Center for Courage & Renewal – writes:
Advice-giving comes naturally to our species, and is mostly done with good intent. But in my experience, the driver behind a lot of advice has as much to do with self-interest as interest in the other’s needs — and some advice can end up doing more harm than good…
Here’s the deal. The human soul doesn’t want to be advised or fixed or saved. It simply wants to be witnessed — to be seen, heard and companioned exactly as it is. When we make that kind of deep bow to the soul of a suffering person, our respect reinforces the soul’s healing resources, the only resources that can help the sufferer make it through.
Registration Open for May and June Start Dates
for Two Highly Praised Online Certificate Courses from HealthCare Chaplaincy Network and the California State University Institute for Palliative Care
Next cohort starts May 18th Learn more or to register here.
Next cohort starts June 15th. Learn more or to register here.
Following the announcement of the new Spiritual Care Association (SCA) two weeks ago, many Board Certified Chaplains have said they will obtain Board Certification from SCA by providing the required documentation of their certification. Other chaplains who are not Board Certified have said they will pursue the BCC or Credentialing process through SCA.
A key requirement for those seeking status as a newly Board Certified or Credentialed chaplain is proof of their competency through SCA's assessment, which consists of the new online test of evidence-based scope of practice plus demonstration through either a simulated patient experience or one or more verbatims.
Chaplains have asked, "In addition to my clinical training, clinical experience and education, what is the curriculum to prepare me for this assessment of my competency?"
The curriculum consists of one credit or the equivalent in at least three of the following areas: a) quality improvement b) research c) spiritual assessment, care planning, and documentation d) cultural competency/inclusion e) end of life f) grief/bereavement g) ethics h) religious faith systems i) communication or j) basic pathophysiology.
These courses can be pursued in two ways - either through SCA's Online Learning Center OR Master's level studies through another institution of higher education.
In addition, to help candidates prepare for testing, SCA will provide test preparation modules for those who apply to become newly BCC or Credentialed.
I extend an open invitation to all chaplaincy education providers to incorporate content from the SCA Online Learning Center as didactics into their programs. Special arrangements can be made for students to participate. I welcome a conversation. Please contact me at info@SpiritualCareAssociation.org.
We welcome your comments and questions at info@SpiritualCareAssociation.org.
Peace & Blessings!
Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association
The chaplaincy field's response has been overwhelmingly positive to the announcement last week of the Spiritual Care Association's new evidence-based standards for Chaplain Credentialing and Certification.
Also, many of you have asked us to explain more the thinking behind the development of these standards.
We were guided by a goal that might be called evidence-based competency. In short, to be included there must be some evidence that a requirement contributes to the competence of the chaplain. For example, the requirement for credits in specific content areas is aligned with and supports the named competencies.
Please find the full rationale document for these evidence-based standards here.
The formation of the Spiritual Care Association (SCA), announced this past week, is aimed at modernizing, standardizing, growing and unifying the profession of chaplaincy and field of spiritual care -- for the benefit of health care settings, providers, and, most of all, patients and their families.
Through our new credentialing and certification process for chaplains, we are opening up the field to include capable and competent chaplains, and we are significantly raising the bar for certification. We will accomplish this through education based on research (evidence) and testing based on knowledge, demonstration of clinical competencies, and skills.
Currently, more than a dozen chaplaincy groups within the U.S. offer varying education/training, research, certification and accreditation. It is time for standardization and objective certification.
SCA's innovative approach to chaplain training, credentialing, certification, and continued education incorporates the desires and issues raised by those of you in the field and thought leaders over decades, and:
SCA can take spiritual care to its next phase of growth in a structured and professional route. We invite you to learn more about SCA at www.SpiritualCareAssociation.org. We welcome your comments and questions at email@example.com, and we look forward to your participation.
Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association
Eric J. Hall is the president and CEO of HealthCare Chaplaincy Network and a member of the Academy’s Age-friendly New York City Commission.
Most of us easily talk about our wishes related to the good things in life: a wish for a child to be the first family member to graduate college, for a granddaughter to marry the love of her life, for yourself to rise in your career and make an impact on health care, the environment, or whatever your passion is. While we may not shout these aspirations from the rooftops, typically we don’t keep them to ourselves either.
Why, then, are so many of us silent when it comes to relaying our wishes about the harsher side of life: sickness, death and dying? This is a silence that can cause unnecessary pain … a silence that can come back to haunt us and our loved ones … a silence that restricts your voice from being heard when it needs to be heard the most.
I’m sure we all know of situations like this. A husband emerges from an unsuccessful surgery, with feeding tubes and breathing tubes, and a distraught wife has no idea if this is how he would want to continue living. A grandmother with Alzheimer’s disease never expressed her care preferences when cognitively able. Or a single father codes after a car accident, leaving his children with no idea whether he would want to be resuscitated.
April 16, 2016 is National Healthcare Decisions Day—a day to shine the spotlight on the value of advance health care planning. It’s all about inspiring, educating and empowering the public and providers about the importance of advance care planning. It’s about giving thought to important choices -- from stating the type of care you want or don’t want, to appointing someone to make medical decisions for you, to drawing up a will. It’s about getting input, if desired, from loved ones, clergy, health care chaplains, doctors, elder law attorneys, and others.
But most of all it’s about taking a deep look at your beliefs, your values, your goals, your priorities—and shaping your health care decisions accordingly. Ultimately, what do youwant when you’re ill or nearing death? I remember one bereaved caregiver after struggling with her spouse’s decision to stop intensive cancer treatments declaring that it all comes down to this: “It’s the patient choice. It’s the patient’s decision.” That’s what advance planning does—it gives the patient the choice, the decision, and it gives loved ones the knowledge for them and health care providers to honor those wishes.
This isn’t the kind of conversation you normally have over a bowl of pasta or chicken soup. It’s likely not in your comfort zone. But it’s the very kitchen table discussion everyone should have in advance of a crisis. It’s never too early to talk about treatment and care plans. It’s never too early to think about what you want at the end of life. It’s never too early to prepare essential legal and financial documents. These are authentic conversations. They are not only practical; they can be emotionally and spiritually healing. As one estate attorney said, “It will give you peace of mind, and you’re giving your family a gift by making your wishes known to them in advance. “
I recall one elderly congregant who gave her family such a gift. She always told her children she didn’t want them to see her suffer at the end, like she had witnessed with her own mother. She tasked her son with making sure she would not be kept alive artificially, and she provided her daughter with the precise financial and funeral information. Every six months or so, this mom would remind her kids where she had her advance care documents—in the metal box in the back of her clothes closet. Despite the pain of their mother’s death, her children felt blessed that their mom’s candor and preparedness eased the stress and potential for family strive -and enabled her to die with dignity.
On April 16, National Healthcare Decisions Day, or any day, make your voice heard. Just like our choices define our life, just like we want quality of life, our choices can define our death and give us quality of death – on our terms.
HealthCare Chaplaincy Network-Led Effort on Competencies Comes
on Heels of Release of Spiritual Care Quality Indicators
NEW YORK, NY (March 16, 2016)– HealthCare Chaplaincy Network (HCCN) today released the first evidence-based scope of practice, or set of competencies, for professional chaplaincy, giving spiritual care specialists, other providers and administrators a framework in which to provide quality spiritual care in health care settings.
The recommendations build on HCCN’s release last month of the first comprehensive evidence-based quality indicators for spiritual care, and suggested metrics and measures for each. The 18 indicators include reducing spiritual distress, increasing client satisfaction, and facilitating meaning-making for clients and family members.
With the quality indicators as a reference point, the new document describes a scope of practice and associated competencies that should be attained by all professional health care chaplains. The scope of practice articulates how chaplains can help their organizations meet these indicators and “effectively and reliably produce quality spiritual care,” according to the document.
While chaplains are considered the spiritual care specialists in health care settings, the emergence of the competencies impacts overall spiritual care and other disciplines, and, ultimately, patients and their families.
Both new documents reflect HCCN’s continuing efforts to fill gaps in the delivery of spiritual care, increase the integration of professional chaplaincy on health care teams, and raise the overall level of care these teams provide. They were developed by separate consensus panels composed of prominent experts in spiritual care, palliative care and other disciplines from the U.S. and abroad.
“These long-awaited and robust tools work in tandem to move forward the field of spiritual care and professional chaplaincy,” said Rev. Eric J. Hall, HCCN’s president and CEO. “They send a loud message about how spiritual care can be fully integrated into health care, and provide the path for administrators, clinical teams, spiritual care providers, and others to seamlessly achieve that goal.”
Representing its potential impact, one quality indicator calls for all clients to be offered the opportunity to have a discussion of religious/spiritual concerns. The scope of practice for that indicator requires that the chaplain “supports and advocates for the establishment of timely and documented spiritual screening to discover and refer clients for discussion of religious/spiritual concerns; and provides timely response to all referrals and facilitates discussions of religious/spiritual concerns.”
There is a growing body of research showing patients’ desire for spiritual care when they are ill or dying, and the impact of such support on important medical outcomes, costs, and the patient experience. Spiritual care is a vital component of whole person care, and is increasingly being incorporated into palliative and hospice care as well as into treatment plans for various diseases.
“These guidelines provide a framework for consistent, evidence-based care that is both deeply human and compassionate,” said Joanne Cacciatore, Ph.D., an associate professor at Arizona State University specializing in traumatic death, and a member of the scope of practice panel.
The panel said it is intended that the scope of practice “will invite and inform the conversations around changes to chaplaincy education and training and become the basis for certification and credentialing processes with the ultimate goal of providing care recipients internationally with demonstrably reliable, high quality care to help meet their spiritual needs and support their spiritual strengths.”
The panel said while the document applies to all professional health care chaplains, investigation should continue on the utility of competencies for different levels of practice and different specialty settings. In addition, as the list of quality indicators expands over time, the scope of practice will need to expand.
For the complete scope of practice document, as well as the quality indicators document, visit www.healthcarechaplaincy.org/research/.
HealthCare Chaplaincy Network Convened International Panel to Develop Recommendations
NEW YORK, NY (February 18, 2016)– A distinguished, international panel of experts convened by HealthCare Chaplaincy Network (HCCN) has developed the field’s most comprehensive evidence-based indicators that demonstrate the quality of spiritual care in health care, in a move aimed at advancing optimal spiritual support and meeting the needs of patients, their families, and health care institutions.
The statement released today provides guidance to professional health care associations, administrators, clinical teams, researchers, spiritual care providers, and other stakeholders worldwide on the indicators of high-quality spiritual care, the metrics that indicate such care is present, and evidence-based tools to measure that quality.
In addition, it puts spiritual care and professional chaplaincy on par with other health care disciplines that are directed by specific quality indicators.
“We believe these evidence-based quality indicators are a game-changer,” said Rev. Eric J. Hall, HCCN’s president and CEO. “They speak to health care’s emphasis on value over volume of services. Being able to identify value in specific situations will help elevate the importance of spiritual care as part of whole-person care, casting aside perceptions and anecdotes about its impact in favor of indicators that can solidly demonstrate quality of care and outcomes.”
The new recommendations apply to spiritual care overall, although they most directly impact professional chaplains, who are considered the spiritual care specialists in health care settings.
The set of 18 quality indicators include spiritual care that reduces spiritual distress, increases client satisfaction, and facilitates meaning-making for clients and family members.
Prior to this development, according to the panel, there were no accepted indicators for determining the quality of spiritual care except for the Quality of Spiritual Care scale (QSC), a scale measuring quality of spiritual care at end of life that was tested on family members of deceased long-term care residents.
Rev. George Handzo, HCCN’s director of health services, research and quality, who chaired the panel, said the new indicators are especially timely given the changing health care landscape, including a mounting body of evidence showing patients’ desire for spiritual care and the impact of such support on important medical outcomes, costs, and the patient experience.
“In the current economy of health care, the value of what one contributes is measured by how much one contributes to an outcome or quality indicator that the system has agreed on,” he said. “To date, because there have been no quality indicators for chaplains, we are in serious danger of being considered valueless and thus expendable, to the detriment of patients, their families, and the health care system as a whole. This effort provides an important start to remedying that situation.”
By assembling a high-level panel of experts of varied backgrounds, HCCN has produced a document reflecting a consensus that spans both disciplines and geographic boundaries.
The panel began with well-established indicators from national guidelines or research, and used tools that have already been developed and tested. The resulting statement consists of the quality indicators—structural indicators, process indicators, and outcomes, supported by metrics that can measure the indicators and suggested evidence-based tools that can reliably quantify those metrics.
For example, one quality indicator calls for certified or credentialed spiritual care professional(s) “proportionate to the size and complexity of the unit served and officially recognized as integrated/embedded members of the clinical staff.” It is measured by institutional policy that recognizes chaplains as official members of the clinical team (the metric) and policy review (the suggested tool).
One of the members of the panel, R. Sean Morrison, M.D., director of the Lilian and Benjamin Hertzberg Palliative Care Institute and the National Palliative Care Research Center at Mount Sinai in New York, and a past president of the American Academy of Hospice and Palliative Medicine, said the comprehensive set of indicators bodes well for patients and their families now and in the future.
“The quality indicators will empower professional chaplains and position them to be essential and effective team members, especially as we witness tremendous growth in palliative care,” he said. “This holds great promise of pushing the field forward.”
For the complete statement, “What Is Quality Spiritual Care in Health Care and How Do You Measure It?” as well as a list of panel members, visit www.healthcarechaplaincy.org/research.
The Rev. George Handzo, BCC, CSSBB
Director, Health Services, Research & Quality
HealthCare Chaplaincy NetworkTM
The Rev. Sue Wintz, MDiv, BCC
Managing Editor, PlainViews®
Director, Professional & Community Education
HealthCare Chaplaincy Network TM
Rhonda S Cooper MDiv, BCC
Chaplain, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Jeffrey T. Berger, MD, FACP
Professor of Medicine, Stony Brook University School of Medicine
Chief, Division of Palliative Medicine and Bioethics
Department of Medicine
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