September 2015 Issue No. 3
We hope that you find this monthly e-newsletter informative. We have included a downloadable PDF version created for readers who prefer that format. Please feel free to send any questions or comments to firstname.lastname@example.org.
Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network, Inc.
How spirituality and religion impact patient outcomes (FierceHealthcare.com)
Three new studies examine how personal beliefs influence cancer patients' physical, social and mental health. Although clinicians may be reluctant to discuss religious and spiritual beliefs with their patients, three new studies shed light on how faith can impact cancer patients' mental, social and physical well-being.
The studies, published online in Cancer, the peer-reviewed journal of the American Cancer Society, indicate there is a significant link between religion, spirituality and patient outcomes but variability on how they relate to the different aspects of health.
3 Highly Visual Infographics Present Research Findings on the Benefits of Spiritual/Chaplaincy Care (HealthCareChaplaincy Network)
View and download these at http://www.healthcarechaplaincy.org/media-kit/infographics.html
Transforming Chaplaincy Project Launched: Promoting Research Literacy for Improved Patient Outcomes (funded by the John Templeton Foundation)
The project, funded by the John Templeton Foundation, with support from the APC, NACC, NAJC and ACPE, aims to equip healthcare chaplains to use research to guide, evaluate, and advocate for the daily spiritual care they provide patients, family members and colleagues. Transforming Chaplaincy has three initiatives. The project will provide: 1) Research Chaplain Fellowships to pay for 16 board-certified chaplains to complete a two-year, research-focused master's degree; 2) Curriculum Development Grants to 70 CPE programs to support incorporation of research literacy education in their residency curricula; and 3) a free Online Continuing Education course, Religion, Spirituality and Health: An Introduction to Research for members of the supporting organizations. Details about these three initiatives, including application information and timelines, are on the project website. The Calendar page lists activities that provide additional information about the Fellowships and CPE Grants. These include a webinar entitled Teaching Research Literacy in CPE, upcoming informational conference calls, and conferences and ACPE regional events where a Transforming Chaplaincy representative will be on hand to answer questions. You can sign up on the website to be on the email list to receive updates on applications and project-related events. You are also welcome to contact the project coordinator, Kathryn Lyndes, PhD, at mailto:MKathryn_Lyndes@rush.edu and 312.942.0247 for further information.
"Tide is turning" in favor of palliative care, experts say (HealthAffairs Blog)
Two recent announcements by the Centers for Medicare and Medicaid Services (CMS) demonstrate a clear commitment to improving the quality of care for older adults with serious illnesses. Together with the introduction of a bipartisan bill to better train our nation’s health care workforce, these announcements suggest that the tide is turning in the effort to provide high-quality, patient-centered care to medically complex and seriously ill patients.
Spirituality may be tied to easier cancer course (Reuters Health)
Cancer patients who report more religiousness or spirituality may also experience fewer physical symptoms of cancer and treatment and more social connection, several new papers suggest.
The new analyses reviewed previous studies of spirituality involving more than 44,000 cancer patients altogether. The studies varied in many ways, but religion and spirituality were associated with better health regardless of specific religion or set of spiritual beliefs.
Importance of End of Life Care Advance Conversations
Why Medicare should reimburse doctors for end-of-life care conversations (theconversation.com)
On July 8, Medicare announced plans to reimburse physicians, nurse practitioners and physician assistants for services to help their patients plan the care they would want if they were too ill to speak for themselves. If approved, the plan will take effect in January 2016. It’s about time.
I am a palliative care provider and a researcher in end-of-life care. In my experience, these kinds of services, called “advance care planning” (ACP), are incredibly valuable, especially to patients who are older and their families. My colleagues and I have found that 43% of elderly Americans require decision-making at the end of life about such things as life support and CPR. But 70% of them lack the capacity to make those decisions for themselves or to communicate them to others.
Can We Talk?: People who discuss their end-of-life wishes are less likely to die in a hospital or burden relatives with tough medical decisions. Here's how to get the conversation started. (NeurologyNow)
For Hospitals, Sleep And Patient Satisfaction May Go Hand In Hand (Kaiser Health News)
As hospitals chase better patient ratings and health outcomes, an increasing number are rethinking how they function at night — in some cases reducing nighttime check-ins or trying to better coordinate medicines — so that more patients can sleep relatively uninterrupted.
“Sleep disruptions are actually not benign as far as patients are concerned,” said Dana Edelson, an assistant professor of medicine at the University of Chicago and an author on the 2013 study. “We’re putting them at unnecessary risk when we’re waking them up in the middle of the night when they don’t need to be.”
And possibly making the recovery a bit more difficult.
“Patients will tell you, ‘I was so exhausted, I couldn’t wait to get home and go sleep,’” said Yale’s Pisani.
Perspectives from Physicians
Why doctors overtreat patients. And how to fix it. (KevinMD.com)
Much of the aggressive and invasive health care we provide in the United States today, compared to time-tested, more conservative approaches, adds little value. And when independent scientific comparisons are done, the more complex approach often results not only in higher costs, but also in complications and adverse effects – all without significant benefit to the patient.
- Overtreatment explained
- How much does an ounce of prevention really weigh?
- How we harm the dying
- What should we do?
Doctors Fail to Address Patients’ Spiritual Needs (The New York Times Well Blog)
Over the years, however, I have increasingly seen how many patients, especially when confronting the end of life, value their emotional, existential and spiritual feelings over further medical treatment when it begins to seem futile.
Eventually, my patient dying from cancer did speak with a chaplain. I noticed him visiting her one day as I walked by her door. I again spotted him two days later heading toward her door. The next morning, I thought that she looked calmer, more relieved than I’d seen her in weeks. She still had unremitting fevers and died a few months later, in that room. But the chaplain had helped her, I felt, in a way that I and medical treatment could not.
I still regret my silence with that patient, but have tried to learn from it. Doctors themselves do not have to be spiritual or religious, but they should recognize that for many patients, these issues are important, especially at life’s end. If doctors don’t want to engage in these conversations, they shouldn’t. Instead, a physician can simply say: “Some patients would like to have a discussion with someone here about spiritual issues; some patients wouldn’t. If you would like to, we can arrange for someone to talk with you.”
Unfortunately, countless patients feel uncomfortable broaching these topics with their doctors. And most physicians still never raise it.
Three comments about professional chaplaincy/spiritual care were posted to the New York Times Well blog site when Dr. Klitzman’s piece was published:
Thank you so much Dr. Klitzman for writing on this very important and too often overlooked aspect of patient-centered care. As a board certified professional chaplain, I've spent over 30 years working with patients and families. I've also educated and supported physicians and other members of the health care team about important issues arising in care and treatment that would not have been addressed if not for the spiritual assessment I'd done through conversation with patients and their families. Spiritual, religious, existential, and cultural beliefs - whatever they may be - are central to how persons experience their illness, make decisions, interact with their families/families of choice and the health care team. We do them a disservice when we 6 ignore or overlook those aspects. In response to your statement that doctors say "If you would like to, we can arrange someone to talk to you" about spiritual issues." Professional chaplains are full members of the interdisciplinary team and in the hospitals in which I worked, consults and/or MD orders were made to me as they were to any other discipline. If someone appears to be experiencing spiritual distress, sometimes asking if they want to see a chaplain, especially if they don't define themselves as spiritual/religious or think that the chaplain is going to try and convert them (we don't, it's against our code of ethics) asking them that question may cause more embarrassment and distress. Just make the consult.
I am also a professional, board certified chaplain, and I will attest that Rev. Wintz is exactly right. Chaplains are professionals with expertise in spiritual assessment and care. Our training is to accompany people on their journeys and help them to access the spiritual resources that are most helpful to them. Many people have pre-conceptions about the role of a chaplain, fearing that we come to preach or proselytize to them in their most vulnerable moments. Nothing can be farther from the truth. If a patient is, for example, a devout Catholic and wishes the sacraments of the Church, I can arrange for a priest to minister to them, but I also remain available to speak with them about the issues that are closest to their hearts and souls. Likewise, I visit with many people who profess no religious affiliation. My primary goal as a chaplain is to help people identify what gives deepest meaning to their lives and gives them the strength to face their health care challenges.
A third comment that was posted: Thanks to Dr. Klitzman for writing about this important issue, which is not only an end-of-life issue but also for patients and their loved ones who are coping with a life-changing health crisis either as an inpatient or outpatient, and wrestling with issues of spiritual distress – a painful disruption in one’s belief or values system. Spiritual distress presents itself both emotionally and physically, from rejection of care to chronic insomnia, and may or may not be grounded in religious belief or practice. Dr. Klitzman's article and some comments mention the role of chaplains, and that's good. To amplify: In addition to clergy who volunteer their services for those of their specific faith, there exist professional health care chaplains who are experts in providing spiritual care for everyone regardless of religion or beliefs. On the interdisciplinary health care team, professional chaplains are the spiritual care specialists. One becomes a professional health care chaplain when he or she is board certified by one of the professional chaplaincy associations. Requirements include graduate level study, 1600 hours of supervised clinical pastoral education, 2000 hours of clinical experience, demonstration of competencies through a rigorous peer review process, adherence to a professional code of ethics to serve all and not promote any particular faith tradition, and continuing professional education.
Hospitals Rev Mobile Patient Engagement (HealthLeaders Magazine)
Providers' willingness to partner with the technology industry to explore collecting personal activity-tracking information demonstrates the value of boosting patient engagement via mobile devices.