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Wednesday, June 8, 2016

Speakers are:

  • Joe Rotella, MD, MBA, HMDC, FAAHPM (American Academy of Hospice and Palliative Medicine)
  • Phillip E. Rodgers, MD, FAAHPM (University of Michigan, Ann Arbor)
  • Stacie Sinclair, MPP, LSWA (Center to Advance Palliative Care)

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.

Register for this free webinar here.

Please contact Stacie Sinclair (stacie.sinclair@mssm.edu) with any questions.


Spiritual Care Association

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!


Eric Hall Signature

Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association


Patient Centered


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 comm@healthcarechaplaincy.org.



Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network & Spiritual Care Association

Patient Engagement

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.”

Read more: http://www.kevinmd.com/blog/2016/03/engage-patients-to-improve-outcomes-and-reduce-risks.html)

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.

Read more: http://hccnproviders.blogspot.com/2016/04/hearing-voice-of-patient.html


Palliative Care

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.

Read more: http://www.reuters.com/article/us-health-cancer-palliative-stigma-idUSKCN0XF27J


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.

Read more: http://www.oncologynurseadvisor.com/daily-oncology-news/collaborative-care-intervention-side-effect-quality-life-management/article/485011/


Spiritual/Chaplaincy Care

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.

  • 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 your 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.

Read more: http://www.kevinmd.com/blog/2016/03/chaplains-valuable-part-health-care-team.html

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.”

Read more: http://plainviews.healthcarechaplaincy.org/articles/Third_Annual_Caring_for_the_Human_Spirit_Conference_is_Best_Yet

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.

Read more: https://cancerkn.com/is-high-quality-spiritual-care-in-your-future/

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.

Read more: http://www.onbeing.org/blog/parker-palmer-the-gift-of-presence-the-perils-of-advice/8628


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

Fundamentals Course: Palliative Care Chaplaincy Specialty Certificate

 “Fantastic course! It is well prepared and is a great foundation the broad aspects of palliative care practice for entry level and long serving palliative care chaplains ─ typical comment from a student who has completed the course

Next cohort starts May 18th   Learn more or to register here.

Advanced Palliative Care Chaplaincy Specialty Certificate

“I believe future students will be amazed by the new skills they will have gained by the completion of the course.   I am one of them.” ─ typical comment from a student who has completed the course

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!

Eric Hall Signature

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.

To summarize:

  • The process to develop these standards was methodical and disciplined.
  • The key feature of this new process is testing, which has two major components: demonstration of clinical competency through use of simulated patient interviews and testing of knowledge and skills through a state-of-the-art online test.
  • An objective assessment of competencies replaces a subjective assessment.
  • Minimum number of CPE units is one part of overall requirements for credentialing and certification. Recognize that the inability to pass the simulated patient interviews may result in a recommendation by the committee to take additional CPE units to acquire the skills necessary.
  • SCA’s credentialing and certification process will not require faith group endorsement. This endorsement is not an evidence-based indicator of the person’s competency as a chaplain.
  • This new system for credentialing and certification, and all of the other components on which it rests are open to continuing research and development by the field.

Please find the full rationale document for these evidence-based standards here.



What a week!

It is with great excitement and gratitude that we announce that in just one week since our introduction, more than 500 members now belong to the Spiritual Care Association! This is not to mention the dozens upon dozens of emails we are currently responding to in which  individuals and organizations of all professions are reacting with enthusiasm to the rallying cry to collaborate around the spiritual care agenda and the profession of chaplaincy.
Months ago when we decided it was time to finally establish a Gold Standard for chaplaincy -- a standard marked by a defined curriculum and competency exams already set and in practice by other health care professions, we believed there was the need, but we were unaware whether those of you in the field would respond as favorably as you have. Would you accept the challenge to raise the bar of your profession and assist in making it on par with other professions?  Based on the responses, you, as well as your organizations and institutions, are in favor of -- and demanding of -- standardization, clearly defined quality indicators, a defined scope of practice, and objective testing of clinical competencies.  Yet another find from your correspondences is the value you place on the SCA Learning Center, our more flexible and convenient approach to Clinical Pastoral Education (CPE), and our robust advocacy agenda.  We are very glad all of these are being so well received.
In just this past week this conversation has risen to the international level with chaplains and organizations from all over the world asking questions and getting involved. Also, surprisingly, several associations are beginning to collaborate. This is great news for us at SCA and HCCN, but most importantly this is awesome news for all of us in spiritual care. Together, united behind this well-defined vision articulated last week, we have the opportunity to make a real difference for the field, the profession, and people in need of spiritual care.
Peace & Blessings!

Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association

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:

  1. Provides education and a required knowledge base founded in the latest research. It will build over time as more research unfolds.
  2. Brings chaplaincy to the level of training and demonstrated clinical competencies required by other professional disciplines, including doctors, nurses, social workers and therapists. SCA's credentialing and certification responds to the need for training to be tested, and relies on standardized testing and a standardized patient encounter to demonstrate clinical competency, knowledge base, and best practices.
  3. Opens professional chaplaincy to all capable and competent individuals, who can now enter the field through various pathways while ultimately demonstrating the required degree of knowledge and competency. By providing pathways for credentialing and certification that focus on knowledge and demonstration of skills, those who have been unable to meet the outdated and rigid requirements that do not consider culture, belief tradition, geographical location, age, and financial resources will now be able to be trained, credentialed or certified, and continually educated to provide the best care for those whom they serve.
  4. Commits itself to continually evolve as further evidence becomes available in the fields of chaplaincy training, practice, and education. 

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 info@spiritualcareassociation.org, and we look forward to your participation. 


Rev. Eric J. Hall

President & CEO

HealthCare Chaplaincy Network and Spiritual Care Association




On behalf of the board of directors of HealthCare Chaplaincy Network, our staff and our supporters ----  I am announcing the formation of the Spiritual Care Association.
The Spiritual Care Association (SCA) is the first multidisciplinary, international professional membership association of this expanse and magnitude for all types of spiritual care providers. It establishes for the first time evidence-based quality indicators, scope of practice, and a knowledge base for spiritual care in health care.
As health care providers emphasize the delivery of positive patient experience, the Spiritual Care Association has been established to lead the way to educate, certify, credential and advocate. Its goal is for more people in need, regardless of religion, beliefs, or cultural identification, to receive effective spiritual care in all types of institutional and community settings in the U.S. and internationally.
Simply put, SCA's vision is Making Spiritual Care a Priority.
I encourage you to find the text and the video recording of the entire formal announcement of the Spiritual Care Association at www.healthcarechaplaincy.org.

And please explore the SCA website at www.SpiritualCareAssociation.org.
I welcome your comments via email at comm@healthcarechaplaincy.org.

Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network and Spiritual Care Association
HealthCare Chaplaincy Network™ (HCCN), founded in 1961, is a global health care nonprofit organization that offers spiritual care-related information and resources, and professional chaplaincy services in hospitals, other health care settings, and online. Its mission is to advance the integration of spiritual care in health care through clinical practice, research and education in order to improve patient experience and satisfaction and to help people faced with illness and grief find comfort and meaning--whoever they are, whatever they believe, wherever they are. For more information, visit www.healthcarechaplaincy.org,  call 212-644-1111, follow us on Twitter or connect with us on Facebook
The Spiritual Care Association (SCA) is the first multidisciplinary, international professional membership association for spiritual care providers that establishes evidence-based quality indicators, scope of practice, and a knowledge base for spiritual care in health care. As health care providers emphasize the delivery of positive patient experience,  SCA is leading the way to educate, certify, credential and advocate so that more people in need, regardless of religion, beliefs or cultural identification, receive effective spiritual care in all types of institutional and community settings in the U.S. and internationally.  SCA is committed to serving its multidisciplinary membership and growing the chaplaincy profession. For more information, visit www.SpiritualCareAssociation.org, call 212-644-1111, follow on Twitter or connect on Facebook and LinkedIn. The nonprofit SCA is an affiliate of HealthCare Chaplaincy Network™ with offices in New York and Los Angeles.
HealthCare Chaplaincy Network & The Spiritual Care Association, 65 Broadway, 12th Floor, New York, NY 10006-2503
Sent by news@healthcarechaplaincy.org in collaboration with
Constant Contact


The Rev. Dr. Walter J. Smith, S.J., was my predecessor as president and CEO of HealthCare Chaplaincy, serving in that role from 1991 to 2013. In 2012, in recognition of his contributions to the field, the COMISS Network (The Network on Ministry in Specialized Settings) honored Walter with its highest recognition - the COMISS Medal. On that occasion, Walter declared a call to action for professional chaplaincy (see his complete address below).  To highlight two excerpts: 
  • "The current system in professional chaplaincy is not sustainable and we must develop and embrace a different mode ...Without an empirical base that validates the outcomes of their professional work, chaplaincy as a profession will remain on the margin of health care, and not be able to justify further investment of limited health care dollars to support its professional endeavors."
  •  "Despite many good efforts, chaplaincy still lacks an organized, strong, united, proactive and representative national voice.  Chaplaincy as a field is not a significant professional participant in the national health care policy debate, nor does it have an appropriate and sustained lobbying presence with those who are playing key roles in shaping the future of American health care.  Chaplains have to be at the table and speaking persuasively if their contributions are to be understood and included as the health care landscape is being re-engineered."
Walter had delivered this message in previous years. So had other thought leaders in the professional chaplaincy field. The problem as I see it is they still do today.  The same message.  The same concerns.  Why when there is so much that can be getting done?

Very recently, we've seen the emergence of evidence-based quality indicators and scope of practice - the work of two distinguished international panels of experts convened by HCCN. These evidence-based criteria are a vital start. (Details here.)
But not enough has been done to strengthen the health care chaplaincy profession.  Not enough has been done to support chaplains in their role.
Not enough has been done to advocate for the profession.
There is much more to accomplish. Now is the time to make spiritual care a priority.

I welcome your comments.  Please send to comm@healthcarechaplaincy.org.

Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network, Inc.

Alexandria, Virginia
8 January 2012
The Rev. Walter J. Smith, S.J., Ph.D.
President & CEO
HealthCare Chaplaincy
New York City
Last month in New York City, I participated in some unrelated events and meetings in an iconic building on Fifth Avenue, which is the landmarked home of the New York Academy of Medicine. 
During the early period of its venerable one hundred sixty-five year history, the Academy of Medicine was an enclave principally of male physicians and surgeons, who eventually-at the turn of the twentieth century-found their way to admit women to their fellowship, and even more recently, to recruit and elect colleagues from the other health professions. 
About fifteen years ago, I was elected a Fellow of this prestigious body, which currently is engaged in a number of cross-disciplinary leadership projects that seek to create environments in cities that support healthy aging; strengthen systems that prevent disease and promote public health; and eliminate health disparities.
Each of the meetings in which I participated in the Academy's building was focused on an intensely collaborative endeavor of civic engagement, health advocacy or health policy reform.  Even though the agendas and outcomes of each of these gatherings were different, they all underscored for me a critical common reality: every important initiative today-whether public or private-relies for its success on an ability to engage the knowledge, experience and effective collaboration of people from diverse professions and academic disciplines. 
These working meetings convened at the New York Academy of Medicine reinforced my belief in the necessity to foster and sustain effective collaborations and served as a catalyst for my thinking as I was formulating these reflections for the annual gathering of representatives of the Council on Ministry in Specialized Settings (COMISS). 
When COMISS was established in 1979, its founding vision was to become the preeminent network for professional organizations, institutions and faith communities.  It aspired to increasingly promote and support collaboration among its members and be a forceful advocate and collective voice for five distinct, but interrelated groups: 
(1) Professional chaplaincy and pastoral counseling certifying organizations;
(2) Professional chaplaincy and pastoral counseling accrediting organizations; 
(3) Religious judicatories that provide endorsement for chaplains and pastoral counselors to perform ministry in specialized settings; 
(4) Professional pastoral care and educational organizations, and lastly;
(5) Chaplain and pastoral care counselor employing organizations, like HealthCare Chaplaincy,  which I represent, that utilize the services of chaplains or pastoral counselors certified by one of the certifying member organizations of the COMISS Network.  
Now, at the dawn of 2012 - some thirty-three years later - we gather to consider the topic: "Professional and Practical: Engaging Pastoral and Spiritual Care Resources."  In offering these observations and personal reflections, I do not intend to be either contentious or confrontational, but to speak candidly and constructively-from the perspective of my own experience-about the serious problems, both professional and practical, that the fields of chaplaincy and pastoral counseling are facing.
For much of its modern history, chaplaincy and pastoral counseling have virtually been the domains of solo practitioners, who effectively have been "going it alone."  It wasn't until 1946 that chaplains began to associate themselves together professionally, and then, as you know, chaplains tended to organize themselves by faith traditions and service specialties. These organizational structures have had the secondary effect of reinforcing fragmentation and progressively weakening the collective voice of these helping professions.
Over the past sixty-six years, chaplains and pastoral counselors have continually struggled to be recognized, respected and compensated as bona fide health care professionals.  Chaplaincy and pastoral counseling membership associations, which were initially established to foster a sense of identity and accountability to peers, have grown into well-organized professional groups that are more collaborative than competitive.  Yet, despite the rhetoric, covenants and strategic planning that have dominated the professional landscape during the past quarter century, professional chaplaincy and pastoral counseling still have not achieved emancipation from the historical shackles that have obstructed their growth as spiritual care helping professions.
More obvious barriers that tend to divide groups- including issues of gender, ethnicity, race, sexual orientation and religious affiliation-are being confronted, and the pastoral and chaplaincy care professions are seeking better ways to collaborate and utilize their limited economic resources to support common strategic interests. 
But other obstacles to the realization of the expansive vision that gave birth to COMISS more than three decades ago remain significant deterrents.  I would like to reflect on some of the more neuralgic issues that impede progress and development within our professions.
I will focus the remainder of this discussion on the field of professional health care chaplaincy, although these observations may apply and be relevant to the other cognate spiritual and pastoral care professions and subspecialties as well.
Looking specifically at the health chaplaincy care profession in America, I find it personally disappointing that after more than a decade since our important conjoint meetings in Toronto in 2000, the major national chaplaincy associations in North America have not found an effective and sustainable way to operationally merge their related missions and purposes and pool their dwindling fiscal resources, governance and executive leadership. 
In an article published in a national news journal ["Collaborative Efforts Can Save Money And Improve Care," Kaiser Health News, Jan 5, 2012], a couple of quotes caught my eye.  The first was from a vice president of a national alliance of 200 health systems that are focused on performance improvement:  "It all starts when leaders in a community say the current system is not sustainable and we've got to find a different model."
The current system in professional chaplaincy is not sustainable and we must develop and embrace a different model.  Chaplaincy still has not been able to remove certain roadblocks to its collaboration and growth as a unified profession.  A second quotation in the Kaiser Health News article states the problem even more succinctly:  "There are still many obstacles to such partnerships.  It's often difficult to get traditional competitors and antagonists to collaborate, including sharing proprietary medical and financial data."   
While I would not like to say that Association of Professional Chaplains (APC) and the National Association of Catholic Chaplains (NACC) and the National Association of Jewish Chaplains (NAJC)  and the Association for Clinical Pastoral Education (ACPE) are traditional competitors or antagonists, but as of yet, they have not felt the crisis urgently enough to put aside self-interests and realize that a single, consolidated, stronger, national organization will serve their members and the profession far more effectively.
While some encouraging and commendable progress has been made during the past decade in important areas, including the development and ratification of standards for certification, ethics and professional practice, these national membership organizations still struggle to maintain their own independent identities and cultures, as well as to fund and staff costly and redundant infrastructures. 
Despite many good efforts, Chaplaincy still lacks an organized, strong, unified, proactive and representative national voice.   Chaplaincy as a field is not a significant professional participant in the national health care policy debate, nor does it have an appropriate and sustained lobbying presence with those who are playing key roles in shaping the future of American health care.  Chaplains have to be at the table and speaking persuasively if their contributions are to be understood and included as the health care landscape is being re-engineered.
The professional chaplaincy organizations are being forced to invest much of their shrinking financial and human resources in maintaining essential operating structures and programs, with limited additional and necessary funds to strategically invest in growing chaplaincy as a profession. 
Let me offer one brief example. Even though these organizations worked diligently to develop and ratify common certification standards that define the skills that a professional health care chaplain must possess, these certifying bodies have not sponsored any subsequent research to validate these standards against chaplaincy outcomes and performance measures.  Without a credible body of research to support it, standards like these will accomplish little in advancing chaplaincy as a profession.  Professional chaplaincy today still lacks the models and methods on which to build a strong empirical foundation that will help define what chaplains do and  measure how successful are their interventions. 
Professional health care chaplaincy's strengths over the past half century have been concentrated in two principal areas, one clinical, the other educational: (1) to provide care at the bedside; and, (2) to develop a content-informed, progressive experiential learning educational paradigm (i.e., Clinical Pastoral Education), which continues to serve as the foundational educational paradigm by which all aspiring professional chaplains are prepared for certification and practice.  
Turning attention briefly to the first of these strengths-clinical pastoral care-it fair to say that much of current chaplaincy care practice remains intuitive and insufficiently documented.  The chaplain, as a solo practitioner, enters patients' worlds with the desire to help individuals to make sense of and find meaning in what they are experiencing.   The chaplain comes to this task with a reasonably sufficient training and experience, but only exceptionally equipped with theories or methods to critically assess the effectiveness of what he or she actually says or does in the clinical setting. 
Generally speaking, many chaplains affirm anecdotally that their interventions do seem to help patients to create or modify their own existential and/or theological "models" and to better understand and accept what is happening to them as a result of an illness, disability or aging.   But, in general, chaplaincy practice issues are not routinely subjected to the rigors of scientific inquiry because most chaplains have been insufficiently trained or encouraged to research these kinds of questions themselves.
Remedying this deficiency does not seem to be on the national agenda of their membership organizations, for good and explainable reasons.  But without an empirical base that validates the outcomes of their professional work, chaplaincy as a profession will remain on the margin of health care, and not be able to justify further investment of limited health care dollars to support its professional endeavors.
This brings me, finally, to what I consider one of the most exigent challenges facing chaplaincy as a health care profession.   As noted earlier, the educational paradigm common to the professional formation of every board-certified chaplain is Clinical Pastoral Education.  While broadly encouraging personal growth and developing a useful set of helping skills  for future chaplains, the CPE curriculum does not prepare the same chaplain-in-training to assess the effectiveness of what he or she may do in the clinical setting or to plan and conduct studies and evaluate the data of qualitative and/or quantitative research.  
Few CPE supervisors (chaplaincy care educators) possess quantitative or qualitative research skills or have sufficient research experience to be able to teach these basic skills to others. Research needs to become a standard part of the CPE curriculum, and resources need to be invested to help CPE supervisors and board-certified chaplains acquire and/or strengthen their research skills.
A recent comprehensive literature review, funded by the John Templeton Foundation and completed by HealthCare Chaplaincy (HCC) under the Reverend George Handzo's leadership is currently available on HCC's website.
This exhaustive review has identified the substantial gaps that exist in understanding what chaplains do and the knowledge on which their practice is based, and how a chaplain's clinical judgment is formed and tested. This report underscores the need for basic research to explore the way in which chaplain practice protocols may be developed and maintained and to investigate the relationships among chaplaincy care protocols, clinical judgment and accountability.
These deficits in contemporary chaplaincy practice and education are intensified in a contemporary healthcare culture that requires all professional disciplines to document and assess of the outcomes of every intervention.  Chaplaincy care is no longer immune from this requirement, even though we believe that what we provide is high-quality care.  Without an ability to reliably document what we do and how we assess the outcomes, the professional work of chaplains will remain occult and underappreciated for its essential value to patients and their loved ones.  Without developing matrices and testing measures, chaplaincy as a health care profession will further weaken and continue to be marginalized.
From my vantage point of a half century as a Jesuit behavioral scientist engaged in clinical, academic and nonprofit managerial ministries, I would venture to assert that health care chaplaincy, as a professional discipline, may be as aligned to  medicine,  nursing and social work as it is to its many spiritual and religious roots.   And I further believe that by assisting chaplains and chaplain educators to better understand and embrace the functional relationships chaplaincy shares with the other cognate health professions will accelerate the development more integrated and effective approaches to multidisciplinary care. 
At HealthCare Chaplaincy, we are currently in engaged in shared efforts to help reform our national health care policies.  We also believe that professional chaplaincy care may play a pivotal role in promoting quality decision-making by patients and their loved ones than any other input source on the healthcare team.  If this assumption is validated, chaplaincy may come to be understood as an optimal discipline to help rationalize medical spending and improve patient satisfaction-two not inconsequential outcomes in managing the economics of health care today and tomorrow.
For these and other reasons, with a $3 million grant from the John Templeton Foundation, we are working together with chaplains and other experienced social and behavioral science researchers over the next two and a half years to expand research capacity within the field of professional chaplaincy.  
We hope that through these initiatives and partnerships we will stimulate development of a consensus model or models that will help test conceptual and practice-based assumptions about health care chaplaincy (with a particular focus on palliative care) and enable future researchers (chaplains and others) to build on and further advance what these seminal efforts can be expected to achieve. 
Our objective is to select the best or most interesting research projects from among those submitted for review and to support those investigators, particularly professional chaplains, who will best advance the nascent field of health care chaplaincy.
What distinguishes this grant-making cycle from others are two important assumptions:  (1) this is a field-defining and field-changing initiative; and (2) we are looking to enable and support the skills development of an emerging group of chaplain-researchers who will form the core of a sustainable generation of researchers to lead and advance the field of professional chaplaincy.
Let me conclude this reflection by returning to my beginning.   For far too long, chaplaincy historically has "gone it alone," and has suffered greatly from its fragmentation and isolation.   As a profession, health care chaplaincy remains under-resourced and insufficiently equipped to describe what it does and measure the effectiveness of its clinical practices. 
The profession possesses a rich anecdotal collective experience that supports the conviction that spirituality matters in the organization and delivery of healthcare.  Bolstered by a unified national leadership and a solid research foundation and growing body of meaningful data, professional chaplains and the membership organizations that support them, will be able to speak in more compelling ways.  Finally, if their representatives can find a way to consolidate their organizations and resources, professional chaplains will have a single, strong and articulate voice to speak for them.  They will be able to demonstrate the effectiveness of their contributions with evidence-based best practices.
In the end, as members of multidisciplinary care teams, professional chaplains will have earned their rightful place as champions and guarantors of fully integrative care.
HealthCare Chaplaincy Network, 65 Broadway, 12th Floor, New York, NY 10006-2503
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Constant Contact


One of the highest viewed websites for medical professionals, KevinMD.com, has published this important call-to-action for the field of spiritual care: "Why Health Care Leaders Should Take a Fresh Look at the Chaplaincy Profession."

Find it at this link.

Please share it with your network and comment on the article.




Rev. Eric J. Hall

President & CEO

HealthCare Chaplaincy Network, Inc.







POSTED: Urban Health Matters Blog by Rev. Eric J. Hall

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.

For more information about advance care planning, visit the American Bar Association. To learn more about healthy aging, visit Age-friendly New York City

   March 2016     Issue No. 8
Patient-Centered Care News
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. Also included is a downloadable PDF version for readers who prefer that format.
Please feel free to send any questions or comments to comm@healthcarechaplaincy.org.

Rev. Eric J. Hall
President & CEO
HealthCare Chaplaincy Network, Inc.
A Patient Writes About Patient-Centered Care

Why Doctors Must Learn From a Patient's Perspective (kevinmd.com)
It is critical that medical professionals receive continuing medical education in empathy training, patient-centered care, and patient harm prevention...

With all the new patient-centered care buzzwords flying around, I am shocked to learn that this topic is still being marginalized. If we truly want to put patients in the center of care, we must learn from a patient's perspective. As a life-long chronic patient, I embrace the digital advancements we've seen in medicine. Yet, all the technology in the world can't make up for human empathy. Now more than ever, we must give credence to the patient's voice.

Read more

Physician Empathy a Key Driver of Patient Satisfaction

New Study Supports Enhanced Physician-Patient Communication Training (American Academy of Orthopaedic Surgeons)

A study presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), links patient-perceived physician empathy with improved outcomes and medical care satisfaction.

Read more 

Spiritual/Chaplaincy Care
Chaplains are Health Care's Undiscovered Assets (Huffington Post) 
Chaplain services are clearly an essential component of quality whole person care - body, mind and spirit - a concept that is increasingly becoming a fundamental part of health care, especially in palliative care for the chronically ill. However, it is often an undiscovered asset by those receiving health care. In fact, studies show, many more inpatients desire conversations about religion/spirituality than have them.
So, the first challenge is that patients and their families need to become familiar with the concept; they need to know that they can request a chaplain, if they so desire, just like they might ask to see a social worker, a physical therapist, or a disease specialist. They need to become their own advocates for spiritual care.
In addition, there's even greater challenges in our health care system. Medicare only covers chaplain services in hospice. Not all interdisciplinary health care teams include chaplains. Those that do are more likely to understand the role and recognize the value. They see that a chaplain's presence provides an opportunity to communicate findings/recommendations into a treatment plan, and increases the likelihood of considering the patient as a whole.
As well, physicians, nurses and other interdisciplinary team members have marginal exposure to spiritual care training. Yes, chaplains are the spiritual care specialists, but spiritual care cannot be their domain alone. We've got to teach people from all types of medical disciplines how to listen and engage people comfortably and care for them spiritually and emotionally.
Read more 
Evidence-based Scope of Practice for Spiritual Care (ehospice International e-newsletter)

HealthCare Chaplaincy Network (HCCN) has 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 healthcare settings in the US. The scope of practice was developed was developed by a consensus panel convened by HCCN and composed of prominent experts in spiritual care, palliative care and other disciplines from the US and abroad.
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.

Strides in Spiritual Care - New quality indicators aim to better meet spiritual needs (nursingadvanceweb.com) 
"Much research has been able to be pulled together in this quality indicators report so that we're now able to see the change and understand the impact that spiritual care does provide to individuals, families and institutions," explained Eric Hall, president and CEO of HealthCare Chaplaincy Network, who was the driving force behind publication of the quality indicators. "What we have now is an understanding that spiritual care does reduce spiritual distress and facilitates meaning."...
"American healthcare is measured on value. It's not how many patients you help, but what the outcomes are for these patients," further explained Hall. "If you work on delivering these outcomes with a more focused approach, good things will happen for patients and in terms of caregiver satisfaction." 
Research is an essential mark of any clinical profession and patient satisfaction, and the quality of research denotes a discipline's development. So, while research on chaplaincy services has spanned nearly a half century, its continuation and advancement helps project spiritual care into a future offering more comprehensive services.

Read more 

Pediatric Bereavement Education for Those Who Deliver Palliative and Hospice Care

(From ehospice USA e-newsletter from the National Hospice and Palliative Care Organization)
A new edition of the pediatric hospice and palliative care e-journal produced by NHPCO's Children's Project on Hospice/Palliative Services in now available.
"Bereavement and Care, Part One" is the topic for the new edition of the ChiPPS E-journal, available free of charge on the NHPCO website.
This E-Journal offers a collection of articles that explore selected issues in bereavement and care. These articles offer suggestions for and examples of engaging in the important work of providing pediatric palliative/hospice care.

Read more

Making ICU's Less Terrifying and More Humane

(From bostonglobe.com)
For many patients, time spent in an intensive care unit is a deeply disturbing experience, and not just because they are suffering from a serious illness. They are often heavily sedated, encircled by beeping equipment, unable to talk or even think clearly. Doctors and nurses prod their bodies as scores of trainees watch.
"I could feel people touching me but I couldn't move,'' said Ashleigh Robert, 30, who spent three weeks in the ICU at Beth Israel Deaconess Medical Center in Boston awaiting a liver transplant. "It was extremely frightening."
Medical advances such as heart pumps and ventilators have led to more ICU survivors. About 80 percent of the 5 million patients who end up in intensive care each year return home. But there is a growing realization that many are left emotionally troubled by the experience, which can be marred by hallucinations, poor communication, lack of respect for privacy, and, later, post-traumatic stress syndrome.
Now, a group of leading hospitals, including Beth Israel Deaconess, is working to make the ICU less terrifying and more humane, using innovative tools such as iPad applications that feature patient biographies and journals kept by nurses.

Read more 

A Physician Writes About Patient-Centered Care

Why Doctors Care About Happiness (NY Times Well blog)

We in the health care professions need to notice and inquire about happiness the same way we do other aspects of our patients' lives. Lately I've started asking about it, and besides getting a much more nuanced understanding of who they are as people, I learn what their priorities are (often quite different from mine as their physician).
I also inquire about obstacles to their happiness, and brainstorm with them on ways to ease some of these. I don't presume that these challenges are facile to solve, but hopefully our conversation helps let patients know that their happiness matters as much as their cholesterol.
And if increasing happiness does in fact improve health - well, why not try to help our patients achieve it. The side effect profile and cost surely beat most of our current medications, and, at least for now, you don't have to get prior authorization from an insurance company.

Read more 
Advanced Care Planning

National Healthcare Decisions Day is April 16, 2016 (www.nhdd.org)

Its purpose is to inspire, educate and empower the public and providers about the importance of advance care planning.

Read more

Two Professional Education Opportunities
The first is for all who provide spiritual care - Nurses, Chaplains, Clergy, Social Workers, Physicians and More:
April 11-13, 2016 - Live Webcast from the Annual
Caring for the Human Spirit ® Conference
Obtain over 60 hours of the latest research and clinical experience information for the Interdisciplinary
Health Care Team for $800. 
  • No limit to the number of participants at your institution who can view content
  • Real-time access to the 3-day Go-To Conference on Spiritual Care.
  • Access to our conference App, which includes the slides presentations for all activities
  • Interact with speakers & presenters as well as other conference participants
  • Earn valuable CEU's for your participants.
  • Consider splitting the cost across multiple departments in your organization
  • Multidisciplinary team professional development for current and future staff
  • After the conference you will receive ALL of the conference content:
    • Keynote Address
    • Four Plenaries
    •  36 Workshops!
New Workshops Have Been Added (for no additional cost):
B7 - Dealing with Hope and Prognosis in Palliative Care: The Role of the Chaplain
E4 - Care for the Hispanic-Latino Patient: A Culturally Competent Approach
D6 - Caring for the Spirit: Can You Hear Me Now!?
F6 - What is Spiritual Care in Health Care and How do you Measure it?*
* (Added by Popular Demand)

Prefer to attend in person?

It's not too late, click here to learn more!

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Alabama School of Medicine (UASOM) and the HealthCare Chaplaincy Network. The UASOM is accredited by the ACCME to provide continuing medical education for physicians.

The University of Alabama School of Medicine designates this live activity for a maximum of 17 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The second professional education opportunity:
Are You a Member of the Palliative Care Team? Some seats are still available for the April 20th class start of the popular online professional continuing education course - Palliative Care Chaplaincy Specialty Certificate. More than 600 professionals have competed the course and say it significantly improved their practice.
HealthCare Chaplaincy Network™ (HCCN), founded in 1961, is a global health care nonprofit organization that offers spiritual care-related information and resources, and professional chaplaincy services in hospitals, other health care settings, and online. Its mission is to advance the integration of spiritual care in health care through clinical practice, research and education in order to improve patient experience and satisfaction and to help people faced with illness and grief find comfort and meaning--whoever they are, whatever they believe, wherever they are. For more information, visit www.healthcarechaplaincy.org,  call 212-644-1111, follow us on Twitter or connect with us on Facebook
HealthCare Chaplaincy Network, 65 Broadway, 12th Floor, New York, NY 10006-2503
Sent by news@healthcarechaplaincy.org in collaboration with
Constant Contact

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.

Learn more from experts about the implications of these quality indicators in this Spiritual Care Grand Rounds webinar:

March 15

The Case for Standardization in Chaplaincy Practice - In Evidence-Based Quality Indicators, Scope of Practice, and Knowledge Base

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


Other Upcoming

grand rounds1

February 25

Hope for a Miracle and the AMEN Protocol

Rhonda S Cooper MDiv, BCC
Chaplain, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins


March 24

Palliative Sedation: Ethical Consideration

Jeffrey T. Berger, MD, FACP
Professor of Medicine, Stony Brook University School of Medicine
Chief, Division of Palliative Medicine and Bioethics
Department of Medicine
Winthrop-University Hospital


For All Webinars:

1:30-3:00pm Eastern Time |Qualifies for 1.5 CE Hours | $40 Registration Fee

Learn More

We Need Your Help!

Take a Brief Confidential Online Survey of Hospital Administrators on Spiritual Care

Find Survey at www.CaringfortheHumanSpirit.org

Why Your Participation is Vital

  • Attention to spiritual and religious needs of patients and loved ones helps them cope with illness and increases patient satisfaction.
  • While the Joint Commission requires institutions to have a plan to provide spiritual care, there is no current data on what those plans entail.
  • Your survey response can help define best practices to improve patient experience.

This survey is being undertaken by HealthCare Chaplaincy Network and will NOT identify you or your institution.

We Need Your Help! The results of this survey can help you improve patient experience. Please participate at www.CaringfortheHumanSpirit.org.

If you are not the appropriate person, please pass this on to the proper administrator (e.g., Director of Pastoral Care).

Conducting the survey is HealthCare Chaplaincy Network™ (HCCN), founded in 1961, a global health care nonprofit organization that offers spiritual care-related information and resources, and professional chaplaincy services in hospitals, other health care settings, and online. Its mission is to advance the integration of spiritual care in health care through clinical practice, research and education in order to improve patient experience and satisfaction and to help people faced with illness and grief find comfort and meaning--whoever they are, whatever they believe, wherever they are.

Thank you for your participation. If you have any questions about the survey, please contact:

Rev. George F. Handzo
Director of Health Services Research and Quality

HealthCare Chaplaincy Network | 65 Broadway | 12th Floor | New York | NY | 10006


What are your thoughts, concerns, and satisfactions about your practice as a health care chaplain? Let your peers know, by writing an article for PlainViews®, the preeminent professional online journal for health care chaplains. Every month, we publish articles that articulate evidence-informed best practices.

Here are some of the areas we are especially interested in publishing:

  • Teaching other health care disciplines about spirituality and the role of the professional chaplain;
  • What chaplains need to know about conflict management and ways to manage it;
  • Negotiation skills when working with patients, families, and staff;
  • The practical integration of resilience as an intervention and support;
  • Working with persons dealing with substance abuse and addiction;
  • Spiritual care to stroke patients and their loved ones.

For more information about writing for PlainViews®, please visit www.plainviews.healthcarechaplaincy.org and read the Editorial Policy at the top of the masthead or contact Sue Wintz at swintz@healthcarechaplaincy.org.





   January 2016     Issue No. 6

Patient-Centered Care News


We hope that you find this complimentary monthly e-newsletter informative. Below are excerpts with links.  Also included is a downloadable PDF version for readers who prefer that format.


Please feel free to send any questions or comments to comm@healthcarechaplaincy.org.


Rev. Eric J. Hall

President & CEO

HealthCare Chaplaincy Network, Inc.





Patient Experience


The Hidden Patient Experience (Health Leaders Media)

How well-meaning and clinically unimportant actions can make or break the patient experience, and how leaders at Cleveland Clinic and Mount Sinai Health System are refocusing efforts.

During her hospital's monthly executive leadership rounds, Cleveland Clinic's executive chief nursing officer, K. Kelly Hancock, MSN, RN, NE-BC, met a patient who didn't seem quite happy, despite his insistence that everything was OK.

"We could just tell that he was a bit hesitant in his answers," Hancock says. So before she and her fellow executives left him, they probed a little more, asking, "Are you sure there's nothing else we could do to make your experience better?"

Actually, something was bothering him. Someone had come in to change his gown, and instead of addressing him by name, such as Mr. Smith, they called him "honey" and "sweetie."

"For him, he was offended," Hancock says.

It may have seemed like a small thing, but it really rubbed him the wrong way, and totally colored his experience as a patient. It was clear that it had been bothering him for quite some time.

"You've really got to dig when you're with the patients and the families," Hancock says. "What's important to that patient [is something] you may miss."

Clinicians might check off all of the important clinical boxes when caring for a patient, but it's often the small-perhaps nearly imperceptible-nonclinical elements of a hospital stay that most affect whether a patient has a good experience.

"I think that patients come to us expecting to get really good clinical care," agrees Sandra Myerson, MBA, MS, BSN, RN, senior vice president and chief patient experience officer at New York's Mount Sinai Health System. "The only way they can really judge us is on the rest of it."

With all the effort, money, and attention that's currently being paid to the patient experience, it's important for clinicians to understand how to get to the real heart of how a patient is feeling, and to do it in real-time.



A Physician Writes: Hospitals Need a Checklist for Patient Experience (KevinMD.com) 


More than twenty years ago, when I was a medical student, I jotted down another surgeon's suggestions. To us students, chief of surgery Dr. Frank Spencer was an intimidating, blunt-spoken, larger-than-life figure who not infrequently hollered at his residents. With patients, he was a different man, and he exhorted us again and again to follow a set of rules - a checklist, really, although he didn't call it that. It was a step-by-step guide to acting humanely with patients, because, after all, the chaos of the hospital makes it so easy to forget:

  • Treat the patient like a family member, with dignity and respect.
  • Be gentle and honest.
  • Don't rush.
  • Make them comfortable.
  • Acknowledge their fear.
  • Don't sit behind a desk.
  • Encourage them to ask questions.
  • Grade yourself by how you feel when you leave the room. If you leave with a smile, give yourself an A.

To be sure, it may be distressing for patients to think that hospital staff need such reminders. But the whole point of checklists is to ensure that we don't overlook the most obvious tasks, like checking temperatures and blood pressures or making sure we are in fact talking to (or taking a scalpel to) the right patient. Or treating a patient like a family member, with dignity and respect, and acknowledging their fear.



Download and View Complimentary Webinar & Slides: "The Critical Role of Spirituality in Patient Experience"


(Presented by: Jason A. Wolf, PhD, President, The Beryl Institute and Rev. George Handzo, BCC, CSSBB Director, Health Services Research and Quality HealthCare Chaplaincy Network™)


Many hospitals have partnered chaplaincy and patient experience or even put chaplains in charge of patient experience. And yet, spiritual care and chaplaincy care remain underutilized in helping to improve patient experience. Sharing insights from The Beryl Institute white paper published in collaboration with HealthCare Chaplaincy NetworkTM, The Critical Role of Spirituality in Patient Experience, this webinar explored the emerging focus of spiritual care and chaplaincy in patient experience excellence and provide a core set of central themes and concepts for organizations to consider regarding spiritual care. Participants will identify key practices on integrating spiritual care into healthcare and understand the impact the professional healthcare chaplain role has on patient experience excellence.



Note: Membership and promotional codes are not required.


Spirituality and the Terminally Ill Patient

A Lesson in Spirituality (e-hospice International & Journal of Pain & Palliative Care Pharmacotherapy)


It is not easy to understand how spiritual support works in a multi-religious environment unless one has lived in such a society.

In a culture where diversity of faiths and spiritual practices exist, there is potential for a complicated situation if a religious leader of one faith provides care to a person who follows another faith. Sometimes, though, the spiritual needs at the end of life can be surprising.

In the narrative entitled: 'A Lesson in Spirituality', published in the Journal of Pain and Palliative Care Pharmacotherapy, Dr Vidya Viswanath describes the story of a Hindu man with advanced cancer. His illiterate wife, in the author's words, turns out to be a "perfect" spiritual caregiver. The woman asked the husband: "If something happened to you suddenly, what would you want me to do?" The man replied that since childhood he has liked the rituals of church, and so would like a Christian funeral and burial. When he died, he was buried the way he wanted. The extended family then performed Hindu rituals.

I find the story so very uplifting - the merging of religious beliefs, all tending to connect the dying person and the family "to nature and the significant or sacred." This story reaffirms that the essence of spirituality is the coexistence of harmony and humanity, transcendent of religion.

The Journal of Pain and Palliative Care Pharmacotherapy in which this story is published, is an indexed journal that has made the narratives free access. That is a noble act on the part of the publishers, who have taken this step to help tell the story of suffering and relief to the world.




Why Hospitals Must Be Hospitable; Why Health Care Must Be Healing -- And Why Chaplains Must Lead the Way -- PlainViews® 


The words "hospital" and "hospitable" and the words "health" and healing" are obviously derived from the same roots.[i] And yet, patient surveys repeatedly demonstrate that there is a significant disconnect between what goes on in a hospital and the idea of being hospitable, and between the modern health care system and any common sense notion of healing.[ii]




Modernity pays lip service to this idea of holistic care, but generally does not practice what it preaches. Increased specialization has led to more rigid separation of these aspects of the person. A hospital patient today can look forward to being seen by innumerable practitioners; only rarely does anyone have panoramic vision of the overall impact of the various discrete interventions upon the patient as a whole.




Returning a Sense of Wholeness


I give them a chance to return to their sense of wholeness. To their sense of empowerment. I reduce their feelings of isolation. I advocate for them (lawyer's genes) and I encourage them to advocate for themselves.

I can't offer drugs, tests or procedures. I offer empathy, warmth, connection, relationship. I diminish loneliness and fear and feelings of vulnerability with information and reassurance. I do not cure people (at least not directly), but I facilitate their healing. I believe people who heal have a much better chance of being restored to health (which may or may not mean being cured). Not only that, I believe they have a much better chance of restoring themselves to health.


What role, then, can chaplains play in enhancing the health care experience of patients and their families.



Chaplains have a unique opportunity to promote positive, constructive and caring relationship for the benefit of patients, families and staff. We are well-equipped to bring hospitality back into our hospitals and healing into health care, and to exhort others to join us. To be sure, there is still much work to be done, even at my small community hospital and certainly in the modern health care system generally. And it is not easy work. On the contrary, changing individual attitudes and institutional culture is a slow, tough slog, fraught with real frustrations and setbacks along the way.


Though our progress may not be linear, it can and must be forward progress nonetheless. The Mishna teaches, "You are not required to finish the work, but neither are you free to desist from it."[x] Chaplains are not responsible for changing the entire system or even an entire workplace, but we are nevertheless obligated to do our part and to lead when and where we can.   


[i] The words "hospital" and "hospitable" are derived from the Latin hospes, meaning "host," "guest," or "stranger." Charlton T. Lewis, 

An Elementary Latin Dictionary (Oxford University Press, 2000), p. 371. The words "health" and "healing" are derived from the Old English"hal," and the Old High German, "heil," meaning "whole." See Byron L. Sherwin, 

In Partnership with God: Contemporary Jewish Law and Ethics (Syracuse University Press, 1990), p. 81.


[ii] See, e.g., Peter Pronovost, "The Patient Wish List," US News and World Report, October 15, 2015; Harvey Chochinov, MD, Dignity in Care.


Author: Karen Lieberman, JD, BCC is a staff chaplain at Columbia St. Mary's Hospital in Mequon, Wisconsin. She received her Juris Doctor from Stanford Law School and her Master of Science in Jewish Studies from Spertus Institute for Jewish Learning and Leadership. Karen is board-certified by both Neshama: Association of Jewish Chaplains and the College of Pastoral Supervision and Psychotherapy.


This piece is dedicated to the memory of her teacher, Rabbi Dr. Byron L. Sherwin, ZT"L.



Palliative Care

A Physician Writes: Timing of Palliative Care Consultations -- Is Earlier Better? (GeriPal Blog)


I think there are three main take home points from this study ("The Costs of Waiting: Implications of the Timing of Palliative Care Consultation among a Cohort of Decedents at a Comprehensive Cancer Center"):

1) If you want to significantly improve early access to palliative care, you must deliver this care outside of the hospital setting. We've seen this with our own data at our medical center. The second we opened up a palliative care clinic nearly a decade ago, our time from consult to death increased from a little less to a month to now over half a year.

2) If you improve early access to palliative care by developing an outpatient clinic, you will see a drop in inpatient deaths. Again, we've seen this in our own medical center. The drop in inpatient deaths though creates problems if quality metrics are only measuring what happens to inpatient deaths (the easiest deaths to capture). For high quality metrics, all deaths need to be captured, something that is difficult in a fragmented health care system.

3) The delivery of high quality of care can also be cost-effective care. This study further adds to the growing list of studies that palliative care can not only can improve the quality of care for patients with serious illness, but can do it in a way that also reduces total health care costs.



Palliative Care Cuts Costs for Cancer Patients With Other Health Problems (HealthDay)


Previous research has found a link between palliative care and lower health care costs, but this is the first study to focus on patients with multiple health issues, the researchers said.

The study included terminally ill cancer patients with a number of coexisting chronic conditions (comorbidities). When they were admitted to the hospital, some were seen by a palliative care team while others received usual care.

Hospital costs for those in the palliative care group were 22 percent lower than for those in the usual care group. Also, costs were up to 32 percent lower for palliative care patients with the greatest number of health problems, according to the study in the January issue of the journal Health Affairs.
"We already know that coordinated, patient-centered palliative care improves care quality, enhances survival, and reduces costs for persons with cancer," said study lead author Dr. R. Sean Morrison, professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

"Our latest research now shows the strong association between cost and the number of co-occurring conditions. Among patients with advanced cancer and other serious illnesses, aggressive treatments are often inconsistent with patients' wishes and are associated with worse quality of life compared to other treatments," Morrison, who is also director of the National Palliative Care Research Center, said in a hospital news release.

It is "imperative" that policymakers act to expand access to palliative care, he added.



A Thank You Letter to David Bowie From a Palliative Care Doctor


Dear David,

Oh no, don't say it's true - whilst realization of your death was sinking in during those grey, cold January days of 2016, many of us went on with our day jobs. At the beginning of that week I had a discussion with a hospital patient, facing the end of her life. We discussed your death and your music, and it got us talking about numerous weighty subjects, that are not always straightforward to discuss with someone facing their own demise. In fact, your story became a way for us to communicate very openly about death, something many doctors and nurses struggle to introduce as a topic of conversation. But before I delve further into the aforementioned exchange, I'd like to get a few other things off my chest, and I hope you don't find them a saddening bore.



High quality programming cost-effectively extends the delivery of spiritual care.  Choose from these three formats on your internal TV system, tablet or DVD, hard-wired or on a tablet.


Learn More


The third annual “Caring for the Human Spirit Conference” on April 11-13 at the Hyatt Regency Mission Bay, San Diego, California will explore the latest in evidence-based thought, research, and clinical experience related to integrating spiritual care in health care

The three-day conference, hosted by HealthCare Chaplaincy NetworkTM, will feature highly-regarded experts in spiritual care and palliative care from around the world, and is expected to draw a multi-disciplinary, international audience of physicians, nurses, social workers, chaplains, researchers, educators, and other health care professionals.

The Poster Session is a chance to share your research, case studies and projects with conference attendees.  Submissions from all disciplines are welcomed along with posters previously presented elsewhere.

Posters will be available for viewing on all 3 days of the conference. All conference attendees, supporters and exhibitors will have an opportunity to talk with you and learn from your work at the poster sessions on Tuesday and Wednesday.  

Abstracts and posters must include:

Action Taken
Contact email and telephone information.   

Abstract submissions will be reviewed on a rolling basis until March 11, 2016. If you choose to display a poster at the Annual Conference, you must be registered and are responsible for your own travel and hotel accommodations.  

To submit for consideration please email the requested information to Ms. Esmeralda Cordero, ecordero@healthcarechaplaincy.org no later than March 11, 2016.

Conference website is http://www.healthcarechaplaincy.org/conference.html



Award honors individuals who provide excellent cancer care

Atlanta, GA – January 14, 2016 – The American Cancer Society recognized Sister Mary Elaine Goodell, PBVM, DMA, BCC, with the American Cancer Society Lane W. Adams Quality of Life Award, a prestigious national honor for cancer care and commitment. 

The Lane W. Adams Quality of Life Award recognizes individuals who consistently exhibit excellence and compassion in providing care to cancer patients, going beyond their duties to make a difference in the life of cancer patients and their families. This award also represents the concept of the “warm hand of service,” which is an integral part of the Society’s commitment to excellence in cancer care and specifically emphasized by Lane W. Adams when he served as executive vice president of the American Cancer Society. Lane’s definition of the warm hand of service was to “serve others and enrich the purpose of one’s existence.”

The award was presented during a ceremony in Atlanta on January 13, 2016. Sr. Elaine was one of ten recipients to receive the award this year.

“These extraordinary awardees deserve to be recognized for their efforts to improve the quality of care for cancer patients and their families,” said Susan D. Henry, LCSW, chair, Lane Adams Quality of Life Award Workgroup. “These individuals represent personal and professional excellence and they provide critical leadership in the American Cancer Society’s mission to serve those who are touched by cancer.”

Sr. Goodell decided to become a certified chaplain at age 60 when looking for something to do in retirement.  She has spent the last 30 years bringing much needed calm and support to patients facing surgery as an employee of HealthCare Chaplaincy Network assigned to Memorial Sloan Kettering Cancer Center in New York. Sr. Elaine strives to visit and offer prayer and comfort to the nearly 40 to 60 patients per day no matter the patient’s faith or religious affiliation.  She never leaves for the day as long as there is a patient waiting to be seen.  She is highly respected for her chaplaincy skills and much loved by her patients and colleagues. She continues to make patients her daily priority.

The Society has recognized cancer caregivers through the Lane W. Adams Quality of Life Award since 1988.

Left to right in the photo are Gary Reedy, CEO, American Cancer Society; Sister Mary Elaine Goodell; Scarlott K. Mueller, MPH, RN, Chair of the American Cancer Society Board of Directors; and Susan D. Henry, LCSW, chair, Lane Adams Quality of Life Award Workgroup.



About the American Cancer Society

The American Cancer Society is a global grassroots force of 2.5 million volunteers saving lives and fighting for every birthday threatened by every cancer in every community. As the largest voluntary health organization, the Society's efforts have contributed to a 22 percent decline in cancer death rates in the U.S. since 1991, and a 50 percent drop in smoking rates. Thanks in part to our progress; 14.5 million Americans who have had cancer and countless more who have avoided it will celebrate more birthdays this year. We're determined to finish the fight against cancer. We're finding cures as the nation’s  largest private, not-for-profit investor in cancer research, ensuring people facing cancer have the help they need and continuing the fight for access to quality health care, lifesaving screenings, clean air, and more. For more information, to get help, or to join the fight, call us anytime, day or night, at 1-800-227-2345 or visit cancer.org.