Tuesday, July 12, 2016

More on Outcome Oriented Chaplaincy...

The Outcomes Oriented Chaplaincy model has three components: assessment, goals/expected outcomes, and interventions.  As a reference point, the Standards of Practice for Professional Chaplains in Hospice and Palliative Care assist the Chaplain in describing the assessment concept.  “Assessment is a fundamental process of chaplaincy practice. Provision of effective care requires that chaplains assess and reassess patient needs, and modify plans of care accordingly.” 


In the pastoral encounter with the patient and/or family member(s) it is predicted that a Spiritual Concern(s) would surface.  Arthur Lucas provides guidance for the Chaplain as he suggests the importance of identifying a person’s needs, hopes, and resources. (VandeCreek, L., & Lucas, A. (2001). The Discipline for Pastoral Care Giving. Binghamton:Haworth Press).  These concerns or singular concern form(s) the kernel of the assessment.  It is at this point that the Chaplain would gain insight from the patient to identify their desire to meet that spiritual concern.  The Goal/Expected Outcome defines where the Chaplain’s journey with the patient will proceed.  The patient’s hopes and resources provide energy, direction, impetus and motivation to touch and attempt to fulfill the goal…or not. This process requires two key pastoral care skills:  reflective listening and skilled verbal communication.  Never should a Chaplain come across as stiff and robotic, but, rather, with a non-anxious demeanor reflect to the patient a sense of ease.  The Chaplain would then use his/her pastoral care skill to employ fitting interventions to meet that goal or expected outcome.  Such Interventions are found in the Spiritual Care Algorithm that we employ at Cornerstone Hospice.  The Algorithm provides a comprehensive approach to identify the Spiritual Concern, the potential Goals/Expected Outcomes and Pastoral Interventions.  If you would like a copy of this tool, please email me at rbehers@cshospice.org and I will forward you a copy.  It was my privilege to present this at the Healthcare Chaplaincy Network annual conference in San Diego in April of 2016.


The Spiritual Plan of Care is a fluid document expected to change from time to time during the Chaplain’s journeying with the patient.  We use the patient recertification date as a prompt for the Chaplain to update the Plan of Care.  CMS requires the Plan of Care be updated.  It is incompetent spiritual care to allow a Plan of Care to languish without being updated. 


I urge you to read The Discipline for Pastoral Care Giving by VandeCreek and Lucas.  This will provide you with additional resources to enhance your spiritual care and skill at developing an effective plan of care.  Feel free to contact me for the Algorithms for Spiritual Care, Users’ Guide, and Documentation Template.



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