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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