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Friday
Feb192016

What Does Quality in Spiritual Care Look Like? 

"Quality" is a term like "motherhood" and "apple pie". Who could be against it?  Who of us wants to buy, own or be a part of anything that doesn't have quality? Who of us as spiritual care providers strives to provide care that lacks quality? Hopefully, none of us.

Thankfully (I think) health care in many parts of the world is becoming more and more concerned with what constitutes quality and is starting to align payments for health care with demonstrations of quality. Increasingly, all services are being judged (and funded) by the value of what they add to the system with value defined as Quality/Cost. In the US, the major quality goals are known as the 'triple aims"- improved medical outcomes, reduced cost and patient satisfaction.

But, as they say, "the devil is in the details".  That is, we are very quick to agree on the idea that "quality" is a value to be supported and sought after, but we are often very slow to agree on what quality actually looks like and how to measure it. This is OK when we are buying a car and it is an individual preference about what constitutes quality for us. It is quite another when the quality indicators are going to drive everything from program decisions, to training of practitioners, to who gets paid for what.

This inability to agree on outcomes has been especially problematic in spiritual care where the normal medical metrics of cure rates and readmissions seemingly do not apply. Further, the normal bar for proposing a quality measure or indicator is that it is "evidence-based". That is, there is research or guidelines or regulation behind it. This evidence has been lacking for any indicator that would support spiritual care.

Thankfully, that situation has now changed. Recently, it was my great honor to facilitate an exceptional international, multidisciplinary panel assembled by the  HealthCare Chaplaincy Network to develop the first comprehensive set of evidence-based quality indicators for spiritual care along with suggested metrics and measures. That set of Indicators is now complete. I am convinced that this is a much-needed and huge step forward.

To be clear, this set of quality indicators is not the end of this development process. It is only the beginning. It represents the indicators that we have evidence for now. As an example, there is no indicator in the area of staff ministry- not because we think its not important- but because there is not evidence to supports its inclusion. Further, as we develop better measures and test these indicators against health outcomes, we will continue to refine and target them so their ability to drive sought after outcomes in health care in general improves.

A highlight for me is the inclusion, for the first time, of a proposed set of outcomes that will allow organizations to actually measure and document the value that chaplains bring to patient care. They will also raise the bar for professional chaplains to be accountable for these kinds of contributions and to focus their training and certification processes on preparing chaplains to deliver these outcomes. But, finally, they will start to focus spiritual care on discovering, assessing, and intervening to improve spiritual issues that are increasingly being shown to affect people's health and well-being.

 The link to the Indicators, the list of the panel members and a short guide for its use can be found at.

 http://www.healthcarechaplaincy.org./research.html

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