Outcomes for Professional Health Care Chaplaincy: An International Call to Action

Click to increase image sizeClick to decrease image size

ACKNOWLEDGEMENTS

The inspiration for this article arose out of the International Consensus Conference on Improving the Spiritual Dimension of Whole Person Care held in Geneva, Switzerland in January, 2013. The authors would like to thank the George Washington Institute for Spirituality and Health and Caritas Internationalis which sponsored this conference and the Fetzer Institute which provided the funding.

Notes

Richard Bohmer argues that health care consists of two types of processes: sequential and iterative; the former applies to well-structured problems to which we can apply a known solution described in a (linear) protocol; the latter applies to uncertain problems that require exploratory approaches, tacit knowledge, and learning cycles. He relates the care process to the development stage of knowledge in the condition which we could apply to spiritual care: “The greater the knowledge, the easier it is to make a prediction about outcome and thus describe the approach to problem solutions as a discrete set of steps” (p. 80).

For the purposes of this article, but also increasingly in line with current practice, we will differentiate spiritual care and chaplaincy care according to the model developed by Puchalski and Ferrell (2010) along with others. In this model spiritual care is a domain of care in which all HCPs have a role, just as they all have a role in emotional care. All HCPs are spiritual care generalists. Chaplains are the spiritual care specialists on the health care team.

Activity Based Funding (ABF) is a model based on outputs agreed by national bodies, that is, how many appendectomies should be completed by a particular health service at what cost. The health service is then free to decide for itself what the inputs are that it needs to deliver to achieve the agreed outputs. In this context, chaplaincy must be able to demonstrate the contribution it makes so that it continues to be funded as one of the inputs.

The establishment of Community Chaplaincy Listening services in family doctor surgeries in Scotland has enabled patients to gain confidence in the self-management, normalized patient experience of loss and transition, and to potentially reduce the time family doctors have to spend with these patients (thus, reducing expenditure).

In 2011, HealthCare Chaplaincy received a $3 million grant from the John Templeton Foundation to (1) begin the process of developing a cadre of chaplain-researchers and building a community interested in research in the efficacy of spiritual care and (2) to provide grant support and supervision to six research groups that would conduct research in this area. The six research projects, all of which include a certified chaplain on the research team, will finish their work and report out in the spring of 2014.

We do recognize that there are funders who have already stepped forward to be involved in this effort. We note especially the Archstone Foundation, the Fetzer Institute, and the John Templeton Foundation in this regard.