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The Advanced Palliative Care Chaplaincy Specialty Certificate is a joint program of the California State University Institute for Palliative Care and HealthCare Chaplaincy Network.

If you are a Board Certified Chaplain or have completed the Fundamentals / Palliative Care Chaplaincy Specialty Certificate course, the Advanced course is designed to help chaplains play a strong leadership role in their palliative care team.  It teaches the skills necessary to effectively work within, lead, and enhance the effectiveness of a palliative care team:

  1. Distinguish and demonstrate ways in which chaplains assist patients and families, in partnership with the palliative team, in identifying the benefits and burdens of specific medical interventions
  1. Demonstrate and apply expertise in palliative care communication skills to assist in goal clarification in patient/family meetings
  1. Define, document, formulate goals, interventions, and plans, through a thorough spiritual assessment, that can be articulated clearly in each palliative care situation
  1. Identify, recommend, and integrate interventions in care plans to meet the needs of diverse patients/families
  1. Analyze the needs and construct assessments and interventions specific to marginalized patient populations
  1. Identify and execute best practices for incorporating chaplaincy assessment and documentation planning/continuity of care
  1. Learn to effectively lead, manage, and inspire a chaplaincy team for better patient outcomes and higher team satisfaction

This course begins June 15, 2016, and there are only a few seats left. If you’d like to reserve your spot, please call today or register online.  You must be a board certified chaplain or have completed the Fundamentals course to register for this course.

For details and to register: https://csupalliativecare.org/programs/chaplaincy-2/



   May 2016     Issue No. 10
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 & Spiritual Care Association
Palliative Care
Dr. Diane Meier: Palliative care may help patients live longer  (AAHPM SmartBrief & Medscape)
Research is showing that palliative care provided along with disease treatment may help patients live longer than if they get treatment alone, said Dr. Diane Meier, director of the Center to Advance Palliative Care. Two reasons may be that palliative care teams can help patients avoid unneeded hospitalizations and reduce incidents of depression, Meier said.
Read more (Medscape requires free registration to access)

Patient Experience
Patient experience: Driving outcomes at the heart of healthcare (Patient Experience Journal - published in association with The Beryl Institute)  

There is no longer a question that patient experience matters in healthcare today. It matters for those that are cared for and served and matters to all those working each and every day to provide the best in care at all touch points across the healthcare continuum. With this recognition, there too needs to be a change in mindset about patient experience itself. When addressing the topic of patient experience, the conversation is about something much broader than the "experience of care", as identified in the triple aim. The idea of experience reflects our biggest opportunity in healthcare, where experience encompasses quality, safety and service moments, is impacted by cost and the implications of accessibility and affordability, is influenced by the health of communities and populations and by both private and public health decisions that have systemic implications. A focus on experience at the broadest sense leads to the achievement of the four outcomes leaders aspire to in varying combinations in healthcare organizations around the world: clinical outcomes, financial outcomes, consumer loyalty, and community reputation. With the rapid growth in research, a diverse and expanding global community, and a shared commitment to outcomes, patient experience has now claimed its place at the heart of healthcare.
Read more 
Spirituality and Running a Hospital
The soul of healthcare: Hospital executives seek spiritual health to support leadership (Becker's Hospital Review)

Hospital and health system executives work hard to create an environment that fosters the healing process. That said, many believe the best way for an executive to do this is to ensure that they themselves are in a healthy place - not just physically, but spiritually.
Three healthcare leaders - Sister Carol Keehan, president and CEO of the Washington, D.C.-based Catholic Health Association; Ed Fry, president of executive search firm FaithSearch Partners; and Anthony R. Tersigni, EdD, president and CEO of St. Louis-based Ascension- agree that spiritual health oftentimes goes beyond religion alone.
For many healthcare executives, nurturing their sense of spirituality might include creating time each day for reflection, meditation, community service or various other activities. Although it might be easy to right off such tasks as low on the priority list, spiritual health is actually an important business strategy administrators and executives can use to become well-rounded individuals and better leaders.
Read more
Care at End-of-Life 
Saying Goodbye When Someone You Love Is Dying (Huffington Post and e-hospice international)  
Saying goodbye to a dying relative or friend - what to talk about, when, and how - doesn't come naturally to most adults. The irony: All these conversations ask of us, ultimately, is what people appreciate hearing at any time of life: words of candor, reassurance and love.
(Here are four lessons from) those who've been through the experience of saying goodbye share what felt right to them - and what they wish they'd done differently.
A new edition of the free pediatric hospice and palliative care e-journal - that continues the discussion of pediatric bereavement and care - is available online. (National Hospice & Palliative Care Organization and its e-newsletter e-hospice USA)
"Bereavement and Care, Part Two" is the theme of the new edition of the pediatric e-journal produced by NHPCO's Children's Project on Hospice/Palliative Services. This resource is available free of charge.
These articles that make up this issue offer suggestions for and examples of engaging in the important work of this aspect of providing pediatric palliative/hospice care. Because this is a huge and very important subject, we have chosen to devote two issues to these discussions. This is the second of those two issues. Part One is also available for download.

Are New York doctors talking to patients about death? Many doctors avoid mandatory discussions with dying patients about end-of-life options (Crain's NY Business)
There is a growing movement in New York to expand options for people who are terminally ill to include physician-assisted suicide. But many who support that legislation are skeptical that doctors are complying with the laws already on the books. In New York, doctors are required to help dying patients decide what they are willing to endure at the end of their lives and advise them of their options....
"People don't get evidence-based care. They get everything thrown at the disease, even if it doesn't change the outcome," said Amy Berman, senior program officer at the John A. Hartford Foundation, a New York nonprofit that aims to improve the care of older adults.
For Berman, like many, the issue is personal. She was diagnosed with terminal cancer more than five years ago. Berman, also speaking on the panel at the New York Academy of Medicine, said she was offered treatments that were unlikely to change the course of her disease, including a mastectomy and chemotherapy. She credits her decision not to accept those treatments with having survived longer than anticipated.
Physicians Write

This pediatrician learned why it's so important to listen to a parent (KevinMD)

Medicine can wear down our hearts and souls.  My journey in pediatrics has been filled with many rewarding experiences but haunting ones as well, like this one from my third year of residency.  By that final year of training, I was no longer certain medicine was really the right choice for me.  I was struggling with the notion that after almost 11 years of education, the destination was not quite what I expected.  It was during this trying time I learned one of the most important lessons of my career:  the value of trusting a mother's intuition. 
Tell Me a Real Story (Pallimed.com)

I am reading Internal Medicine: A Doctor's Stories by Terrence Holt, MD. It is an evocative book about medicine residency that had my long-dead intern-year butterflies swirling by the second page. In his introduction, he details how difficult it is to tell a patient's story without identifying that person. It's "not enough to respect the patient. As long as there's an actual, unique individual beneath that disguise, you're making a spectacle of somebody's suffering, and that's a line no one should cross. It's bad for the patient. It's not good for you the writer, either."
I would argue that it is essential to continue our story telling in medicine. And that they are real stories about real people because that's who we treat.

7 surprising things patients should know about their physicians (KevinMD.com)
Patients and families wagging their fingers and nodding their heads angrily in the direction of clinicians.  Doctors, nurses, and therapists have been accused of being incompetent, lazy, or downright cruel.
There is a basic loss of faith in the ability of our health care practitioners.
I think that the Internet plays a role.  The ability to Google one's symptoms and come up with a host of diagnoses has made the populace feel that medicine is easy.  Furthermore, the lay press and some of our own physicians and administrators decry the system as befouled by errors.  They say that we account for as much death and disability as heart disease and cancer.
While I believe that medicine requires a continuous and stringent effort to improve itself, I also think that the populace is becoming progressively fooled and brainwashed.

Research & Measurement

Implications for Spiritual Care from Recent National Quality Forum Meeting (HealthCare Chaplaincy Network)
The Rev. George Handzo, BCC, Director, Health Services Research and Quality for HealthCare Chaplaincy Network writes:
The National Quality Forum (NQF) is a not-for-profit, nonpartisan, membership-based organization that works to catalyze improvements in healthcare. One of NQF's activities is to convene multi-stakeholder Standing Committees in topical areas that are charged to review and recommend submitted quality measures for endorsement to NQF's Consensus Standards Approval Committee (CSAC). NQF endorsement is often a stepping-stone to inclusion on federally required data sets for various levels of health care providers.  These data sets are often tied to reimbursement for those providers. So this endorsement is a big deal...

Using a chaplaincy example, it might be reasonable to start by proposing the Rush spiritual screening protocol that has some validity testing already done. What would be needed in addition is (1) significantly more validity and reliability testing and (2) research evidence that using the Rush improves some particular health outcomes. It is important to note here that demonstrating that treating spiritual distress improves health outcomes is a contribution and some of that evidence does exist but this evidence is not sufficient for NQF endorsement. The evidence must demonstrate that doing the screening itself leads to improved outcomes. 
It is certainly true that few chaplains have the ability or resources on their own to do this kind of research. However, many have the ability to advocate for this kind of research in their institutions and lend their expertise to the projects. The reality is that unless and until this kind of effort occurs in our field, except in a very few instances, spiritual care quality measures will not take the place they need to occupy to help move spiritual care integration in health care forward.

Patient Engagement Survey: Improved Engagement Leads to Better Outcomes, but Better Tools Are Needed (Fierce HealthCare and NEJM Catalyst)

Most healthcare providers believe that improved patient engagement leads to better outcomes, but were divided on the best strategies to accomplish this, according to survey results published in an NEJM Catalyst blog post.

Forty-two percent of the 340 hospital or healthcare executives, clinicians and clinical leaders who responded to the NEJM Catalyst Insights Council survey, reported that less than a quarter of their patients were highly engaged in their care decisions. More than 70 percent said less than half of their patients are highly engaged. Only 9 percent of respondents reported high levels of engagement among their patients. 

"These results highlight the challenges in front of us; while having patients who are engaged with their health and with the health system is important, low rates of engagement appear to be the norm," wrote the study authors.

Read more

More About the Patient Engagement Survey

Please see below about two upcoming webinars.

Announcing the Patient Centered Care 
Spiritual Care Grand Rounds Webinar Series 
What Patients Want -- And How a Patient-Centered Approach to Care Delivers
Presented by Planetree -- 
Since 1978, the Global Leader in Advancing Patient-Centered Care
Thursday, July 28, 2016 from 1:30 PM to 3:00 PM (EDT)

Learn more and register

Free Webinar
Sponsored by the National Coalition for 
Hospice and Palliative Care
"Medicare Access and CHIP Reauthorization Act (MACRA) and the Palliative Care Provider" 
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.
Please contact Stacie Sinclair (stacie.sinclair@mssm.edu) with any questions.

Wednesday, June 8, 2016

The goals of this webinar are to:
1.       Educate all in the field around Medicare Access and CHIP Reauthorization Act (MACRA), Merit Based Incentive Payment Systems (MIPS), and Advanced Payments Models (APMs);
2.       Identify possible opportunities and pitfalls for palliative care; and
3.       Solicit comments and questions from our audience.

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)
  • George Handzo, BCC, CSSBB (HealthCare Chaplaincy Network)

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