The Value of an HCMA Chaplain

The professional pastoral/spiritual care services of an HCMA Board Certified Chaplain (BCC) or Certified Clinical Chaplain (CCC) provide several distinct benefits to a healthcare facility.

 Patient Well-Being Is Improved

• Professional Chaplains play an integral role in supporting and strengthening patients’ religious and spiritual beliefs and practices, which help them feel better and get better.
• In a study of nearly 600 older, severely ill, medical patients, those who sought a connection with a benevolent God, as well as support from Clergy and faith group members, were less depressed and rated their quality of life as higher, even after taking into account the severity of their illness.¹
•  In a study of 1,600 cancer patients, the contribution of patient-reported spiritual well being to quality of life was similar to that associated with physical well being. Among patients with significant symptoms such as fatigue and pain, those with higher levels of spiritual well being had a significantly higher quality of life.²

Patient/Family Satisfaction Is Enhanced

• Patients expect competent and compassionate spiritual care services;³ therefore, Chaplains enhance the image of the healthcare organization as they provide these spiritual services. Studies indicate that between 33-66% of all patients want to receive spiritual care.⁴
• In an age of high medical technology, brief hospitalizations, and shortened contacts with physicians and other healthcare professionals, Chaplains offer one of the few opportunities for patients and families to discuss their personal and spiritual concerns.⁵
• When Chaplains help a patient’s family, they tend to cope better with the hospitalization.⁶
• People who are satisfied with the spiritual care provided during their hospitalization are more likely to return to that institution again for future medical care and are more likely to recommend the facility to others.⁷ Spiritual Abuse Is Avoided
• Professional Chaplains can reduce and prevent spiritual abuse, acting as gatekeepers to protect patients and family from unwanted proselytizing.
• Codes of professional ethics stipulate that Chaplains themselves must respect the diverse beliefs and practices of patients and families.⁸

Length of Stay Is Shortened

• Research has consistently shown that pastoral/spiritual care helps patients “get better faster” and enhances their “readiness to return home” because the visits help them feel more hopeful.⁹
• One study showed a savings of over $4,000 per patient stay for those who received regular Chaplain visits.¹⁰

Staff Retention and Productivity Is Improved

• Losing staff is costly to a healthcare organization, but spiritual care encourages staff so that they persevere. Their supportive consultation can enhance morale and decrease staff burnout, thus reducing employee turnover and the use of sick time.
• One study reports that 73 percent of Intensive Care physicians and nurses believe that providing comfort to staff is an important role of the Chaplain, and 32 percent believe Chaplains should be available to help staff with personal problems.¹¹
• Chaplains provide sensitive, supportive spiritual care to patients and family during potentially stressful times for staff (e.g., terminal illness, codes, death, oncology, etc.), thereby allowing these medical specialists to attend to their primary duties.

Employee Assistance Is Appreciated

• Some staff members do not take advantage of assistance programs offered by the healthcare organization, but they do turn to the spiritual care staff for counsel.¹²
• When there’s a need for a staff memorial service, the Chaplain can provide a valuable service to the healthcare facility and their staff.

Risk Management and Litigation Is Mitigated

• Chaplains play an important role in mitigating situations of patient/family dissatisfaction involving risk management and potential litigation.
• When patients or their family become angry or threatening, Chaplains can mediate and defuse these intense feelings in ways that conserve valuable organizational resources by reducing risk and potential litigation.¹³

Death Care Is Enhanced

• No other healthcare provider is as highly trained to deal with grieving families as the
  Chaplain is.
• The spiritual care provided to families near or at the time of death helps free the healthcare
  staff to do their job.

Accreditation Standards Are Met

• Chaplains help healthcare organizations fulfill a variety of accreditation standards of the Joint Commission on Accreditation of Health Care Organizations (JCAHO), including those associated with patient’s rights for spiritual care and support.¹⁴
• When JCAHO comes to survey a healthcare facility, it reflects positively on the institution when they have a professionally competent Chaplain on staff.

Hospital Mission Statement Is Fulfilled

• Chaplains help organizations develop their mission, values and social justice statements that promote healing for the body, mind, and spirit — the whole person.
• Chaplains can help promote mission awareness and enhancement.

Medical Ethics Support Is Improved

• Chaplains help patients and family members identify their values regarding end-of-life treatment choices and communicate this information to the healthcare staff.
• Families respond better and in a timelier manner to end-of-life situations when Chaplain support is provided.
• Chaplains help families to clarify values and improve communication with medical staff, which can reduce expensive and unwanted medical care.¹⁵

Community Relations Are Enhanced

• Some people choose a healthcare facility because of the spiritual care provided.
• Chaplains establish and maintain important relationships with the community clergy, who often make referrals of their parish people to the hospital.
• Chaplains make unique contributions by providing many community services (such as participation in wellness programs, support groups, guidance and support for parish nurse programs, educational programs for lay spiritual visitation, etc.).

Bottom Line: Spiritual Care Provided by Chaplains Is Cost Efficient

• The only published chaplaincy cost study reported that the services of professional Chaplains range between $2.71 and $6.43 per patient visit.¹⁶
• Approximately three quarters of HMO executives surveyed reported that if spirituality (expressed through personal prayer, meditation and other spiritual and religious practices) can have an impact on well-being, then it can helpfully impact cost containment.¹⁷

Resources

¹ Harold G. Koenig, Kenneth I. Pargament, and Julie Nielsen, “Religious Coping and Health Status in Medically Ill Hospitalized Older Adults,” Journal of Nervous and Mental Disease 186, no. 9 (1998): 513-521.
² Marianne J. Brady, Amy H. Peterman, George Fitchett, May Mo, and David Cella, “A Case for Including Spirituality in Quality of Life Measurement in Oncology,” Psycho-Oncology 8, no. 5 (1999): 417-428.
³ Paul Alexander Clark, Maxwell Drain, and Mary P. Malone, “Addressing Patients’ Emotional and Spiritual Needs,” Joint Commission Journal on Quality and Safety 29, no. 12 (December 2003): 659-670.
⁴ Todd A. Maugans, William C. Wadland, “Religion and Family Medicine: a Survey of Physicians and Patients,” Journal of Family Practice31 (1991): 210-3; Raymond D. Carey, “Change in Perceive Need, Value and Role of Hospital Chaplains,” in Lawrence E. Holst, ed., Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing Company, 1985), 28-41; George Fitchett, , P. Meyer, and L. A. Burton, “Spiritual Care: Who Requests It? Who Needs It?” Journal of Pastoral Care 54, no. 2 (2000): 173-186.
⁵ Margot Hover, J. L. Travis III, Harold G. Koenig, and Lucille B. Bearon, “Pastoral Research in a Hospital Setting: A Case Study,” Journal of Pastoral Care 46, no. 3 (1992): 283-290.
⁶ Raymond G. Carey, “Chaplaincy, Component of Total Patient Care?” Journal of the American Hospital Association 47, no. 14 (1973): 166-172.; Raymond D. Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains,” in Lawrence E. Holst, ed., Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing Company, 1985), 28-41; Harold G. Koenig, Margot Hover, Lucille B. Bearon, and , J. L. Travis III, “Religious Perspectives of Doctors, Nurses, Patients, and Families,” Journal of Pastoral Care 45, no. 3 (1991): 254-267.
⁷ James L. Gibbons, J. Thomas, Larry VandeCreek, and A. K. Jensen, “The Value of Hospital Chaplains: Patient Perspectives,” Journal of Pastoral Care 45, no. 2 (1991): 117-125.
⁸ HCMA Code of Ethics, Healthcare Chaplains Ministry Association, 377 E Chapman Ave, Suite 260, Placentia CA 92870.
⁹ J. L. Florell, Bulletin of the American Protestant Hospital Association 37, no. 2 (1973):29-36. Study shows empirical evidence of the effectiveness of a Chaplain working with surgery patients. Randomized patients were assigned to either Chaplain intervention, which involved Chaplain visits for 15 minutes/day/patient, or to a control group (“business as usual”). The Chaplain intervention reduced length of stay by 29%, Patient-initiated call on RN time to one-third, and use of PRN pain medications to one-third.
¹⁰ Bliss, J. R., McSherry, E., and Fassett, J. “Chaplain Intervention Reduces Costs in Major DRGs ,” NIH Conference on Spirituality and Health Care Outcomes (1995). Patients in the intervention group had an average 2 day shorter post-op hospitalization, resulting in an overall cost savings of $4,200 per patient. Randomized 331 open-heart surgery patients to either a Chaplain intervention (“Modern Chaplain Care”) or usual care. See also: Florell, J. L. “Crisis-Intervention in Orthopedic Surgery,” Bulletin of the American Protestant Hospital Association 37, no. 2 (1973):29-36. Empirical evidence of the effectiveness of a Chaplain working with surgery patients. Randomized patients either to a Chaplain intervention, which involved Chaplain visits for 15 minutes/day per patient, or to a control group (“business as usual”). The Chaplain intervention reduced length of stay by 29% (p<.001), patient-initiated call on RN time to one-third, and use of PRN pain medications to onethird.
¹¹ Sharp, Cecil G. “The Use of Chaplaincy in the Neonatal Intensive Care Unit.” Southern Medical Journal 84, no.
¹² (1991): 1482-1486. 12 Ibid
¹³ Gerald B. Hickson, et al, “Factors that prompted families to file medical malpractice claims following perinatal injuries,” JAMA 267 (March 11, 1992): 1359-1363; Gerald B. Hickson, et al, “Patient Complaints and Malpractice Risks,” LAMA 287 (June 12, 2002): 2951-2957
¹⁴ The Joint Commission on the Accreditation of Healthcare Organizations. 2003 Comprehensive Accreditation Manual for Healthcare Organizations: The Official Handbook. Joint Commission on the Accreditation of Healthcare Organizations: Chicago, IL (2003).
¹⁵ Gail Daly, “Ethics and Economics,” Nursing Economics 18, no. 4 (2000): 194-201.
¹⁶ Larry VandeCreek, and Marjorie A. Lyon, “The General Hospital Chaplain’s Ministry: Analysis of Productivity, Quality and Cost,” The Caregiver Journal 11, no. 2 (1994/1995): 3-13.
¹⁷ Yankelovich Partners, Inc. Belief and Healing: HMO Professionals and Family Physicians. Report Prepared for the John Templeton Foundation (1997)