Spiritual care is arguably one of the most misunderstood aspects of clinical care. Its clinical benefits and importance to critically ill patients, their families, and care teams is well documented in reducing trauma and burnout. Many critical care areas are places of high-stress for patients, care teams, and families. It is in this environment where spiritual care has the opportunity to make the largest impact to patient care and experience for all stakeholders so that communication and collaboration can be enhanced for the mental and physical well-being of all.

goShadow partnered with a Spiritual Care Department at UPMC Magee-Womens Hospital to better understand the challenges they face and how we could support them to improve the delivery of their services and patient care across the organization. We asked the chaplains to fill out a “What Matters to You?” survey that posed the following questions:

1. What matters most to you in your role?
2. Please describe what your ideal role would be as part of a patient’s care team?
3. What support do you need to achieve your ideal role?
4. Please list the top 3 departments where you believe your services could be best utilized/have the most impact.

You can read the full report of their responses. 

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‍Industry Look on Spiritual Care

Not surprisingly, the chaplain’s responses reflect what is found in peer-reviewed literature. Spiritual Care is a powerful service and intervention that is too often perceived as only religious care. While that in of itself is still an integral service that is provided, Spiritual Care is an expansive service that bridges clinical care with a person’s emotional and spiritual needs, offering patients, their families and staff with counseling, helping them understand their emotions during often difficult times.

One study found that 88% of hospitalized patients considered spiritual and religious beliefs important to them.¹ Of those patients, 67% felt those beliefs were important for coping with illness. Other studies have reinforced the need for spiritual care services, 73-85% of advanced cancer patients detailed having at least 1 spiritual need - overcoming fear, finding hope, finding meaning, seeking closer connection, and seeking forgiveness.^2-4 Spiritual care services were also demonstrated to help staff manage symptoms of burnout and building resilience. This is not only important for staff mental well-being but staff spiritual and emotional satisfaction are strongly correlated to patient satisfaction as well as family perception of care.

Spiritual Care is also emphasized by The Joint Commission on the Accreditation of Healthcare Organizations and The Canadian Council on Health Services as well as other national organizations. All together the evidence shows that there is an overwhelming consensus - dying is a spiritual event that is integral to a patient’s personal narrative, dignity, and respect. Then why does spiritual care only occur in 6-13% of critically ill cases?⁵ 

goShadow’s partners point to one large reason - there is a fundamental lack of system-wide education of what chaplains do and how both patients and staff benefit from their collaboration. The result is poor communication between clinicians and chaplains which leads to missed opportunities to address spiritual concerns. Another result is disproportionate use of their services–5.9% of ICU patients met with a chaplain vs 80% of patients who recently died. The social perception of the chaplaincy as a service sought out only after death is another barrier to utilizing chaplains throughout a person’s care experience. 

Breaking the Stigma and Aligning our Services

Over half the hospitals in the US offer chaplaincy services and spiritual care. If organizations take the time to fully understand and innovate the integration of spiritual care and chaplains into the entire care experience instead of only at the time of death, trauma to both families and care teams that result in burnout and poor perceptions of experiences would be reduced significantly. 

goShadow has over 10 years of expertise developing changemakers as well as staff/patient education. We’re working with our Spiritual Care staff partners to develop comprehensive educational collateral, training, and tests of change to help patients and staff understand and integrate chaplains into the care team sooner and with more value to all stakeholders. We’ve formed partnerships with leaders to pilot integrating chaplains into rounding care teams to demonstrate impact on patient experience and satisfaction. Success will be assessed by shadowing, rounding, and survey data. We will also help develop tools to help identify those in the ICU who are in need of spiritual care. This includes staff members who can then become advocates of spiritual care. 

All of our improvement tools, such as “How to have a WMTY conversation”, shadowing starter guide and our methodology for analyzing survey data can be found on our website goshadow.org. If you’re looking for a direct partnership - we offer 1:1 coaching, training and data analysis! Reach out to learn more!  

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Sources:

1. Koenig HG. Religious attitudes and practices of hospitalized medically ill older adults. Int J Geriatr Psychiatry. 1998;13(4): 213-224
2. Moadel A,Morgan C, Fatone A, et al. Seeking meaning and hope: selfreported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology. 1999;8(5):378-385. 
3. Astrow AB, Wexler A, Texeira K, He MK, Sulmasy DP. Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol. 2007;25(36):5753-5757. 
4. Alcorn SR, Balboni MJ, Prigerson HG, et al. “If God wanted me yesterday, I wouldn’t be here today”: religious and spiritual themes in patients’ experiences of advanced cancer. J Palliat Med. 2010;13(5):581-588.
5. Spiritual care in the intensive care unit: A narrative review. (n.d.). Retrieved July 25, 2022, from https://www.parishnursingalberta.ca/wp-content/uploads/2019/02/Spiritual_care_ICU_Ho_Nguyen_2017.pdf 

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