All Courses Forums Course Discussion Forums Strategic Chaplaincy Week One: Professional /chaplaincy: Establishing a Hospital-based department

10 replies, 5 voices Last updated by Rose McKeown 2 years, 7 months ago
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    • #4368

      Rose McKeown
      Member
      @rmckeown

      Feb. 17, 2019: Professional Chaplaincy: Establishing a hospital-based department

      I found this article much easier reading than the second article! Our first learning goal “to learn 3 best practices for increasing pastoral/spiritual care strategic presence” was addressed.

      We are in the process of deciding staffing needs at our hospital where I have worked now for 15 years. In 2007, we celebrated our Centennial year. For 100 years the Adorers of the Blood of Christ sponsored the hospital and staffed many of the departments but especially the pastoral care department. Pastoral care has always been part of the mission of the hospital since its foundation. I am not sure when we actually started a formal pastoral care department. The department was staffed by the Sisters and at times there was a priest as part of the team.
      When I came in 2004 the hospital was just transitioning to becoming a Critical Access Hospital. Which means, we had a 25-bed capacity hospital. Our pastoral care department was staffed by two of us Sisters, both board-certified by NACC and two per diem chaplains from the local clergy who were per diem for over-night on-call. I was full-time and the other Sister was part-time. Eventually the other Sister retired at the age of 84! Another Sister was hired in her place. She had one unit of CPE and was part-time. She retired at the age of 75! Right now, I work part-time and am the only chaplain. We have a per-diem chaplain who covers for me on my day off. He is of the local clergy and has one-unit of CPE. I moved out of management and our department is now over-seen by the Director of Ancillary Services. Pastoral care is very much valued by patients, families and staff. But, pastoral care was often seen as “The Sisters”. But, there are no more Sisters. I am the last Adorer here and will probably be the one ‘to turn the light out’ as far as Sisters are concerned.
      I have no doubt that pastoral care services will continue. Pastoral care is valued and appreciated throughout the healthcare system. But, it will be a new model as we move into a new building in early 2020. Our hospital will mainly be out-patient and swing-bed patients with 2-3 acute care patients. So, the question of staffing is being addressed. We have been blessed all these years to have had all the staffing we’ve had with only a 25-bed capacity hospital! Our average daily census is about 17-18 patients. We looked at our data on how often chaplains are called in overnight and it was only about 1-2 times a month. We no longer have chaplains on-call overnight but have asked the area clergy to take these calls if it is a member of their congregation. I have asked to be called otherwise. Sometimes they call me and sometimes they don’t. It is a work in process.
      The next question being asked is: Do we need a chaplain 8-hours a day? The other Critical Access hospital in our healthcare system has a board certified chaplain who works only four hours a day and that could be a model we move into and with no pastoral care coverage on weekends. Again, a work in process.

      In another article I read from George Handzo, he talked about learning Lean Six Sigma-doing things effectively and efficiently. Process improvement. Adding value and reducing waste. “..to survive at a progressive hospital and to prosper chaplaincy, we have a clear edict. Demonstrate to the hospital that you’re providing maximum value and minimum waste with the resources you have”. (PlainViews, December 7, 2011, Vol. 8, No. 21)……this is our challenge in our healthcare world today. We know we are doing this but how do you demonstrate it?!

      Sorry I am so late in posting my first week reflection! It has been a busy week!
      Rose

    • #4375

      Joy Freeman
      Participant
      @jfreeman

      Rose,

      You reflect well on what it means to work with in a living system.  The questions you ask about demonstrating value are ones we all struggle with.  I think the challenge is that each system looks for different things to buy into the value we provide.  It’s a constant dialogue.

      Thank you for sharing your experience.

       

      Joy

      • #4377

        Rose McKeown
        Member
        @rmckeown

        Thank you Joy! Yes, it is a constant dialogue!

    • #4380

      Michael Porter
      Participant
      @mkporter

      Rose thank you for sharing this: “There is no one so poor that they have nothing to give.  There is no one so rich they have nothing to receive.”  This is so true.  I may not be a leader like others, but I have gifts and I am a leader where I use those gifts.  This is what I get from the article.  People bring different things to the table and they work together in the evolving of the system.  This is the dance that happens.

      Mike

    • #4415

      While the article introducing complexity theory challenged me with its highly theoretical approach, Handzo and Wintz’s article seemed at the other end of the spectrum to me … a pretty basic introduction regaring how to make a business case for a pastoral care department. I should clarify that this is basic information for professional chaplains, but likely not to administrators, whom I presume is the intended audience of this article. Still, it is helpful to look at “the business case” from this perspective. One of the biggest challenges I face personally is trying to figure out how healthcare executives think. It is so counter-intuitive for me to focus on the types of data that they are interested in to the exclusion of other important factors. This creates inner tension for me. I know I need to understand how they think but at the same time I don’t want to “become one of them” and buy into that philosophy. I think our hospital has great leaders overall. I just don’t think like an administrators and don’t want to be an administrator. So I need help understanding administrators.

      • #4431

        Rose McKeown
        Member
        @rmckeown

        Thanks Melanie! That is a big challenge to try to ‘figure out how healthcare executives think”! And, I appreciate how you don’t want to become one of the and buy into their philosophy! Me either. One type of data they are probably interested in is money, funding for all that the healthcare system is involved in! I sometimes hear from staff that they feel ‘money is the bottom line’ yet the executives say that is not true, we are there for the patient. It’s a challenge for everyone to stay in business today and to be honest about the bottom line.

    • #4439

      Daniel Roberts
      Member
      @DanielRoberts

      I agree  with Melanie that the complexity theory article was challenging.  To be honest, I think that it is a great example of how many academic writers struggle to write effectively.  Larry McEnerney is a professor at University of Chicago that teaches academics how to write.  He has a great YouTube video titled “LEADERSHIP LAB: The Craft of Writing Effectively.”  The article was a boring and laborious read without quality examples.

      I have read the article by Handzo and Wintz before, and after reading it again, I again agree with Melanie that it is basic.  We are not taught the language of business, science, or healthcare at seminary, so it is a struggle sometimes to know what data administrators want.  I would encourage you to meet with your administrators and ask them about the data that is important to them.  Ask them what data will influence them to increase your department’s budget.  I did this one year at a hospital I served.  I did staff benchmarking based on average daily census with over twenty other similar hospitals.  I had research articles that showed spiritual cares impact.  They agreed that I went above and beyond what I was asked to supply.  Unfortunately, my budget along with several other department’s budgets were significantly cut.

       

      • #4455

        Rose McKeown
        Member
        @rmckeown

        • Dan, ditto to Melanie, Joy and Mike! Dan, I smile at your description of the complexity article “The article was a boring and laborious read without quality examples.” I will have to look up the YouTube video titled “LEADERSHIP LAB: The Craft of Writing Effectively. Thanks for sharing that link with us! None of that language was part of our training as chaplains but it is for new chaplains today!
        • And you did all that good research to validate the need for chaplains but still got your budget cut. We just don’t bring the revenue in and that seems to be the data that counts the most.

    • #4441

      Hi Daniel, thanks for your courage to call out the writing on the complexity theory article! I agree with you that academic writing is often quite ineffective. And how disappointing that you did all that work with benchmarking and gathering the data they wanted, yet your budget got cut rather than expanded. That might have been enough to send me packing!

    • #4451

      Joy Freeman
      Participant
      @jfreeman

      Daniel and Melanie,

      You raise a good point about academic writing.  I think that is something for us all to keep in mind when looking at our written communication as leaders.

      Daniel, I appreciate your struggle with data.  Where I am we have gone through many cycles of leadership wanting data, not caring about our data and statistics/wanting data again.  And like you it seems no matter what the numbers show – it never translates to dollars.

      Joy

    • #4453

      Michael Porter
      Participant
      @mkporter

      Dan, I have had similar experiences with administration, using data from studies, best practices etc. only to have things cut at budget time.  I continue to use what I have learned from studies and best practices in what I do and I have seen positive results.  In our organization the budges are set by the CFO and his staff.  This has made things more difficult to get things through.  I think bean counters look at things differently than  the other administrators.  If they do not see a direct correlation of something to the bottom line, it does not make it to the budget.

      Mike

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