Development of a Physician Driven Department of Healthcare and Spirituality: At a Large Hospital System
John Guarneri, MD, Florida Hospital
J. David Moorhead, MD, Florida Hospital
Gregory Ellis, MDiv, BCC, Florida Hospital
The intent of this presentation is to show how the aspect of spiritual care in healthcare can initially be introduced and developed under a biopsychosocial spiritual framework of care to a large faith-based hospital system. It will be described how this concept evolved from a personal holistic approach of my medical practice into an initiative of adapting this holistic approach by fellow physicians at a 300+ bed community hospital. It will be further elaborated regarding the progressive development of this concept at an eight campus faith-based hospital system where a physician driven Department of Healthcare and Spirituality was formalized. The history of this Department of Healthcare and Spirituality will be described regarding its development and its initiatives. Details regarding its mission, vision, objectives and key points learned will be described. Concluding points will be discussed and this will then be followed by a question, comment and answer period.
After my residency in obstetrics and gynecology and evolving as a private practitioner I included not only the biopsychosocial aspect of care but casually began addressing aspects of my patients’ spirituality/religiosity. This first occurred with patients whom I was comfortable with and knew well. As I began to further research this field, I realized that I needed to formalize this query with my patients within the written intake history. It was of interest, that about 75% of my patients completed these spiritual questions and opened the door to discuss this aspect of their lives when appropriate. The other 25% that left these questions blank, implied that they did not wish to discuss this, which I wholeheartedly respected.
As I continued not only with my practice in 1999, I also began in a medical leadership role at the community hospital. One of the glaring problems that I saw with patient care was this “Big Black Hole” where physicians were good at taking care of the body but rarely the mind, and just about never the spirit. Our administrator at the community hospital agreed with my thoughts and we began discussions and meetings that led to other physicians and our chaplain joining in this dialogue. The question that I would challenge my fellow physicians in a friendly way was, “if you believe that as human beings we are body, mind and spirit, shouldn’t we be addressing our patients’ body, mind and spirit when we care for them?” This eventually led to meetings at our community hospital where a percentage of our physicians wished to further explore this aspect of care inclusive of our chaplains being part of our clinical team.
As the years passed, in 2001 I was elected to the system medical leadership of our 8 campus faith based hospital system. Still having this passion to further integrate the spiritual aspect of care into clinical practice, I pursued this developing a formalized medical driven Department of Healthcare and Spirituality. Further dialogue took place with the medical system leadership discussing the formation of this department with the definition of spirituality which would embrace all of our physicians and patients. I formerly brought this to our medical executive committee with the proposal of forming this Department of Healthcare and Spirituality which as unanimously accepted. This was further vetted at the Board level of our institution and approved as well.
With our Department up and running in 2008, the first strategy was to find physicians who had interest and passion in this aspect of care at our eight campuses. The second strategy was to contact not only the Pastoral leadership but to make contact as well with the senior chaplains at our eight campuses. As we brought the interested physicians and chaplains to our Department of Healthcare and Spirituality meetings, both at a system level as well as a campus level, we then formulated together our mission, vision and objectives.
MISSION
Embracing the patient’s spiritual needs of care along with the psychosocial and physical needs, while uniting the caregiver’s spirituality and wellness.
VISION
Integrating the spiritual needs of our patients into their medical care and research initiatives by our healthcare providers, supported by our clinical team including our chaplains and faith communities.
OBJECTIVES
OBJECTIVES IN ACTION
OTHER OBJECTIVES AND OUTCOMES IN ACTION as of 2014 include: Schwartz Center Rounds at all eight campuses; care giving workshops with faith communities and parish nursing program; care giving webinars; palliative care initiative; integrating spirituality into practice research; development of a pediatric spiritual history
Important Points That We Emphasize about our Department of Healthcare and Spirituality:
Concluding Remarks:
J. David Moorhead, MD, Florida Hospital
Gregory Ellis, MDiv, BCC, Florida Hospital
The intent of this presentation is to show how the aspect of spiritual care in healthcare can initially be introduced and developed under a biopsychosocial spiritual framework of care to a large faith-based hospital system. It will be described how this concept evolved from a personal holistic approach of my medical practice into an initiative of adapting this holistic approach by fellow physicians at a 300+ bed community hospital. It will be further elaborated regarding the progressive development of this concept at an eight campus faith-based hospital system where a physician driven Department of Healthcare and Spirituality was formalized. The history of this Department of Healthcare and Spirituality will be described regarding its development and its initiatives. Details regarding its mission, vision, objectives and key points learned will be described. Concluding points will be discussed and this will then be followed by a question, comment and answer period.
After my residency in obstetrics and gynecology and evolving as a private practitioner I included not only the biopsychosocial aspect of care but casually began addressing aspects of my patients’ spirituality/religiosity. This first occurred with patients whom I was comfortable with and knew well. As I began to further research this field, I realized that I needed to formalize this query with my patients within the written intake history. It was of interest, that about 75% of my patients completed these spiritual questions and opened the door to discuss this aspect of their lives when appropriate. The other 25% that left these questions blank, implied that they did not wish to discuss this, which I wholeheartedly respected.
As I continued not only with my practice in 1999, I also began in a medical leadership role at the community hospital. One of the glaring problems that I saw with patient care was this “Big Black Hole” where physicians were good at taking care of the body but rarely the mind, and just about never the spirit. Our administrator at the community hospital agreed with my thoughts and we began discussions and meetings that led to other physicians and our chaplain joining in this dialogue. The question that I would challenge my fellow physicians in a friendly way was, “if you believe that as human beings we are body, mind and spirit, shouldn’t we be addressing our patients’ body, mind and spirit when we care for them?” This eventually led to meetings at our community hospital where a percentage of our physicians wished to further explore this aspect of care inclusive of our chaplains being part of our clinical team.
As the years passed, in 2001 I was elected to the system medical leadership of our 8 campus faith based hospital system. Still having this passion to further integrate the spiritual aspect of care into clinical practice, I pursued this developing a formalized medical driven Department of Healthcare and Spirituality. Further dialogue took place with the medical system leadership discussing the formation of this department with the definition of spirituality which would embrace all of our physicians and patients. I formerly brought this to our medical executive committee with the proposal of forming this Department of Healthcare and Spirituality which as unanimously accepted. This was further vetted at the Board level of our institution and approved as well.
With our Department up and running in 2008, the first strategy was to find physicians who had interest and passion in this aspect of care at our eight campuses. The second strategy was to contact not only the Pastoral leadership but to make contact as well with the senior chaplains at our eight campuses. As we brought the interested physicians and chaplains to our Department of Healthcare and Spirituality meetings, both at a system level as well as a campus level, we then formulated together our mission, vision and objectives.
MISSION
Embracing the patient’s spiritual needs of care along with the psychosocial and physical needs, while uniting the caregiver’s spirituality and wellness.
VISION
Integrating the spiritual needs of our patients into their medical care and research initiatives by our healthcare providers, supported by our clinical team including our chaplains and faith communities.
OBJECTIVES
- Educate and facilitate physician understanding of the spiritual aspects of patient care
- Collaborate with the healthcare delivery team on the spiritual aspects of patient care with emphasis and consultation from the Pastoral Care Team
- Collaborate, and further establish, relationships with the faith communities and their leaders on the spiritual care of patients
- Support and foster the spiritual life and wellbeing of physicians
- Identify the hospitals and national best practices, and collect data to determine where evidence supports improved outcomes
OBJECTIVES IN ACTION
- The deepening of the healthcare providers’ knowledge through dialogue with national speakers, faith community leaders and chaplains.
- Promoting multidisciplinary rounds inclusive of chaplains especially in our
- Intensive Care Units; further enhancing our Emergency Department physicians with chaplain availability
- Physician dialogues with our faith community leaders (ministers, rabbis, priests, imams….) where we intersect in the care of issues of our patients
- Encouraging the healthcare providers’ well-being through Meaning in Medicine dialogue
- Collaborative research with chaplains, nurses, and physicians on the biopsychosocial spiritual approach in helping our patients cope and heal
OTHER OBJECTIVES AND OUTCOMES IN ACTION as of 2014 include: Schwartz Center Rounds at all eight campuses; care giving workshops with faith communities and parish nursing program; care giving webinars; palliative care initiative; integrating spirituality into practice research; development of a pediatric spiritual history
Important Points That We Emphasize about our Department of Healthcare and Spirituality:
- Our department is not about evangelizing nor proselytizing, it is looking to recognize and facilitate the patient’s spirituality including their particular religiosity
- Hospital administration alignment; easier for a faith based hospital system but realize according to the Joint Commission, spirituality should be addressed at all hospitals
- Understand institutional infrastructure: administration, physician leaders and physician staff, clinical and nursing staff, chaplains
- Understand and facilitate the important connection of the hospital institution to the faith communities
- Spirituality cannot be addressed in isolation since it is so intimately involved with the patient’s psycho-sociology
Concluding Remarks:
- It is always about relationships with patients, fellow physicians, chaplains, administrators, nursing and clinical staff
- Realize that you develop slowly but surely
- We are slowly changing culture in a profound way