Embedding Compassion in Clinical Systems: The Ramadan Care Pathway as a Model for Faith-Concordant Healing
Layla Al-Zubi, Harvard Medical School, Harvard Law School, Sara Al-Zubi, Massachusetts General Hospital, Zarin Rahman and Abd-Al-Rahman Trabousli, Brigham and Women's Hospital, Eesha Irfanullah and Iman Moawad, Massachusetts General Hospital, and Nora Abo-Sido, Brigham and Women's Hospital
Background:
Healthcare providers increasingly care for patients whose religious practices profoundly influence their clinical needs. For Muslims who observe Ramadan, fasting introduces unique challenges involving the timing of medication, laboratory draws, perioperative management, nutritional requirements, and access to spiritual resources, yet most healthcare systems lack standardized pathways to guide compassionate, faith-concordant care. Clinicians—especially trainees—frequently report uncertainty and variability in practice, with ramifications for both patient trust and clinical outcomes.
Objective:
To develop, implement, and evaluate an Epic-integrated Ramadan Care Pathway, paired with a resident education module, aiming to enhance clinicians’ knowledge, confidence, and capacity to deliver equitable, culturally responsive care for patients fasting during Ramadan. This initiative seeks to model how clinical systems can embed compassion and religious humility as key competencies, operationalizing the intersection of medicine and spirituality in contemporary practice.
Methods:
The intervention was co-created through a cross-disciplinary collaboration at Massachusetts General Hospital and Brigham and Women’s Hospital, engaging internal medicine and emergency medicine residents, clinical nutrition specialists, chaplaincy services, and information technology analysts.
The Ramadan Care Pathway incorporates:
• Fasting-aware order panels for medications and lab testing, adaptable to Suhoor (pre-dawn) and Iftar (post-sunset) schedules.
• Streamlined dietary orders to ensure halal and Ramadan-appropriate meals.
• Documentation prompts capturing fasting status, prayer needs, modesty preferences, and family involvement.
• Epic SmartPhrases with embedded educational pearls, facilitating best-practices and respectful patient communication.
A complementary, case-based one-hour teaching module promotes religious literacy and dialogue skills, including recommendations on counseling patients about religious exemptions where medically indicated and strategies for asking about, rather than assuming, religious observance. Interactive narratives, peer reflections, and practical management guidance are integrated to deepen clinical competence and empathy.
Evaluation:
Study participants include internal medicine and emergency medicine residents (n ≈ 60). A mixed-methods approach analyzes impact via:
• Pre/post surveys assessing changes in knowledge, confidence, and attitudes (Likert scale).
• Epic utilization metrics: order panel frequency, order accuracy, and documentation rates.
• Qualitative feedback from residents (focus groups and open-ended survey items), chaplains, and—where feasible—Muslim patient communities, guided by the International Office.
Baseline measures include pre-intervention survey scores and Epic audit of relevant clinical orders. Data collection spans January to June 2026, with analysis and dissemination planned for fall 2026. Only de-identified data are included, compliant with IRB and HIPAA stipulations.
Results (Projected):
Early piloting demonstrates increased resident confidence, improved recognition of religiously significant clinical needs, and higher Epic pathway utilization. Qualitative feedback suggests enhanced satisfaction with faith-concordant care provision and strengthened therapeutic alliances. Ongoing analysis will quantify changes in fasting-related documentation and spiritual care engagement.
Significance:
The Ramadan Care Pathway represents a scalable model for embedding faith literacy and compassion in healthcare infrastructure—bridging the prophetic call to healing with empirically sound, equitable systems change. By operationalizing humility via education and EMR workflow redesign, providers are equipped to ask about, rather than presume, patients’ religious practice, fostering dignity, justice, and trust. The initiative carries implications beyond Ramadan and Muslim patient populations, offering a template for integrating faith-responsive innovations in diverse settings and advancing the moral imagination of medicine.
Conclusion:
Strategic integration of spiritual understanding into both electronic health systems and clinician education can catalyze more just, creative, and humane care for religiously diverse populations. The Ramadan Care Pathway moves faith-informed, patient-centered medicine from aspiration to reality, bearing witness to the power of compassion in transforming clinical outcomes and institutional culture.
Healthcare providers increasingly care for patients whose religious practices profoundly influence their clinical needs. For Muslims who observe Ramadan, fasting introduces unique challenges involving the timing of medication, laboratory draws, perioperative management, nutritional requirements, and access to spiritual resources, yet most healthcare systems lack standardized pathways to guide compassionate, faith-concordant care. Clinicians—especially trainees—frequently report uncertainty and variability in practice, with ramifications for both patient trust and clinical outcomes.
Objective:
To develop, implement, and evaluate an Epic-integrated Ramadan Care Pathway, paired with a resident education module, aiming to enhance clinicians’ knowledge, confidence, and capacity to deliver equitable, culturally responsive care for patients fasting during Ramadan. This initiative seeks to model how clinical systems can embed compassion and religious humility as key competencies, operationalizing the intersection of medicine and spirituality in contemporary practice.
Methods:
The intervention was co-created through a cross-disciplinary collaboration at Massachusetts General Hospital and Brigham and Women’s Hospital, engaging internal medicine and emergency medicine residents, clinical nutrition specialists, chaplaincy services, and information technology analysts.
The Ramadan Care Pathway incorporates:
• Fasting-aware order panels for medications and lab testing, adaptable to Suhoor (pre-dawn) and Iftar (post-sunset) schedules.
• Streamlined dietary orders to ensure halal and Ramadan-appropriate meals.
• Documentation prompts capturing fasting status, prayer needs, modesty preferences, and family involvement.
• Epic SmartPhrases with embedded educational pearls, facilitating best-practices and respectful patient communication.
A complementary, case-based one-hour teaching module promotes religious literacy and dialogue skills, including recommendations on counseling patients about religious exemptions where medically indicated and strategies for asking about, rather than assuming, religious observance. Interactive narratives, peer reflections, and practical management guidance are integrated to deepen clinical competence and empathy.
Evaluation:
Study participants include internal medicine and emergency medicine residents (n ≈ 60). A mixed-methods approach analyzes impact via:
• Pre/post surveys assessing changes in knowledge, confidence, and attitudes (Likert scale).
• Epic utilization metrics: order panel frequency, order accuracy, and documentation rates.
• Qualitative feedback from residents (focus groups and open-ended survey items), chaplains, and—where feasible—Muslim patient communities, guided by the International Office.
Baseline measures include pre-intervention survey scores and Epic audit of relevant clinical orders. Data collection spans January to June 2026, with analysis and dissemination planned for fall 2026. Only de-identified data are included, compliant with IRB and HIPAA stipulations.
Results (Projected):
Early piloting demonstrates increased resident confidence, improved recognition of religiously significant clinical needs, and higher Epic pathway utilization. Qualitative feedback suggests enhanced satisfaction with faith-concordant care provision and strengthened therapeutic alliances. Ongoing analysis will quantify changes in fasting-related documentation and spiritual care engagement.
Significance:
The Ramadan Care Pathway represents a scalable model for embedding faith literacy and compassion in healthcare infrastructure—bridging the prophetic call to healing with empirically sound, equitable systems change. By operationalizing humility via education and EMR workflow redesign, providers are equipped to ask about, rather than presume, patients’ religious practice, fostering dignity, justice, and trust. The initiative carries implications beyond Ramadan and Muslim patient populations, offering a template for integrating faith-responsive innovations in diverse settings and advancing the moral imagination of medicine.
Conclusion:
Strategic integration of spiritual understanding into both electronic health systems and clinician education can catalyze more just, creative, and humane care for religiously diverse populations. The Ramadan Care Pathway moves faith-informed, patient-centered medicine from aspiration to reality, bearing witness to the power of compassion in transforming clinical outcomes and institutional culture.