Charles Millikan - Institute of Medicine

IOM Report: Spirituality in HealthcareThe Rev. Charles R. Millikan, D. MinVice-President for Spirituality and Values IntegrationThe Methodist Hospital System1

Spirituality in HealthcareSpirituality has been difficult to integrate intohealthcare:1. Limitations of defining spirituality2. Spirituality is very different than anythingtraditionally encountered in the acute caresetting.3. Healthcare professionals don’t know howto address spirituality in patient care.2

What is a Spiritual Need? An indication of unfinished businesso “I just feel like there’s more I could havedone in my relationship with my daughter.” A need to experience nature A need to have involvement and controlo “I want to control how the last few days ofmy life are lived.” A need to relate to God or an ultimate other• “Maybe I should have read the Bible more.”3

What is a Spiritual Need?A Need to:Have gratitude and optimismo “I need hope to make it through this.”Love otherso “I need my wife by my side. She’s my rock.”Receive from otherso “I want to take care of myself. I don’t want to bea burden on others.” Create meaningo “Why is this happening to me?4

Role of Chaplains Restore feelings of connectedness Address spiritual pain

Role of Chaplains Acknowledge spiritual distresso Use standardized instruments—FICA Integrate into treatment plan6

Non-Denominational Serve patients of all faiths and of no faith andprotect patients against proselytizing.7

Non-DenominationalStandards of chaplaincyo Outcomes of CPE Level II: “Studies must be ableto provide pastoral ministry to diverse people,taking into consideration multiple elements ofcultural and ethnic differences, social conditions,systems, and justice issues without imposing theirown perspectives.” (Pastoral Competence, CPE)o APC: For certification, the candidate must be ableto “function pastorally in a manner that respectsthe physical, emotional, and spiritual boundariesof others.”8

Leading MedicineThe Methodist Hospital System Mission“To provide high quality, cost-effective healthcare that delivers the best value to the peoplewe serve in a spiritual environment of caring inassociation with internationally recognizedteaching and research.”9

Leading Medicine: Values and Culture• Faith-based ministry• I CARE values• Patient-centered care:─ Service─ Quality─ Safety• Community benefit support• Engagement of our physicians• Commitment to education and research• Attention to staff needs10

Historical PerspectiveThe Methodist ExperienceThe Methodist ExperienceSystem IntegrationThe Patient Experience20072012ServicePride2005ICARE Values2003200211

Leading MedicineThe Methodist Hospital SystemSpiritual CareRev. Charles R. Millikan, D.Min.Vice PresidentSpiritual Care & Values IntegrationTMH Medical Center Willowbrook Sugar Land San JacintoRev. Bob KiddDirectorRev. Mark Young, D.Min.DirectorRev. Bill BrossDirectorRev. Linda TolonDirectorWest HoustonRev. Craig BradleyDirector12

Spiritual environment of healingBlessing of the handsNurses week 2013Jesus: The GreatPhysician13

Leading MedicineBereavement Ministry• Chaplains attend every death, including miscarriages and infant deaths• Letters are sent to every family who has had a loved one die in the hospital,expressing sorrow, acknowledging grief and resourcing them with local griefsupport group information• Invitations to a memorial service are sent to every family who has had a loved onedie in the hospital (Two Memorial Services a year)• We have a No One Dies Alone (NODA) program that provides compassionatecompanions to be with patients at end of life who do not have family or friends14

Leading MedicineCollaboration (Internal & External)• Chaplains attend every code in the hospital (pare of Code Team)• Chaplains attend interdisciplinary rounds on clinical units• Chaplains assist physicians in difficult conversations (Compassionate CareConversations)• Chaplain(s) are represented on the Biomedical Ethics Committee and consult team• SCE partners with (and trains) lay persons from our local community of several faithtraditions who come in on a weekly basis to provide spiritual care, which expands ourreach within the hospital; 182 TMHS Lay Ministers and 33 Faith Group Volunteers (6different traditions)15

Leading MedicineChallenges• Spiritual Care as a Center of ExcellenceFor Spiritual Care to thrive, it must work incollaboration with all the services of the hospitalsystem and not be isolated to just a chapel.Spiritual Care is holistic.16

Practical Tips for Faith-Based HospitalsPractical Tips• Develop Institutional Mission and Vision Statements17

Leading MedicineThe Methodist Hospital System Mission“To provide high quality, cost-effective healthcare that delivers the best value to the peoplewe serve in a spiritual environment of caringin association with internationally recognizedteaching and research.”18

Leading MedicineThe Methodist Hospital Statement of Belief“The Methodist Hospital, a Christian organizationestablished by the Texas Annual Conference of theUnited Methodist church, exists to provide qualityhealth care services. As it fulfills this purpose, theSystem participates in the redeeming activity of Godthat makes the world a better place for allhumankind. This health system is based on the beliefGod can heal through the lives, actions, and words ofpersons, regardless of various religious perspectives.Therefore, in all endeavors The Methodist HospitalSystem strives to treat everyone as a person ofsacred worth and value, created by God.”19

Leading MedicinePractical Tips• Collaborate and Partner with Faith Based Communities20

Leading MedicineCommunity Benefits• Bering Omega CommunityServices• Communities in SchoolsHouston, Inc.• Eye Care for Kids Foundation• Ft. Bend Family HealthCenter, Inc.• Houston Hospice• Krist Samaritan Center forCounseling and Education• Matagorda Episcopal HospitalOutreach Program• Montrose Counseling Center, Inc.• Northwest Assistance Ministries• San Jose Clinic• Seven Acres Jewish Senior CareServices• Shalom Mobile Health Ministries• Sheltering Arms Senior Services• The Community Clinic• The Women’s Home• TOMAGWA Health Care ministries21

Practical Tips for Non-Faith BasedHospitals There should be a commitment to chaplaincy. Chaplains can and should address spiritualconcerns, even in a non-faith based hospital22

References1. Jacobs MR. What are we doing here? Chaplains incontemporary health care. The Hastings CenterReport. 2008; 38(6): 15.2. Ferrell B and Munevar C. Domain of spiritual care.Progress in Palliative Care. 2012; 20(2): 66.23

Questions?24