Accountable in Acute Care

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How do we reflect upon and examine our practice, and hold one another accountable in our profession of chaplaincy in acute care beyond our own NACC standards for certification and our Common Standards? The Association of Professional Chaplains with the assistance of other groups of pastoral care givers, including NACC, joined together to create the Standards of Practice for Professional Chaplains in Acute Care (SOP-AC) to use as an important sounding board that we all need to become more closely familiar and conversant with.

You may recall that in our November-December 2011 Vision, we focused on long–term care ministry. In my column in that issue, I offered reflections on the Association of Professional Chaplains’ (APC) Standards of Practice for Professional Chaplains in Long-Term Care (SOP-LTC). I noted that the SOP-LTC were for the most part identical in structure and content with the Standards of Practice for Professional Chaplains in Acute Care (SOP-AC), except for some very important points of distinction offered in the introduction and in the designation of those served. www.nacc.org/vision/Nov_Dec_2011/ed.asp.

This issue of Vision is dedicated to exploring the SOP-AC themselves. Several excellent articles have been prepared. We believed it was appropriate and timely to do so as the NACC has also partnered with Catholic Health East (CHE) and other Catholic health systems that helped plan the Spiritual Care Champions webinars to prepare 2012-2013 webinars based on the SOP-AC. The NACC can be proud of its dedication to preparing and certifying members to meet these standards, as well as to providing ongoing educational opportunities with several partners to help our members further develop their competencies in these standards. Let me offer a few introductory thoughts about these SOP-AC’s, their preparation, development, and endorsement.

We applaud the initiative of the APC’s Commission on Quality in Pastoral Services in assembling an inclusive work team (members of APC, Association for Clinical Pastoral Education (ACPE), and NACC) to draft the SOP-AC’s. They used the standards of practice for social work and nursing as models, as well as the prior work on chaplain standards done by our Australian and Canadian confreres. Their primary goal was “to reach consensus about what standards of practice are most important at this time and to set those standards in front of the profession for further discussion.” The drafts were vetted through our respective organizations. There was also the realization and humble acceptance that SOP-AC’s are not written in stone, but are expressions of our practice at this point in time and so “will be adjusted as the profession moves forward.” www.professionalchaplains.org/index.aspx?id=1210

The endorsement/affirmation process of the SOP-AC included the Spiritual Care Collaborative (SCC) cognate groups as the SCC formally affirmed the SOP-AC in fall 2009. On the SCC website you can read: “Building on the work of the Council on Collaboration, which established common standards for professional certification, education and a common code of ethics, the Spiritual Care Collaborative Steering Committee affirms the Standards of Practice for Professional Chaplains in Acute Care Settings that were recently developed by the APC Commission on Quality in Pastoral Services that included representatives from other SCC participating associations.” www.spiritualcarecollaborative.org/standards_of_practice.asp

The rationale for the development of the SOP-AC included the professional peer importance of articulating and holding ourselves to our own professional standards since “others with whom chaplains serve and communicate, such as doctors, nurses and those from other disciplines in healthcare settings, have standards of practice.” When announcing the SOP-AC in Hospital and Health Networks, Sue Wintz, then president of the APC Board, in making this point, said: ”We want to be recognized as leading the clinical team in cultural competency and for our contributions to patient outcomes and quality issues.” Chaplains Launch New Standards of Practice

The other important rationale was to foster greater professional growth among ourselves, as the introduction states: “Having standards of practice can help chaplains communicate with others about chaplaincy and assist chaplains in discussions with other chaplains.” www.professionalchaplains.org/index.aspx?id=1210

Ultimately, this last rationale is foundational and essential, and makes the first reason credible and persuasive. How do we reflect upon and examine our practice, and hold one another accountable in light of the SOP-AC? Thus the purpose and importance of this issue of Vision and the 2012-2013 CHE Spiritual Care Champions webinar series.

We are deeply grateful to our members who wrote the articles on specific SOP-AC in this Vision as an invitation to have each of us articulate his or her experience of practicing these standards. Here are the SOP-AC’s we are examining together.

The Preamble: Chaplaincy care is grounded in initiating, developing and deepening, and bringing to an appropriate close, a mutual and empathic relationship with the patient, family, and/or staff. The development of a genuine relationship is at the core of chaplaincy care and underpins, even enables all the other dimensions of chaplaincy care to occur. It is assumed that all of the standards are addressed within the context of such relationships.

Section 1: Chaplaincy Care with Patients and Families

Standard 1, Assessment: The chaplain gathers and evaluates relevant data pertinent to the patient’s situation and/or bio-psycho-social-spiritual/religious health.

Standard 2, Delivery of Care: The chaplain develops and implements a plan of care to promote patient well-being and continuity of care.

Standard 3, Documentation of Care: The chaplain enters information into the patient’s medical record that is relevant to the patient’s medical, psycho-social, and spiritual/religious goals of care.

Standard 4, Teamwork and Collaboration: The chaplain collaborates with the organization's interdisciplinary care team.

Standard 5, Ethical Practice: The chaplain adheres to the Common Code of Ethics, which guides decision making and professional behavior.

Standard 6, Confidentiality: The chaplain respects the confidentiality of information from all sources, including the patient, medical record, other team members, and family members in accordance with federal and state laws, regulations, and rules.

Standard 7, Respect for Diversity: The chaplain models and collaborates with the organization and its interdisciplinary team in respecting and providing culturally competent patient-centered care.

Section 2: Chaplaincy Care for Staff and Organization

Standard 8, Care for Staff: The chaplain provides timely and sensitive chaplaincy care to the organization’s staff via individual and group interactions.

Standard 9, Care for the Organization: The chaplain provides chaplaincy care to the organization in ways consonant with the organization’s values and mission statement.

Standard 10, Chaplain as Leader: The chaplain provides leadership in the professional practice setting and the profession.

Section 3: Maintaining Competent Chaplaincy Care

Standard 11, Continuous Quality Improvement: The chaplain seeks and creates opportunities to enhance the quality of chaplaincy care practice.

Standard 12, Research: The chaplain practices evidence-based care including ongoing evaluation of new practices and, when appropriate, contributes to or conducts research.

Standard 13, Knowledge and Continuing Education: The chaplain assumes responsibility for continued professional development, demonstrates a working and current knowledge of current theory and practice, and integrates such information into practice.

We look forward to our ongoing dialogue on these standards with one another, while holding sacred the blessed and reverential relationships with patients, families and staff members within which these practices are lived out.

I welcome your reflections at dlichter@nacc.org.

Appreciatively,
David A. Lichter, DMin
Executive Director