By Michele LeDoux Sakurai
“For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”
Certification is a process that validates the skills of chaplains. Every chaplain shares the journey of an advanced degree, four or more units of CPE, endorsement, and sitting before an interview committee prior to being recommended for certification by the Commission. In my training, the process was fondly referred to as “birthing barbed wire.” It takes years, and the assumption has always been that if certified, a chaplain has evidenced the competencies of 40 standards.
Imagine our surprise, during our hospital’s last accreditation survey, when the surveyors told us that neither certification nor licensure necessarily provides assurance of competency. The surveyors expected that professional competencies would be evaluated annually.
The disciplines scrutinized in this particular survey did not include chaplaincy. Yet healthcare seems to be moving toward a stronger commitment to skill assessment as a way to make patients safe. If the discipline of spiritual care is to be remain fully engaged as part of the care team, it may require a more systemized approach to competency assessment.
Historically, when hiring a certified chaplain, it was unnecessary to note all 40 competencies in the job description; “certified” said it all. Annual evaluations may or may not specifically address these competencies; in many institutions, the evaluations focus more on the goals of the organization to meet its strategic initiatives. The competencies of the chaplain may be noted as meeting professional competencies under a specific category, such as “customer service,” and still not ultimately meet the expectations of accreditors.
To meet surveyor expectation, we needed to identify an assessment tool, which was easy. The NACC Standards list the competencies that the major certifying bodies share, and we created a template using much of the hospital system’s terminology from our annual evaluations. For each NACC Standard, two categories were identified. The mode of verification is simply how the competency was revealed (demonstrate, verbal response, education, performance improvement monitors, etc.). The vehicle for verification describes detail of the mode (staff/patient feedback, chart review, presentations, one-on-one interaction between director and chaplain, committee participation, etc.).
The chaplain is assessed for skill status: meets, skill development in progress, does not meet competency, or advanced skill evidenced. For a “skill development in progress” or “does not meet competency,” a development plan is created to follow the chaplain’s progress.
Below is an example of how a template might be used to assess a chaplain needing development in several areas.
Using the NACC Standards for annual assessment benefits spiritual care as a discipline in at least four ways:
- The standards are shared by the major certifying bodies in North America, giving the competencies a common language and understanding across the discipline.
- Such a tool encourages a stronger accountability for the discipline by both directors and chaplains.
- It provides managers/directors a means to track chaplain improvement over time.
- It creates continuity (for development, education, and discernment) for chaplains between each five-year renewal of certification.
All disciplines will be expected to strive towards improvement and greater efficiency; spiritual care will not be exempt. This tool is an attempt to create options for assessment that can move chaplaincy as a discipline forward in healthcare. If you or your department carries a best practice for annual assessment/evaluation of spiritual care provision, please share your wisdom with the NACC. Together we can create the tools to better serve our patients and residents.
Michele LeDoux Sakurai, BCC, is manager of mission and pastoral care at Providence Health Care Stevens County in Colville, WA.