By David Lichter
We are very appreciative of the many members who have contributed articles to this issue of Vision on measuring quality in spiritual care. This is a challenging yet very important area.
I know some departments set their own goals to improve the quality of their work, whether it is by targeting improvement in the Press Ganey scores, through an associate survey on their performance, or setting improvement targets in their coverage or response time to referrals. Still, how do we understand the very concept of quality as it relates to spiritual care?
The important question also arises, “How do we integrate with and contribute to our hospital’s or system’s quality improvement initiatives?” The National Committee for Quality Assurance’s publication, The Essential Guide to Health Care Quality, refers to the 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, and its definition of quality health care as “safe, effective, patient-centered, timely, efficient and equitable.” That publication also referred to the Agency for Healthcare Research and Quality’s concise and memorable definition of quality care: “doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results.”
We also know that the World Health Organization, in its 2006 document, adopted these six areas: effective, efficient, accessible, acceptable/patient-centered, equitable, and safe. So quality answers the questions: Does the service work? Does it maximize resources? Is it timely, in a reasonable geographically and in appropriate setting? Does it taking into account patient’s preference and cultural sensitivities? Does it not vary to whomever and wherever? And does it minimize risk and harm?
Our quality improvement initiatives in spiritual care certainly should fit into our own hospital or system initiatives. In fact, the Institute of Medicine would postulate direct correlation between the (quality) indicators for improved health services and an individual’s and a population’s desired health.
How do our initiatives to improve our spiritual care service integrate with and/or contribute to the initiatives within our system? Do our improved contributions to electronic medical records and our more concise, clear narrative in the charts inform the members of the interdisciplinary team? Does it lead to better communication with the patient and family and more informed treatment choices?
These and many other questions will arise as we explore ways to evidence quality in our work. I hope you can use the articles in this issue, as members share their journeys toward more effective, efficient, and patient-centered care. We deeply appreciate their willingness to share their work in progress.