By immediately recruiting new Chaplain Interns and launching an intensive summer CPE course beginning June 2, 2003, the Director, instructed and effectively utilized Chaplains in patient care throughout the center. Interventions by clinically trained Chaplains with patients, as part of the course work, significantly raised patient satisfaction scores during the two months the Chaplains were in training.

Title:
Department of Pastoral Care Chaplain Interventions and its effect on Patient Satisfaction scores.

Description:
Based on our commitment to provide and continue to enhance our role as part of a health care system that offers high quality, cost effective medicine with the goal of high patient satisfaction, Clara Maass Medical Center initiated a revitalization of its Department of Pastoral Care in May of 2003. A new Director was hired to manage the day to day operations of the Department and resurrect and direct new Clinical Pastoral Education (CPE) programs. The new Director is ordained clergy, a credentialed Diplomate and a certified CPE Supervisor. By immediately recruiting new Chaplain Interns and launching an intensive summer CPE course beginning June 2, 2003, the Director, instructed and effectively utilized Chaplains in patient care throughout the center. Interventions by clinically trained Chaplains with patients, as part of the course work, significantly raised patient satisfaction scores during the two months the Chaplains were in training.

Success Outcome:
For the periods indicated below (two months), the figures illustrate the impressive impact Chaplains had in addressing emotional and spiritual needs of patients which directly affected patient satisfaction scores in a positive manner.

Press, Ganey Patient Satisfaction Survey

• Overall Hospital Rating
June 1, 2003 to July 31, 2003
From 78.6 to 85.3 percentile
A 9% overall gain

• Sample Significant Single Unit Improvement: 3North Annex
June 1, 2003 to July 31, 2003
From 63.9 to 86.3 percentile
A very significant 35% improvement in performance

• Most Significant Single Unit Improvement: SICU
June 1, 2003 to July 31, 2003
From 1 to 75 percentele
A dramatic 99% increase in satisfaction scores!

Narrative Summary
In 1925, the Religion and Health Care movement established Clinical Pastoral Education as a vehicle upon which to train clergy for the Chaplaincy. The Chaplaincy is a vocation that ministers in a theological, psychological and sociological grounded fashion, combining knowledge, skill and insight to meet spiritual needs. Helen Flanders Dunbar, M.Div., PhD, MD, an icon of the Religion and Health Care movement, conducted a number of epoch-making studies in psychosomatic medicine at Columbia Presbyterian Medical Center during the 1930s. In 1950, she discovered that patients who had meaningful interventions with clinically trained Chaplains compared with those who did not:

• Left the Hospital sooner
• Healed more rapidly
• Lived longer

As a result of this study and many more since then, professional organizations such as Hospitals, Hospice and Palliative Care Centers and more importantly, the general public, are today increasingly demanding improvement in the spiritual needs of patients and family. Interest in spirituality or spiritual care in medicine is also increasing rapidly. There is a body of growing literature exploring the relationship between patients’ spiritual needs and the more traditional aspects of their medical care.

The Director of Pastoral Care at Clara Maass, being a clinically trained Chaplain, a CPE Supervisor, and an ordained Minister and clearly understanding the positive benefits of clinically trained Chaplain Interventions, immediately initiated an intensive CPE training course of ten weeks upon arrival at Clara Maass Medical Center. He recruited clergy and seminarians in a successful three week aggressive campaign. The course began June 2, 2003 with five new Chaplain Interns; three Pastors and two Seminarians. CPE training had been absent from Clara Maass for over a year. Patient satisfaction scores were low. Improvement could be achieved using CPE and hence, clinically trained Chaplains.

As part of the course work, Chaplains were assigned to specific units of the Hospital. Nurse Managers of all units were informed of the forthcoming arrival of the new Chaplains and asked to assist and cooperate with them. New instructions were given to the Nursing Stations and to Telecommunications on how to effectively communicate a request for a Chaplain through the department and the on-call Chaplain. The curriculum required each Chaplain Intern to overnight once a week for the ten week duration of the course. This substantially increases unit coverage.

The CPE training curriculum is intense. The intent is to have the Chaplain Intern understand her/himself, his/her spirituality. As clergy and seminarians, they already believe in God. What is sought in CPE is an understanding and belief in self, self awareness, and spirituality.

CPE brings theological students and ministers of all faiths (Pastors, Priests, Rabbis, Imams, Seminarians and others) into encounter with persons who are ill or in crisis. Out of an intense involvement with persons in need, and the feedback from peers and the Supervisor, students develop new awareness of themselves as individuals and of the needs of those to whom they minister. From theological reflection on specific human situations, they gain a new understanding of ministry. Within the interdisciplinary team process of helping people, they develop skills in inter-personal and inter-professional relationships.

The CPE method uses: the pastoral experience, reflection on the pastoral experience by the Chaplain in written and oral reports, and reflection and critique of those reported experiences by members of the peer group and the Supervisor. Through these experiences and evaluations the student learns effective evaluation of his/her ministry and how he/she is perceived as a pastoral person.

Group therapy exercises, group interaction, evaluation and sharing become a laboratory for learning. Students are encouraged to recognize their differing gifts for ministry and how those gifts may be shaped and improved. The Supervisor is the guide for the students to discover their gifts for ministry. Both peers and Supervisor serve as consultants, challengers, supporters, in the process of self learning and self growth. The basic impetus for learning, however, comes from the students themselves, as they negotiate their contract for learning and invest in the learning opportunities available to them. Patient, family, peer, staff and supervisor encounters all contain the seeds for challenge and support which can lead to growth and development.

CPE mainly grows out of the clinical experiences (encounters with patients and families, staff and peers) of the students. There is also an extended body of knowledge of pastoral care, social awareness, psychology, sociology, technical aspects of health and human care, etc., that is communicated to the students through educational seminars and didactics. These seminars are led by resource people from within and outside the institution and the pastoral care staff. Since some of the subjects are of universal concern, certain material is routinely scheduled into the CPE program. Since CPE is adult experience-driven learning, other subjects are added as the needs of the students in a particular unit make those subjects appropriate.

CPE is a mind and life altering process. The words of a graduate trained Chaplain Intern can probably best describe the growth that takes place:

"Spirituality is my being; my inner person. It is who I am...unique and alive. It is my body, my thinking, my feelings, my judgments, and my creativity. My spirituality motivates me to choose meaningful relationships and pursuits. Through my spirituality I give and receive love; I am driven forward, sometimes because of pain, sometimes in spite of pain. Spirituality allows me to reflect on myself. I am a person because of my spirituality…..motivated and enabled to value, to worship and to communicate with the holy, the transcendent".

Patients’ only possession at times is "who they are." An intervention with a spiritual being who knows "who I am" can be a powerful healing encounter for the patient.

The improved patient satisfaction scores speak for themselves. At the end of July, 2003, the Department of Pastoral Care received a "Certificate of Recognition" from the Executive Director and the Director of Patient Satisfaction in acknowledgment of attaining the most improved Patient Satisfaction Score of all Departments at Clara Maass for the month of July. On October 7, 2003, a Chaplain Intern and former team member was presented with a “Certificate of Appreciation” from the Nursing Manager of the Same Day Surgical Unit for Excellence in Pastoral Care and in displaying Outstanding Patient Service Behavior.

Team Members
Rev. Dan Mena, Ed.D
Director, Department of Pastoral Care and CPE Supervisor
Pamela Mack, Chaplain Intern
Rev. Elbert Maxwell, Chaplain Intern
William Moore, Chaplain Intern
Rev. Eusebius NNolim, Chaplain Intern
Rev. Marcellinus Uwandu, Chaplain Intern