Cost-effective Resource to Increase Patient Satisfaction Are Professional Chaplains

A recent survey on patient satisfaction in Modern Healthcare, the most widely read journal among senior hospital administrators, failed to account for the cost-effective influence on patient satisfaction from the spiritual care and attention to cultural practices by a professional chaplain.

Acknowledging this shortcoming, Modern Healthcare published the following letter from Rev. George Handzo, BCC, HealthCare Chaplaincy’s Vice President for Pastoral Care Leadership & Practice and Rev. Sue Wintz, BCC, President of the Association of Professional Chaplains:

“It is not surprising to us that the research reported in the June 1 issue doesn’t find significant correlation with patient satisfaction (“The bottom line on happiness,” supplement, p. 8). In our opinion, the researchers were not using the right variables. The researchers failed to account for the influence on patient satisfaction of spiritual care and attention to cultural practices.

“Research studies have demonstrated significant impact of spiritual, religious and cultural practices as well as values and beliefs on healthcare outcomes, including quality of care and patient healthcare decision making. Whether patients’ spiritual needs were attended to in hospital stays has been demonstrated to be a strong predictor of patient satisfaction with care and patient perception of quality of care. Additionally, demonstration projects have shown that when spirituality is integrated into hospital settings, healthcare professionals find greater meaning in their work and cope with stress more effectively—again, contributing to patient satisfaction.

“Research has also demonstrated that the issues of cultural beliefs, norms and values have significant impact upon a patient’s and family’s understanding of health and their experience of and participation in their treatment. Diversity, cultural, spiritual, religious, language and literacy issues are variables that must be included in any effort to increase patient satisfaction.

“We believe that some of the values that did correlate with higher satisfaction are simply surrogates for the fact that those hospitals also attend to spiritual and cultural issues. Such hospitals employ professional chaplains to provide services to patients and family as well as education and support to staff. Conversely, many hospitals seeking to cut costs shortsightedly cut chaplaincy services believing that they do not contribute to mission or margin.

“Finally, because many hospitals do not appreciate the contribution professional chaplains can make to patient satisfaction, they fail to align the chaplaincy goals with the overall goals of the hospital, including the patient-satisfaction goals. Professional chaplains are arguably the most cost-effective and underutilized resource for increasing patient satisfaction.”

Life Goes On: Observations of a Chaplaincy Student

By Melinda Nasti

It was an average day at North Shore University Hospital. I was checking in on all the critical care units – stopping to speak with patients and families as I saw the need. I asked one of the nurses if there was anyone in particular that she thought I should see. “If you speak Spanish,” she said, “you could talk to the family of the patient in room 5. She just expired. She was only 40.”

I have been present right after quite a few deaths, and although I knew nothing of this patient or her family, something struck me particularly hard on this occasion about the fact that life goes on.

I became acutely aware of the whirl of activity on the floor – nurses tending to patients, a doctor and social worker doing rounds, family members of other patients coming and going, and a cleaning crew coming through the unit with their cart. The floor was full of life. Nothing came to a halt. In the instant it took me to process what she had said, the nurse, too, had moved on. This is the reality of life at a busy hospital.

I had these same feelings once before – during a funeral procession to the cemetery. It had been so amazing to look out the car window and see that children were still getting on the school bus, garbage trucks were still picking up garbage, and people were still hurrying off to work. They were unaware of the enormity of what was happening to those within that procession of cars that was creeping towards a final resting place.

And so it was in the hospital at that moment. I thought about how wrong this moment felt and fantasized about an announcement being made over the PA system requesting a moment of silence for a beautiful young woman who had succumbed to her illness. The goal of a health care institution is to keep everyone alive. In that regard a death could be viewed as a failure. I realize that announcing a death, in a place dedicated to healing, would be ridiculous. And yet somewhere deep inside it strikes me as just as ridiculous that in that moment of death no bells rang, no flags went up or came down, and the great heart of the hospital did not skip a beat.

I looked at the patient's father sitting on the bench. He was surrounded by family and yet was alone. He was only six feet away and yet I could barely see him through the blur of activity. I went to him. He told me of his daughter and her suffering, of the wife that he lost only a few short months ago, and of his faith in God.

As I sat there holding his hand while he told his story, I realized that we were no longer in the hallway of this busy hospital, but in a sacred space that held only the two of us. The hustle and bustle melted away as he built this shrine for his daughter. When we finished our conversation we just looked into each others eyes for a moment.

I have never been so grateful for a moment in my life – grateful that I was there to participate in marking this critical time with words and with silence. Grateful because I understood that I was standing in for many others - friends, family and hospital staff - who weren’t able to be here, or whose responsibilities didn’t give them the opportunity of stopping to share this deep and profound moment of tribute at the time of the patients’ death.

As a Chaplain I am so fortunate to be given this time. It is a gift which leaves me deeply moved and humbled. People often ask me how I have the strength to be on the critical care units and witness as much pain and suffering as I do. I understand the question and appreciate the concern, but I can't help but imagine a life that is filled with these sacred moments. What a life that would be.

Author’s note: This reflection was written to my supervisors, Sr. Dr. Maureen Mitchell and Rev. Jon Overvold, as a way of thanking them for the opportunity to serve.