NACC Member Value Survey

NACC Member Value Survey

NACC Chaplaincy Outpatient Involvement Survey

  1. In your work as a professional chaplain, do you work in any Outpatient settings?
  2. Yes – 45%
  3. No – 55%
  1. How often do you work in an Outpatient setting?
  2. Occasionally – I spend less than half of my time in Outpatient – 35%
  3. Sporadically – I go to Outpatient when I am assigned but have no regular responsibility to Outpatient – 28%
  4. Frequently – I spend more than half of my time in Outpatient –20%
  5. All of the time – I am assigned to Outpatient – 18%

Majority of those have a split time between outpatient and inpatient. Many only see outpatients when there is a referral for an Advance Directive, while others have full-time duties in a hospice or home care setting. One response stated, that although she does not work in a hospital setting, there is a definite presence and may be asked upon request to visit a patient with spiritual or other needs, regardless of church or “no church” affiliation. It seems that Cancer Treatment Centers are a bulk within the hospital setting.

What is the type(s) of Outpatient setting in which you work?

  1. Ambulatory?
  2. Yes,I work upon request – 37%
  3. No, I do not work in this setting – 30%
  1. Palliative Care Programs
  2. Yes, I work upon request – 35%
  3. No, I do not work in this setting – 13%
  1. Cancer Centers
  2. Yes, I work upon request – 33%
  3. No, I do not work in this setting – 22%
  1. Specialty Clinics
  2. Yes, I work upon request – 32%
  3. No, I do not work in this setting – 38%
  1. Rehabilitation/Outpatient
  2. Yes, I work upon request – 31%
  3. No, I do not work in this setting – 36%
  1. Hospice Agencies
  2. Yes, I work upon request – 27%
  3. No, I do not work in this setting – 27%
  1. Primary Care Clinics
  2. Yes, I work upon request – 27%
  3. No, I do not work in this setting – 46%
  1. Psychiatric Centers
  2. Yes, I work upon request – 26%
  3. No, I do not work in this setting – 30%
  1. Community/Social Services
  2. Yes, I work upon request – 24%
  3. No, I do not work in this setting – 44%
  1. Palliative Care Programs
  2. Yes, I work upon request – 35%
  3. No, I do not work in this setting – 13%
  1. Behavioral Health/Outpatient
  2. Yes, I work upon request – 23%
  3. No, I do not work in this setting – 38%
  1. Employer or Occupational Health
  2. Yes, I work upon request – 20%
  3. No, I do not work in this setting – 56%
  1. Long-Term Acute Care Hospitals
  2. Yes, I work upon request – 19%
  3. No, I do not work in this setting – 27%
  1. Skilled Nursing (SNF)
  2. Yes, I work upon request – 18%
  3. No, I do not work in this setting – 27%
  1. Wellness/Fitness Centers
  2. Yes, I work upon request – 17%
  3. No, I do not work in this setting – 50%
  1. Home Health
  2. Yes, I work upon request – 17%
  3. No, I do not work in this setting – 49%
  1. Assisted Living
  2. Yes, I work upon request – 15%
  3. No, I do not work in this setting – 27%
  1. Alternative Care Programs
  2. Yes, I work upon request – 15%
  3. No, I do not work in this setting – 39%
  1. Sleep Centers
  2. Yes, I work upon request – 12%
  3. No, I do not work in this setting – 59%
  1. Adult Day Care
  2. Yes, I work upon request – 10%
  3. No, I do not work in this setting – 40%
  1. Telemedicine Programs
  2. Yes, I work upon request – 9%
  3. No, I do not work in this setting – 53%
  1. PACE Programs
  2. Yes, I work upon request – 5%
  3. No, I do not work in this setting – 41%
  1. Please check any of the following training services that you or other chaplains provide or have provided in Outpatient settings.
  2. Identifying Spiritual Needs – 83%
  3. Introduction to Pastoral Services – 76%
  4. Using Spiritual Screenings (such as FICA, F=Faith, Belief, Meaning; I=Importance; C=Community; A=Action in Care) – 48%
  5. How and when to refer – 45%

Bereavement support is often mentioned. The spiritual and emotional support to be assisted with the mentioning of DNR, comfort care, and Power of Attorney forms for guidance at end-of-life care.

  1. Please check any other services that you or other chaplains provide or have provided in Outpatient settings.
  2. One-to-one interaction between chaplain and patient – 87%
  3. Bereavement – 85%
  4. Helping with difficult conversations – 74%
  5. Support staff, especially during critical incidences and One-to-one interaction between chaplain and staff member(s) – 73%
  1. Please check any materials that you use in your clinics
  2. Spiritual Care Brochures promoting spiritual care and how to contact a chaplain – 78%
  3. Care Notes Booklets – 51%
  4. Daily Devotional – 49%
  5. Prayer Request Cards – 37%

Bibles, The Koran, Baghavad Gita, Our Daily Breads, prayer request booklets and others are readily available in the chapel. Not often mentioned, but not to be overlooked were sympathy cards, cd music, sacramental items: rosary, medals, crucifix, and prayer rugs.

  1. Is the Outpatient setting using any screening tools? If yes, what tools are being used?
  2. No -78%
  3. Yes – 22%

FICA – Faith, Importance, Community, Application

HOPE – sources of hope and strength, organized religion, personal spirituality, and effects of medical care and end-of-life decisions

  1. Do you chart visits?
  2. Yes – 81%
  3. No – 19%
  1. If you do chart visits, is your charting done in electronic medical records? If so, what is your EMR system?
  2. Yes – 79%
  3. No – 21%

Systems listed include: MEDITECH, EPIC, Cerner, PowerChart, Allscripts Home Care, and several others.

  1. For what are referrals made?

Traumas, Deaths, Advance Directives, Palliative Care, Life Support (withdrawal of), Advanced aging

  1. Family needs support – 92%
  2. Patient expresses needs for spiritual or cultural support around faith or beliefs – 91%
  3. Patient expresses/evidences emotional or spiritual distress – 91%
  4. Patient needs support with end-of-life decisions – 84%
  1. How do you or other chaplains respond?
  2. In person – 99%
  3. Phone – 31%
  4. Email -10%
  5. Video Conferencing – 2%

Day or night as coverage is available via phone, pager, or letter. There tends to be a low ratio for beds to chaplains. For example, where there are 350 beds, there may only be two to three chaplains staffed.

  1. Does your regular setting have/own/partner with any of the following?
  2. Oncology – 77%
  3. Cardiology – 66%
  4. Ambulatory Surgery Center – 62%
  5. Specialty Clinics (on hospital grounds) – 61%
  6. Specialty Clinics (off hospital grounds) – 39%
  1. If your setting has any of the above, are there plans to attend to the spiritual needs of the patients who will use them?
  2. Yes – 79%
  3. Not at this time – 21%
  1. If yes, how will Outpatient settings access your service?
  2. Pager, orders to chaplains; hospital office as needed – 86%
  3. Chaplain will make regular rounds at Outpatient setting – 41%
  4. Chaplain(s) will be hired when demand increases to a certain point -10%
  1. Are there any further competencies that you need to work in the Outpatient setting?
  2. No - 77%
  3. Yes – 23%

For those who answered yes:

Responses include some of the more challenging issues. Outpatient issues and needs, how to break through the clinic culture and be more effective when you are available upon request, more on counseling and conflict resolution to name a few. Since there is very little privacy, chaplains in outpatient settings need to be able to function properly by being more outgoing and making contact with patients.

  1. If you answered yes to the previous question, what is the best way to gain these competencies?

Enrichment programs through appropriate channels, patient centered dialogue within settings. On the job training, coaching, mentoring, seminars, workshops, etc. Sharing with and dialogue amongst colleagues while seeking effective models used in other settings, adapt them, train and implement.

  1. Please indicate your position within your setting.
  2. Board Certified Chaplain – 61%
  3. Chaplain – 33%
  4. Director/Manager – 22%
  5. Clinical Pastoral Education/Supervisor – 4%
  1. I have a membership in a professional organization.
  2. NACC – 99%
  3. APC – 5%
  4. Other – 5%
  1. Please indicate your state of residence.
  2. NY – 11%
  3. CA – 8%
  4. WI – 8%
  5. IL – 6%
  6. PA – 6%

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