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Spiritual Care and the Affordable Care Act

Spiritual Care and the Affordable Care Act. Data and Guidance for a New Age. Changes are A Coming. Healthcare is becoming a competitive retail business – Means more competition less money– “ probably ” Therefore: Get Costs Out- “ Cost Repositioning ” Patients navigating a new access system

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Spiritual Care and the Affordable Care Act

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  1. Spiritual Care and the Affordable Care Act Data and Guidance for a New Age

  2. Changes are A Coming • Healthcare is becoming a competitive retail business – Means more competition less money– “probably” • Therefore: Get Costs Out-“Cost Repositioning” • Patients navigating a new access system • More patients less money • Money impacted by a patient’s experience • Medicare holds back 1% depending on patient experience scores.

  3. Research and what it Means • Journal of General Internal Medicine • Patients who discussed religion and spirituality as a part of their care rated their experience at the highest level on 4 key patient experience areas. 2011; 12:p. 1265-1271 • Cleveland Clinic • Areas surveyed improved by at least a third, pain, mood, comfort, hope, relaxation. JAMA • H70 a case study • Went from 30 % to 90% of their goal with a dedicated practitioner • Bottomed out when support for the practitioner ended • H 50 a case study • Dedicated practitioners focused on pain and spirituality • HCHAPS questions on pain: pain levels stayed about the same; however “Is everyone doing all they can for your pain” went way up

  4. Theory • Organizations and individuals have spiritual covenants that govern decision making. • They often are not identified • Personal and organization covenants don’t always match • Individuals match with the overt covenants of the organization. • Organization’s quiet covenants don’t always match the stated or overt Mission and Values of the organization • The organization is limited when the impact of the clash is unidentified or underappreciated

  5. Theory (cont.) • Key decisions are most often made from the Quiet Covenants and will be during the Affordable Care Act reactions • Individuals working in the organization are limited when they don’t know what influences decision making. • Covenant Breakers are behaviors that violate the overt or quiet covenants. • Don’t break them

  6. Cleveland Clinic • Covenants Overt Quiet • Patient First -To be no. 1 • Every life deserves World Class Care -To Act as a Unit Covenant Breaker • “To appear to be for yourself and not for the “Unit” • You can be a “kingdom builder or for yourself” you just can’t appear to be unless you’re helping us be # 1. • Being # 1 trumps all.

  7. Spiritual Assessment ?’s for an Organization • Identify the stated mission and values of the organization • Identify the quiet covenants of the organization • What are the covenant breakers of the organization based on the above.

  8. Limitations of Unrecognized Covenants • Leads to diminished trust in leaders • Positioning and third partying grows • Ideology and values are hardened • opportunities for creativity and collaboration are lost. • Focus is on differences rather than bridge building • Employees become disengaged.

  9. Managing to Covenants • CHANGE: • If you are suggesting change or presenting proposals you must write them to both the overt and quiet covenants of the organization. • If you are in conflict or experiencing push back this often comes from people accusing you of “breaking the covenant. i.e. “You are not acting as a unit”. “case study” • If you have presented your position from the covenants push back and conflict are less likely.

  10. Cleveland Clinic • What have we done that positions us for change • We have been guided by the Quiet Spiritual Covenants of the Clinic • We will be # 1- “Wanting to be regional leader” • We will act as a unit • Partnered with the office of Patient Experience since 2007. (Since 2013 we report to them) • Developed Code Lavender and Healing Service teams using spiritual care staff as key components. • We have committed to Data and Research and Presentations, locally and nationally

  11. Clinic (cont.) • We have kept our eye on where we effect patient and employee experience and talked about it. • We are aware of and align ourselves with the strategic plans of the medical center. • We communicate our impact in line with those plans. • It hasn’t happened over night • It hasn’t always been heard • We did it without added resources • Additional resources followed initial action. • We used pilot projects to begin.

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