FAQs

1. How was the Pastoral Care Standard Work and Staffing Model developed?
   
   In late 2018 members of the CHA Pastoral Care Advisory Committee came together to create a staffing benchmark consistent with the commitments of our Catholic identity.
   
   Through collaboration, dialogue, and surveying more than 50 leaders in spiritual care across the Catholic health ministry, the group decided to link staffing with the provision of essential services key to providing holistic spiritual care rooted in the dignity of each person. Following the identification of these critical services the group considered staffing and set about answering the question, "How many chaplains are necessary to do the work?"
   
   Considering blinded data from more than 60 facilities of varying size, geography and system affiliation, using annual adjusted patient days as a metric, ranges were determined reflecting a team's ability to provide services both consistently (with triage, able to be provided over the course of a week) and broadly (within and external to an acute facility). The initial model was launched as a draft proposal in late summer 2019. Modifications were made based on member feedback and the tool was made available to the wider public in spring 2020.
   
   
2. Why was the tool developed?
   
   Leaders of pastoral care departments within our ministries became aware that, in the absences of a standard metric based on professional competencies and ministry priorities, teams were vulnerable to external consultants and those outside the discipline defining best practices and standards of care.
   
   The tool was developed to address meeting spiritual needs in an acute care facility while keeping in mind these facilities sometimes "lend" their chaplains to ambulatory or virtual settings during the current transition in locations of care. It is intended to provide a starting point in dialogue for teams, leaders and ministries.
   
   
3. Why are these 15 Essential Services?
   
   The committee began with a list of more than thirty pastoral care services. Through group discussion and surveying directors of spiritual care, these 15 services were consistently named as essential. These baseline services meet the moral and ethical commitments of our Catholic identity.
   
   
4. Not all of the 15 Essential Services apply to my facility; can I still use the calculator tool?
   
   Yes; with modification. While the committee surveyed spiritual care providers and leaders at all levels of the organization and came to consensus on these 15 areas, it understood that some ministries provide high value, unique or targeted pastoral services not included in the above. Those ministries may substitute such services for any of the above that they deem to be of less priority in their local context.
   
   
5. What are "Annual Adjusted Patient Days" and how do I find that number?
   
   This is a relatively standard health care measure of acute care occupancy that includes an ambulatory factor (various hospital outpatient departments as well as ED volume), thereby noting the presence of that arena for ministry. Formulas differ from system to system so the tool assumes the following formula for annual adjusted patient days:
   
   

   (Total Gross Patient Charges ____________________________ Total Gross Inpatient Charges)

   X Total Inpatient Days

   = Adjusted Patient Days

   
   The numbers in the formula are typically accessible for you to recalculate based on this formula. Ask your local finance leader to assist you in getting this number. When given the option, use the number that does not include newborns with mothers; infants in the NICU are counted within the metric.
   
   
6. We are a small facility; will this tool work for us?
   
   If you are in a facility with less than 35,000 adjusted patient days annually, this tool will not be reliable for your facility. The tool will misrepresent your staffing model. Under 35,000, different staffing models will be utilized to ensure coverage and spread that are not able to be appropriately represented in the calculator. The Pastoral Care Advisory Committee is committed do continue the work and conversation on best practice staffing models for smaller and critical access facilities.
   
   
7. How do I calculate FTEs?
   
   Your FTE counts should include all FTEs of chaplains, the percentage of working manager time involved in direct care, percentage of an FTE allotted for on-call, PRN and per diem providing extended coverage. CPE students are to be counted as 0.50 of an FTE. The focus is on how much time is spent in direct care of patients, families and staff.
   
   
8. My team came in as critically low what should I do next?
   
   Don't panic. Consider your results; consider your felt sense of your team. Look again at the Essential Services and reflect on your ability to provide them consistently. Look again at how far from the next threshold you were in terms of FTEs. This is an opportunity to strategize with your leadership on how to prioritize crucial services, how to advocate for expanded professional coverage, and how to extend the services you currently are able to provide with chaplain extenders.

Catholic health care is committed to the dignity of each human being as whole person made in the image and likeness of God. This commitment requires that we provide quality spiritual care to those we serve. This proposal on standard work and staffing are offered as a tool in the conversation around how to adequately provide for the spiritual needs of our patients and their families in times of suffering and illness. 

For more information about CHA's work in pastoral and spiritual care or questions about this proposal, please contact Jill Fisk, Director, Mission Services