spirituality - the new elixir in the care continuum

“Where Miracles Collide*”*collide v. (physics) the close approach of two or more particles

resulting in an abrupt change of momentum or exchange of energy.

“The Deconstruction of Suffering”:“The New Elixir in the Care Continuum”

Presented by Joe Steier, President and CEO of Signature HealthCAREand Dianne Timmering, Vice President of Spirituality, Signature HealthCARE

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2014 Strategy2014 Strategy

“The future of healthcare rests in the consumer experience—value added in each episodic nugget

rolled into a continuum of integrated moments of one.”

- Dianne H. Timmering and E. Joseph Steier III

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2014 Oates Institute PresentationThe Deconstruction of Suffering: The New Elixir in the Care Continuum

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2014 Themes: A Radical 2014 Themes: A Radical ResolveResolve

• Deconstruct suffering at each point of the care delivery system for best patient experience

• Spirituality: an “invention” of healing; an “injection” into optimum patient outcome

• Activate and operationalize the spiritual into the formal care-planned system

• Spirituality as a business core competitive advantage

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How to bring God into the workplace

in a for-profit world . . .

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First Amendment to the First Amendment to the United States United States ConstitutionConstitution

“Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the

people peaceably to assemble, and to petition the

Government for a redress of grievances.”

- September 25, 1789

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Current case of note - Hosanna-Tabor Evangelical Lutheran Church and School v. E.E.O.C – January 11,

2012

The First Amendment to the Bill of Rights

is engraved on the front wall of the Newseum in Washington DC.


Title VII of the Civil Title VII of the Civil Rights ActRights Act

Title VII of the Civil Rights Act of 1964 makes it clear that an employer must provide an

“accommodation” for “all aspects of religious observance and practice, as well as

belief, unless an employer demonstrates that he is unable to reasonably

accommodate to an employee’s or prospective employee’s religious observance

or practice without undue hardship on the conduct of the employer’s business.” SEC. 2000e, Section 701, Part (j)

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CMS Guidelines For CMS Guidelines For Nursing HomesNursing Homes

• In order to develop individualized care planning goals and approaches, the facility should obtain sufficient, detailed information (even if the Activities CAA is not triggered) to determine what activities the resident prefers and what adaptations, if any, are needed.

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• Sources of relevant information include the resident's

lifelong interests, spirituality, goals, strengths, activity pursuit patterns and preferences.

- CMS Guidelines For Nursing Homes


God In The WorkplaceGod In The Workplace• We believe in the freedom to

worship or not to worship but the freedom to choose.

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• Prayer and reflection in the workplace is expressed and respected.

• Spirituality highly values its indelible partnership with Human Resources and the Legal Department.


Departmental TenetsDepartmental Tenets

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• Founded on the emotional and spiritual healing well of unconditional love for diverse cultures and faiths.

• Non-proselytizing culture

• One of education and un-watered-down spirituality, embraced by choice and one’s own faith tradition

• Meeting people at the point of their need


Spirituality: A Signature Spirituality: A Signature PillarPillar

Our for-profit based company believes that spirituality is most sacred to the human experience.

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We embrace this belief and support the Divine in our residents, staff and

family through this interfaith environment that respects all faiths.


Spirituality: A Signature Spirituality: A Signature PillarPillar

We seek jewels in cultural differences and fold then into a library of awareness which binds and unifies the human spirit

in respect and new understanding.

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We are a social movement of mercy and hope in miracles as life-

changing interventions for our people and within our communities.


Mission and VisionMission and Vision

Mission: an inter-faith approach of binding up the broken-hearted and helping to heal

the sick.

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Vision: Serving as a spiritual intervention with the care team to radically change the

essence of aging and attack the hopelessness of suffering.


Department HistoryDepartment History

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• Started with Part Time chaplain pilot program

• Prevented a suicide in one of our facilities

• Emerged early with a stakeholder focus due to specific needs they were battling


• Precedents established with resident hope in healing, family restoration, and a reduction in suffering

We Began To Learn . . .We Began To Learn . . .

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Inside our emerging Chaplain program-building framework, the Department of

Spirituality began to align itself to:

“ . . . help facility leaders meet CMS initiative for culture change, improving staff retention and enhancing resident-centered care.”

(CMS 2007 Action Plan, page 22).


Early ResultsEarly Results• Therapy Refusals decreased

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• Family Satisfaction increased

• Turnover Rates decreased

• No substantiated complaint surveys during full-time chaplain study in region of East Tennessee for one full year*


*Timmering, Stockton, and Cox, “Spirituality and Its Value-added Impact On Care Delivery And Revenue In The Long-Term Care Setting,” LTCI Press, 2011.

By-Products of By-Products of SpiritualitySpirituality

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• Enhanced Wisdom• Clearer Discernment of Business Decisions

• Self-Expression

• Driving Purpose

• Eradicating Bitterness

• Healings• Conflict Resolution


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ReimbursableNon-Reimbursable

Non-Clinical Clinical

““The Healthcare Value The Healthcare Value Paradox”Paradox”

Our customers prize the non-clinical services for which

we do not get paid.

Source: “Heart of Signature Customer Survey”


SHC Full-Time Chaplain SHC Full-Time Chaplain CorpsCorps

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Linchpin to program execution• Critical to success of the model – process

owner for services delivery• Accountability to residents, family and

stakeholders• Chaplain Advisory Board from community

to meet any religious, spiritual or cultural need

• Brand equity in the community – core competitive advantage

2014 Goals2014 Goals• Formalized clinical integration• Stakeholder wisdom thru SEI—how to prevent a

future negative act?• Evidence based spiritual interventions —proof of

concept, linked to scorecard and optimum outcome• Market focused: integrated spiritual interventions

linked to programs of distinction• Segment-based strategic plans focused on diversity

and cultural traditions• Palliative care as a business product-line• Bedside/volunteer army• Compassion explosion through CF and other

initiatives

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Clinical Care Delivery Clinical Care Delivery SystemSystem

• QUESTION: How to deconstruct suffering at every point of the care continuum? The fear, the anxiety, the deleterious sounds of the symptoms of suffering from the honesty of bad news, the slather of hopelessness, an unstoppable mind pinging loud with the bell which tolls that sickness is near?

• ANSWER: Deliberate intent. Spiritual inputs for optimized outcome, offering the support of prayer, the hope in the Divine, the power of comfort in the belief and practice traditions of a particular faith, and integrating that with the prescription of our care.

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Proof of Concept: Current Proof of Concept: Current Studies and ToolsStudies and Tools

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• Qualitative research - 134 case studies conducted in the field

• Spiritual Scorecard - Best practice interventions as input for optimum quality outcomes codifying results

• Quantitative Study◦ Spirituality in the Workplace study conducted

in partnership with University of Louisville Department of Leadership, Foundations and Human Resource Education

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The Deconstruction of The Deconstruction of Suffering Through the Impact Suffering Through the Impact

of Clinical Metricsof Clinical Metrics

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Spiritual Scorecard interfaced with clinical metrics to impact resident care for optimum outcome.• Prevalence of Falls• Prevalence of depression• Residents who had moderate to severe pain • Prevalence of anti-anxiety hypnotic use• Residents who lose too much weight• Prevalence of Pressure Ulcers Acquired Since Admission

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The FutureThe Future• The future of healthcare is the customer

satisfaction in care delivery as value added episodic components into a continuum of integrated times of one experience.

• From a business perspective, spiritual integration is an effective way to foster a cohesive, collaborative team which provides synergies of cost minimizations as well as fostering a competitive-advantage-rich environment.

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“All in all, the essence of love and the sanctity of respect, even in all our

imperfections, have moved the mountains and rooted spirituality into the depths of

the revolution, binding us, one to another.”

Dianne Timmering, Vice President of Spirituality, Signature HealthCARE, [email protected]

ConclusionConclusion

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spirituality - the new elixir in the care continuum

Healthcare

severe pain prevalence

anxiety hypnotic use