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Metrics in Spiritual Care

Metrics in Spiritual Care. What to Measure and Why. Dean V. Marek Mayo Clinic, Rochester. Your Expectations. when you read the schedule and the topic of my presentation, what did you want to see covered, ask about, or comment on?. We use metrics all the time.

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Metrics in Spiritual Care

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  1. Metrics in Spiritual Care What to Measure and Why Dean V. Marek Mayo Clinic, Rochester

  2. Your Expectations • when you read the schedule and the topic of my presentation, what did you want to see covered, ask about, or comment on?

  3. We use metrics all the time

  4. so why not use metrics inchaplain services? we do it subconsciously anyway! Bring it out into the light!

  5. Are Chaplains Professionals? definition of professionalism: 1. skillfulness by virtue of possessing special knowledge 2. professional status, methods, character, or standards

  6. A “Raw” View of Professionalism • "a focused, accountable, confident, competent, motivation toward a particular goal, with respect for hierarchy and humanity, less the emotion" - Edward B. Toupin

  7. Accountability“motivation towarda particular goal” • what is measurable? • quantity • quality • what is the common factor? • time

  8. Variability • the human factor • individuality of the patient/client • skill and experience of chaplain as Independent practitioners • when services provided are: • self-initiated or by referral

  9. Quantity - 1 • why count services provided? • what can the numbers show? • metric for accountability • report for goals achieved • cost for services (expense per Unit of service)

  10. Relative Resource Unit • a relative resource unit (RRU) is the factor of each service event relative to the amount of time it takes to provide that service. • time is the common factor for every provider • the service that takes the least amount of time has an baseline RRU of 1.0 • another service that takes 25 minutes has an RRU factor of 2.5

  11. Units of Service (UOS) a Service Event (SE) times its Relative Resource Unit (RRU) equals a unit of service (UOS) SE x RRU = UOS 50 - SE #1 x 2.50 = 125.00 60 - SE #2 x 4.00 = 240.00 46 - SE #3 x 6.20 = 285.20 One Month Total UOS = 650.20

  12. Expense per Unit of Service (UOS) • an Expense per UOS is determined by dividing the budget by the total number of units of service (all service events times their Relative Resource Unit) • Budget  Total UOS = Expense per UOS

  13. come again?

  14. Expense per UOS • an Expense per UOS is the way we report direct patient care activity in relation to the budget for our department • It is our method of accountability to our administration • It is expected that we meet or beat our Expense per UOS on a monthly basis

  15. Here’s How It All Fits Together

  16. Calculating an Expense per UOS Budget  Total UOS = Expense per UOS 2009 Plan $120,000.00 • 01/09 Total Direct Expense $10,000.00 • 01/09 Service Events x RRU = 650.20 • 01/09 Expense per UOS $15.38

  17. Cost of Services at $15.38 per UOS Service EventRRUCost • SE - #1 2.50 $38.45 • SE - #2 4.00 $61.52 • SE - #3 6.20 $95.36

  18. Quantity - 2 why count services provided? what can the numbers show? unmet needs - i.e., what remains to be done (how is this done?)

  19. Unmet Needs

  20. Unmet Needs

  21. Unmet Patient Needs • 60% (300 patients) receive spiritual/pastoral care at least once during their stay • 40% (200 patients) do not • If chaplains were to care for those 200 patients they would find that: • 27% would result in a pastoral contact • 73% would result in a significant spiritual care intervention

  22. Quantity - 3 why count services provided? what can the numbers show? assignment of resources department and individual productivity other?

  23. Reprise definition of professionalism: 1. skillfulness by virtue of possessing special knowledge 2. professional status, methods, character, or standards.

  24. Quality “skill, methods, character, standards” • elements in each encounter that are measurable/observable: • greeting • rapport/mutuality • spiritual assessment • religiosity • spirituality and practices

  25. Quality “skill, methods, character, standards” • elements in each encounter that are measurable/observable: • spiritual/pastoral issues addressed • service or services provided • outcome of the intervention • client response to the intervention • follow up plan

  26. Quantity/QualityImprovement • department dashboard metrics • expense per UOS (drill down to cause of increase or decrease) • productivity (drill down to teams, individuals, services) • chaplain response time – codes, referrals • death protocol follow through

  27. Quantity/QualityImprovement referral sources with max and min times of day; e.g. time frame when am-admit patients want a priest for anointing patient unit use of chaplain resources ministry to staff continuity of care –referrals out

  28. Quantity/QualityImprovement what else can the numbers show?

  29. The End • Questions: marek.dean@mayo.edu

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