PlainViews

APC Quality Commission on defining what we do

Standards vs. Best Practices

Professional chaplaincy is making significant strides as a profession. Our Common Standards (i.e., competencies) and Common Code of Ethics,[1] our research into and development of benchmarks,[2] and our discussions around “Best Practices”[3] all provide evidence of this. In an effort to continue this process of “professionalization,” the Commission on Quality in Pastoral Services is endeavoring to define “Best Practices” and “Standards of Practice” for professional chaplaincy more precisely.

Over 65 years ago, Russell Dicks wrote, “The chaplain can no longer wander from bed to bed, chatting agreeably, relieving distress occasionally as he [sic] discovers it.”[4] Harold Schultz, speaking of these early days, said, “Anyone who read the Bible and the like to 50 patients or more … was considered equipped to be a chaplain.”[5] Because we have no established nor minimal Standards of Practice to which professional chaplains are held accountable, the observations of Dicks and Schultz still hold true for many chaplains in healthcare settings today.

Susan Wintz and George Handzo recently defined Standards of Practice as follows:

“Standards of practice are those established principles and practices that represent the profession and include minimum levels of practice to which professionals are held accountable. They are articulated in observable and measurable terms and are the guiding principles by which professional chaplains conduct their day-to-day responsibilities within their scope of practice.”[6]

Critical in this definition is the phrase “established principles and practices that represent the profession.” Standards of Practice are principles and practices that all professional chaplains must hold in common regardless of setting. We use these Standards of Practice as “guiding principles” in helping us develop our own unique scope of practice within our own particular settings. For example, if spiritual assessment is a Standard of Practice, then a particular scope of practice must address spiritual assessment, but may vary depending on which kind and number of patients assessed, the time frame that is deemed appropriate, and the particular assessment tool that is used.

Our definition also refers to the articulation of Standards of Practice “in observable and measurable terms.” Continuing our example, if our assessment includes the patient’s ability to utilize religious resources for coping, then we need to observe directly or indirectly what those resources are and then measure if and how the patient’s condition changes through utilizing those resources.

Finally, our definition speaks of “minimum levels of practice to which professionals are held accountable.” This is important! Standards of Practice are our bottom line—not our Best Practice! Doing spiritual assessments and charting and providing spiritual care across the faith continuum, for example, should not be seen as extraordinary—they are ordinary. And for these ordinary and minimal requirements we should be held accountable.

Already our analysis indicates that the differences between “Best Practices” and “Standards of Practice” can be confused and confusing. In a follow-up article we will examine Best Practices, but we feel it is important that we first come to a clearer understanding of Standards of Practice. Our hope is that the larger chaplaincy community will respond to this initial article and provide valuable feedback through the “Talkback” section of PlainViews.

Footnotes:

[1] Common Standards for Professional Chaplains and Common Code of Ethics for Chaplains & Pastoral Counselors. Available in the “Reading Room” at: http://www.professionalchaplains.org.

[2] Larry VandeCreek, Eileen Gorey, et. al., “How Many Chaplains Per 100 Inpatients? Benchmarks of Health Care Chaplaincy Departments,” Journal of Pastoral Care and Counseling, v. 55, no. 3 (Fall, 2005), pp. 289-301; Susan K. Wintz & George F. Handzo, “Pastoral Care Staffing and Productivity: More than Ratios,” Chaplaincy Today v. 21, no. 1 (Spring/Summer, 2005), pp. 3-8.

[3] See George Handzo, “Best Practices in Professional Pastoral Care,” Southern Medical Journal v. 99, no. 6 (June, 2006), pp. 663-664.

[4] Russell L. Dicks, “The Work of the Chaplain in a General Hospital,” (Reprint) The Caregiver Journal v. 12, no. 1 (1996), pp. 2-5.

[5] Harold P. Schultz, “Reflections on the Past,” Bulletin of the American Protestant Hospital Association (July, 1982), pp. 35-36.

[6] Susan K. Wintz & George F. Handzo, “Pastoral Care Staffing and Productivity: More than Ratios,” Chaplaincy Today v. 21, no. 1 (Spring/Summer, 2005), pp. 3. Examples of Standards of Practice may be found in the “Reading Room” at http://www.professionalchaplains.org.