As professional chaplains we need to be in dialogue with each other about what we do, how we do it, and why we do it a certain way and how these practices benefit our patients. The ultimate goal of MyPractice is to build a consensus about what constitutes “good practice” and eventually establish “Standards of Practice” for chaplains. As with quality improvements in our institutions, this is an ongoing process in order to improve our practice.

To have a description of a practice that you use in your setting considered for inclusion here, write it up and send it to PlainViews for consideration. The Association of Professional Chaplain's Quality Commission’s Best Practice Committee will work with the Managing Editor of PlainViews to review submissions and select articles for publication. Your submission does not necessarily need to be cutting edge (although that’s okay, too). We want to identify “good practices” that could be recognized as standard practice.

PlainViews will highlight one article in the second issue of each month. Readers are invited to respond to the featured practice. Responses will be posted as they are received. This is a great opportunity to start a process that will move us forward in professional chaplaincy.

If you’d like to respond to MyPractice, please send a comment of no more than 400 words. You can use the e-form below (click on "hearing from you," link) or submit your commentary to the editor in the body of an e-mail (or as a Microsoft Word attachment) sent to Info@PlainViews.org. Please put the phrase “MyPractice” in your subject line.

We look forward to hearing from you.

A Clinical Advancement Program for Chaplains

After I had been at Cincinnati Children’s Hospital Medical Center (CCHMC) for a number of years, and my staff had begun to grow, someone on my staff raised the question about the possibility of advancement in the hospital system. What they were wondering about was the opportunity for promotion, for moving into leadership roles. They noticed, for example that, while senior nursing directors might be recruited from both within and without the walls of CCHMC, most of the assistant directors were recruited from the ranks of the staff nurses – persons who had shown leadership abilities and were being given an opportunity to take on formal leadership roles, and thus move up in management. Were there similar opportunities for staff chaplains? The answer, not surprisingly, was no. We were a small department, which had a director, and associate director (who was director of CPE) and then everyone else.

But this led me to think more about the issue. CCHMC was committed to fostering professional growth in all its disciplines, but what incentive (other than satisfaction for a job well done) was there apart from an annual performance review? Around this time I began to notice that such disparate clinical professionals as social workers and dieticians were instituting a clinical advancement program (informally known as a “clinical ladder”). I wondered if such a model could be implemented for chaplains. I consulted with a clinical advancement “guru” to check it out. She was very encouraging, and with the support of my boss, I set to work to develop a clinical advancement program for chaplains.

The guru and I, along with one of my staff chaplains, began by looking at the process developed by the social workers. There was much in their process and standards that was translatable; we did not need to reinvent the wheel. Then, we produced the following purpose statement for the program:

• To encourage all chaplains to strive for excellence through professional growth
• To promote recruitment and retention of experienced and skilled chaplains within the medical center.
• To increase the clinical competence and clinical leadership skills of the staff.
• To strengthen the clinical and programmatic leadership of the department.
• To recognize chaplains with superior clinical and leadership skills.

Two critical tasks emerged. One was to come up with three job descriptions – one for each level. Level I was the baseline – all new hires would enter as Level I. It essentially required Board Certification (APC, NACC, NAJC) and professional pastoral experience. Levels II & III added skills and competencies of such rigor that time and investment would be needed to develop them.

The other task was to define the process. This meant deciding what materials would be required and what the review process would entail. We borrowed most heavily from our colleagues. Materials include such things as a CV, documentation of clinical work, letters of reference from clinical peers, a justification statement, etc. Review for Level II would be a paper review by committee; for Level III it would include a face-to-face meeting with a committee. If the review found that the chaplain demonstrated competence at the next level, then the chaplain received a promotion and a 10% raise (which is standard in the hospital).

Two things were communicated at the outset. One was that no one was required to move “up the ladder.” We hire at a base-line level of competence and recognize that some chaplains are content simply to do their job and do it well. The other was that all conversations about advancement needed to start with the director and would have the goal of beginning a dialogue about the chaplain’s readiness to make this move. The chaplain would be discouraged from formally applying until there was agreement that s/he was ready and his/her materials were in good order.

All of this was put together in a manual which was presented to the staff in 2004. Since then, one chaplain has successfully completed the process and four others are preparing to complete it in the next few months. We believe that this process keeps faith with our staff by offering tangible rewards for professional development. It also places us among our professional peers in defining and rewarding professional excellence.

Send your comments about MyPractice to info@PlainViews.org.